I can see the status bar

Chapter 489 Admission (Second Change)

The patient's name is Qian Aiwu, aged 65 years, 155 cm tall, and weighs 68 kg.He was admitted to the hospital due to irregular lower body bleeding within two years.After CT and pathological examination, it was determined to be grade III poorly differentiated squamous cell carcinoma, and it had already involved the lower third of the vagina.

There are three stages, and after the classification has been confirmed, the next surgical treatment has become a natural treatment process.Because the stage belongs to the middle and late stage, the scope of operation is also relatively large.In addition to the hysterectomy, the doctors also removed Qian Aiwu's ovaries and accessories on both sides, and cleaned the lymph nodes in her abdominal cavity.

The operation went smoothly, and no signs of lymphatic or peritoneal metastasis were found during the abdominal operation.After the two-hour operation, the chief surgeon Feng Chujie finished the treatment, and the first assistant doctor closed the abdomen.

"There is no problem during the process, and there is no problem with the postoperative check-at least we definitely did not leave a piece of gauze in the patient's body." Feng Chujie said to Sun Lien, "According to our inquiry, the patient had a history of high blood pressure before. The drug is felodipine tablets."

Pushing open the door of the ward, Sun Lien saw Qian Aiwu lying on the bed.

"Qian Aiwu, female, 65 years old, after hysterectomy (07.34.42), bowel edema (05.11.24), thoracoabdominal subcutaneous tissue and fascial edema (05.09.10), pelvic cavity and abdominal pelvic subcutaneous tissue Scattered gas accumulation (03.22.26)."

This time the status bar seems to have become a radiologist, and the status prompts are all diagnostic content in radiology.

"Have you had a CT?" Seeing so many obvious changes in imaging symptoms, Sun Lien's first reaction was to ask the patient about the results of imaging examinations.At least judging from the information on the status bar, this may be an infection involving the chest, abdomen and pelvic cavity at the same time - just judging from the extent of the infection, it is a serious case.

What's worse, the patient had just undergone a rather traumatic organ removal operation, and the operation also involved lymphatic tissue. The so-called radical lymphadenectomy is actually a medical term for en bloc lymphadenectomy.In Qian Aiwu's abdominal cavity, in order to prevent the lymphatic metastasis of cancer cells, a large number of lymph nodes, which are an important part of the immune system, were removed.

If Qian Aiwu's chest, abdomen and pelvic cavity were infected at the same time, the abdominal cavity and pelvic cavity that had just undergone surgery must be the hardest hit areas.

"It was done before the operation, but not yet after the operation." Feng Chujie frowned and replied, "She is not in a very good condition now, we want to avoid moving as much as possible."

Resting in bed after major surgery is a must.This is not only to allow patients to recover as soon as possible, but also to avoid wound rupture caused by exercise.Generally speaking, if it is not particularly necessary, doctors will not move a patient who has just undergone an organ removal operation out of bed and send it to the CT room for another examination.

"Send it for a CT later." Sun Lien put forward his own opinion, "I'll ask the patient first."

Qian Aiwu had already woken up. She was lying on the bed, pale and in pain.

"Doctor, I'm in pain..." She vaguely saw a few white shadows flashing in front of her.Under the severe pain, she could barely speak, "Help me..."

Sun Li'en put on the gloves and quickly palpated Qian Aiwu's abdomen.And let Xu Yourong listen to her lung sounds.

"The abdomen is distended, without tenderness, abdominal muscles are tense, and the lower limbs are not swollen." After the examination, Sun Lien and Xu Yourong quickly exchanged the examination results, "Dry and wet rales were not heard in both lungs, and the patient was conscious, agitated, short of breath Prompt. Heart rate 126, no pathological murmur."

"The initial examination is like this first, take blood and send it for testing for culture, and quickly send the person to the imaging department for a CT scan..." At this point, Sun Lien thought for a while and added, "Do a liver function to check for myocardial damage Markers. Biochemistry and PCT should be done again." He looked at Feng Chujie who looked a little tired again, "The patient's examination before admission was normal? Are the liver and kidney functions good?"

"Yes." Feng Chujie answered very neatly. She glanced at the urine bag hanging beside the patient's bed, "The amount of urine is also normal now."

"Check the CT first." Sun Li'en nodded. If Qian Aiwu had a three-cavity infection of the chest, abdomen, and pelvis as indicated on the status bar, then he should be more careful—such a large-scale infection may cause serious damage. There are many organ failures. "Give her imipenem and cilastatin sodium."

Imipenem cilastatin sodium is a broad-spectrum antibiotic, and it is a "super broad-spectrum antibiotic" with a clinical effective rate as high as 93%.The clinical use of imipenem cilastatin sodium is generally to combat very serious bacterial infections that have not yet completed culture and sensitivity tests.

It is also a "restricted use" antibiotic.Doctors generally do not prescribe this drug for anti-infective treatment when other options are available.If a doctor uses drugs such as imipenem cilastatin sodium too many times, he will even be criticized by the pharmacy and medical departments and even deduct money.The risk of bacterial infection faced by human beings has always been at a relatively high level, but our ammunition against bacterial infection has not been updated for a long time.In order to allow existing antibiotics to be effective for a longer period of time and not lose their effect due to drug resistance, doctors must use antibiotics cautiously.

"Okay." Feng Chujie agreed to Sun Lien's request without hesitation, "Then what about this patient? Transfer it to you?"

Qian Aiwu is now an inpatient in the gynecology department. If she is to be treated according to Sun Lien's doctor's orders, then she should be transferred out of the gynecology department and transferred to Sun Lien's department for treatment.

But Sun Lien is in the emergency department - there is no reason to transfer gynecological patients to the emergency department of his own hospital for treatment.

As soon as these words came out, Sun Li'en also fell into trouble.He thought for a while, and decided to leave the most troublesome problem to the leader, "First give the medicine to people, and I'll ask Dean Liu for other questions—he was the one who handed over this case to me. .”

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"Brother Luo, are you alright?" In the operating room of the CT room, Sun Lien looked at the disheveled Luo Sanguan, and asked cautiously, "Why do I see your face turn green?"

Luo Ge rolled his eyes with difficulty, "It's not the director who made it." He rubbed his head and moaned, "I thought my head was broken when I woke up this morning."

"It's okay, I've seen it. You just let the door pinch your head." Sun Lien smiled, "You can just tell me if you can't drink. If you can't drink with others, you will be a ghost if you are not drunk. And , whose family name is Wei."

"Whatever his surname is, if I drink with him again, I'll be an eggplant!" Luo Ge said indignantly, and then covered his head again, apologizing, "Xiao Sun, brother, I think it will be difficult for me to watch movies today. Don't worry, I'll find someone else to review the film later."

Sun Lien looked at the image displayed on the computer screen, pondered for a moment, and then took a picture of the screen with his mobile phone, "Then you call someone first, I just happened to ask Dean Liu how to accept this patient."

(End of this chapter)