I can see the status bar

Chapter 658 Contradictions and Errors

Wang Ge was sent to the comprehensive diagnosis center, and Sun Lien finally returned to his familiar position.

As for the emergency department... Dr. Cao Yanhua decided not to intervene. He invited other doctors to replace Sun Lien.

"Long time no see." Dr. Brunn hugged Sun Lien, and then patted him on the shoulder with his thick hands, "Welcome back."

Dr. Pascal waited for the Texan to leave before he came over and shook Sun Lien's hand, "Come back when you come back, what are you doing with a gift?"

Sun Lien thought for a while before realizing that Dr. Pascal was talking about Wang Ge.

"His condition is more troublesome, so I think it's best for you to take a look." Sun Lien explained, "I think he has SLE."

"Then immunosuppression." Dr. Pascal spread his hands, "This should not be the trouble - you must be very clear about the plan to control SLE."

"He also has coronary heart disease, three-vessel disease." Sun Lien nodded, "Emergency monitoring showed that he had acute renal injury."

Dr. Pascal frowned, this is a bit difficult to deal with. "Blood fat is normal?"

"Yes." Sun Li'en gave an affirmative answer, "The three-vessel stenosis should be the result of SLE, and it is dangerous to put a stent on this level."

If people with SLE develop arteritis or other symptoms of immune bodies attacking the inner walls of blood vessels, their blood vessel walls will gradually begin to lose their elasticity.become hard and brittle.In this case, interventional stent placement is performed, and the metal guide wire responsible for the installation is likely to directly puncture the artery or even the aorta.In addition, the three-vessel disease itself means that the installation of the stent is of little significance, so Sun Lien said this.

"This is a little troublesome." Dr. Pascal felt helpless after pondering for a while, "This kind of patient cannot take hormones. If the hormones cause hyperlipidemia, then his narrowed coronary arteries are likely to be directly blocked."

"I'm also worried about this." Sun Li'en honestly stated the reason for his request for help, "My idea is to see if we can give him conservative treatment first."

It's not that Sun Li'en has changed too much before and after, but that the current situation is really not suitable for bypass surgery.

After Wang Ge was admitted to the hospital, he developed acute renal injury quickly.There are many possibilities for causing injury, whether it is lupus or renal hypoperfusion caused by coronary heart disease, or even renal hypoxic injury caused by the inability to infuse a large amount of fluid to promote excretion after using a contrast agent, all of which may cause this acute injury. damage.

Bypass surgery is the best way to treat three-vessel lesions, but if the patient has already suffered from kidney damage, the risk of further surgery is too high.

Now Wang Ge is like a glass doll, there are problems everywhere but he can't touch his whole body.

The situation is not optimistic.

"Problems that can't be solved by surgery can only be solved by internal medicine." Sun Lien issued his first instruction as the deputy team leader, "First find a suitable immunosuppressive plan and give him CRRT (continuous blood therapy) Dialysis), the amount of fluid replacement should be increased a little, so that he can metabolize the contrast medium as soon as possible.”

This will be a long and urgent process.Due to the existence of SLE, many commonly used methods cannot be applied to Wang Ge, and many organs that should not have problems will fall into failure one after another.In order to save Wang Ge, Sun Li'en and his team must control the current situation, and stop the falling domino queue called SLE before many organs in the body have problems.

The first thing that needs to be addressed is his acute kidney injury.

Zhou Ce rushed back from the inpatient department and began to participate in the treatment process.He has some different opinions on Sun Lien's judgment, "If it is acute renal failure caused by SLE, the speed should not be so fast. Personally, I am inclined to contrast nephropathy."

Dr. Pascal also gave his own suggestion, "This patient's condition is obviously severe active SLE. To be on the safe side, I suggest a round of hormone shock first, at least to suppress SLE - as long as CRRT and hormones start As long as his blood lipids are tested frequently and his lipid intake is controlled, the risk of coronary artery blockage should be minimized."

Sun Li'en nodded, then froze for a moment.

He didn't bother to continue talking with Dr. Pascal and Zhou Ce, and walked quickly from the office to Wang Ge's ward.

Not long after Wang Ge was transferred to the room, he was still only accompanied by his girlfriend here—his parents were rushing to Ningyuan on the high-speed train, but there were still four hours before they arrived.

Sun Li'en broke into the ward without saying a word, and then did not respond to Wang Ge's inquiry at all.Sun Li'en glanced at the top of Wang Ge's head, then picked up the inspection sheet on his hospital bed and looked at it.

"Doctor..." Wang Ge's girlfriend asked worriedly, "He...does he have any problems?"

"The problem is big now." Sun Lien replied with a frown while reading the test report, "The biggest problem is that I think there is something wrong with his question."

This is very awkward to say, but Sun Lien really can't explain it directly to the patient's family. How can this be said? "Your boyfriend's systemic lupus erythematosus activity is different from what I saw from the plug-in"?
The degree of activity of systemic lupus erythematosus is estimated with a clear score-different symptoms have different scores.Scores were scored according to the symptoms exhibited by the patients, 0-4 points belonged to the resting period, 5-9 points belonged to light activity, 10-14 points belonged to moderate activity, and more than 15 points belonged to severe activity.

The status bar clearly states that Wang Ge's SLE is a static period.In other words, the sum of the symptom scores he exhibited should be below 4 points.

But vasculitis has 8 points in the SLE score. If it is a mental symptom, then it is 8 points plus the proteinuria indicated in the status column is 4 points. If these three symptoms are all caused by SLE, then Wang Ge's SLE activity score is as high as 20 points.In any case, it is impossible to be regarded as a "quiescent period".

That's why Dr. Pascale believes that Wang Ge's SLE is in a severe active period.And it was this contradiction that made Sun Lien rediscover the contradiction in the status bar prompt.SLE patients with proteinuria and vasculitis cannot be in the quiescent period, and Wang Ge did have vasculitis and proteinuria-urinalysis confirmed the proteinuria part, and vasculitis was the third symptom of his normal blood lipids. The only explanation for branch disease.

This is not right, this is very wrong.Sun Lien can be sure that since he got the ability of the status bar, the status bar has never made a mistake.Since the "quiescent period" is indicated, then Wang Ge's SLE must be a quiet period.

Sun Lien put down the inspection report in his hand.If there's nothing wrong with the status bar, then... what exactly went wrong?
　No one saw the foreshadowing of Wang Ge's case... You still need to study harder
　　
　
(End of this chapter)