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Chapter 751 Treatment Details
Discussions were not very positive.After all, for Tang Min's illness, the entire diagnostic team has held many consultation meetings.What should be said and what can be said has basically been said at previous meetings.What needs to be discussed by doctors now is mainly the details and plans in the treatment process.

Injecting hypertonic glucose into a child, and it seems likely that multiple continuous injections will be required at present, there are many things that need to be paid attention to.Ma Yongfang, deputy director of the department of endocrinology, is in charge of dealing with this part of the problem - hypertonic glucose may cause many adverse reactions.Simply using hypertonic glucose without other treatment can easily lead to hyperglycemia and even further hyperketosis.However, if insulin is used in combination with adult doses, reactive hypoglycemia may occur.

The simple use of hypertonic glucose as a dehydrating agent may also cause Tang Min to experience electrolyte disturbance.This part of the response is also Ma Yongfang's job.

Zhou Ce is responsible for controlling the use and dosage of arginine vasopressin.The nephrology department has at least more experience in using arginine vasopressin than the emergency department. At the same time, Zhou Ce needs to work with the doctors in the anesthesiology department to monitor Tang Min's blood pressure and other physiological conditions—arginine vasopressin and The meaning on the table is the same, it has the effect of increasing blood pressure, and maintaining blood pressure during the operation requires the anesthesiologist and Zhou Ce to discuss strategies together.

Sun Lien was assigned a key position to communicate with the Imaging Department by everyone.The imaging department needs to dispatch imaging doctors to monitor Tang Min's intracranial edema in real time in the operating room.And every time the MRI equipment in the hybrid operating room is turned on, it is necessary to transfer Tang Min on the hospital bed to the MRI equipment, and it is also necessary to ensure that there is no metal on and in her body, especially magnetic metal.

This also means that every time MRI monitoring is performed, Tang Min needs to leave the state of treatment.During the treatment, this kind of operation needs to be repeated many times, and any operation is very critical and cannot be missed - as long as there is a single mistake, the metal dragged by the violent magnetic force may leave a fatal line in Tang Min's body. wound.

Sun Lien needs to decide with the doctors in the imaging department when to start MRI for detection. At the same time, Sun Lien also needs to decide when to complete the treatment of Tang Min based on the opinions of the imaging doctors, and start to switch to the treatment that inhibits AQP4 protein and prevents rebound. treatment phase.

The person in charge of AQP4 protein inhibition is Dr. Brun and Yuan Pingan.Two high-level experts from the emergency department were in charge of "feeding medicine" to Tang Min—this was no fuss, because what kind of work did two doctors do to coax children.In order to ensure Tang Min's full cooperation and sedation during the treatment process, Tang Min needs to be given general anesthesia and sedation during the entire medical treatment and medication process.At that time, Dr. Brunn and Yuan Ping'an need to perfuse Tang Min's feeding tube under the condition that the anesthesia tube is withdrawn.

During anesthesia, due to the widespread use of muscle relaxants, the smooth muscles belonging to the digestive system will also be in a state of inhibited activity.In this situation, oral trifluoperazine presents difficulties in use.Even if the risk of anesthesia is ignored and Tang Min is given the medicine before anesthesia, it will still take several hours for the digestive system to start working again after the metabolism of the muscle relaxant drug is completed.And during this period of time, the phosphorylation of AQP4 protein has been maintained, and the risk of rebound is too great-in order to keep AQP4 protein to discharge water in the correct direction, hypertonic glucose needs to be injected all the time, which is too dangerous.

The use of feeding tube perfusion is also risky, but it has a relatively big advantage-the feeding tube can pass directly through the stomach and enter the duodenum, and the duodenum and the intestinal tract behind it happen to be the main area for drug absorption.The feeding tube can avoid waiting for the stomach to work again before administering the drug, and at the same time avoid the uncontrollable absorption and the risk of anesthesia caused by taking the drug in advance.

However, withdrawing the anesthesia and then injecting the feeding tube means that Tang Min may gradually develop intolerance to the feeding tube.The gag reflex will make her try to spit out the feeding tube.This also requires Dr. Brunn and Yuan Ping'an to release the tube and administer the drug quickly.After quickly completing the entire drug delivery process, the pipeline is withdrawn.

After the pipeline was withdrawn, Sun Lien and the doctors in the imaging department needed to conduct MRI examinations several times to confirm that Tang Min's brain edema area no longer rebounded.And check one or two hours after the peak of the drug to finally verify the effect of the treatment.

It can be said that this is a high-precision "surgery" that does not require a surgeon.No matter in terms of the use of equipment or the monitoring of the effects of drugs by doctors, the difficulty of this treatment can be compared to a level [-] surgery.Lack of data support, no previous experience, different body reactions, and only seven years old... These difficulties are placed on other treatments, and it is likely that doctors will give up this plan directly and seek other ways of treatment.But Tang Min has no other way to go - she only has this glimmer of hope.

The job of Sun Li'en and others has become to bite the bullet and continue on this road, and then do everything possible to make the possibility of success a little bit higher.

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"Okay, then you guys are ready to come over." Liu Tangchun was in his office, bowing his head like a defeated rooster.On the other end of the phone, Professor Zhu Minhua smiled impudently, while the defeated general Liu Tangchun didn't even have the mood to roll his eyes.

The second test of Tang Min's sample was carried out by Professor Zhu Minhua, and he also knew that Yuan Ping'an was nervous and called to have another test in order to clarify Tang Min's diagnosis.Zhu Minhua, who was staring at the side the whole time, even knew the final test results earlier than Yuan Pingan and Sun Lien.After years of working and studying in Tongxie, Zhu Minhua immediately realized what kind of treasure this is - this is a rare autogene sequence genetic disease first discovered by Chinese doctors!
Of course Professor Zhu was thinking about it, but he also knew that the patient was in the fourth hospital and the diagnosis was made by Sun Li'en.It is neither realistic nor ethical for the association to take this case into its hands to obtain academic achievements.But such a big discovery was made by relying on the ability of the co-workers... It would be a strange thing if Professor Zhu didn't think about it.

Fortunately, Professor Zhu maintains very smooth and convenient communication channels with Sun Lien and Yuan Pingan.Even more coincidentally, Sun Li'en did have the idea of ​​bringing in experts from other courts to complete the project together.And Liu Tangchun, who was protecting the food, was suppressed by Dean Song's messy roll.

Under the joint influence of these three key elements, Professor Zhu successfully obtained permission to lead a team to Ningyuan, organize consultations and participate in treatment.At the same time, Liu Tangchun's unwilling "consent" was also obtained.

"That's what you said!" On the phone, Professor Zhu Minhua was like an old farmer who has been in drought for a long time, and his smile was extremely flamboyant, which even made people a little worried.

Liu Tangchun waved his hands impatiently, as if he could stretch out his hand along the phone line, and slapped Zhu Minhua's bald head twice, "Hurry up and get ready to go, the patient is still waiting here." What about treatment?"

"Has Xiao Sun's treatment plan come out?" When it comes to business, Professor Zhu is much more serious, "You can let them send the plan first, it is easier for me to find someone to help when I am in the association—— After I pass by, I have to send messages back and forth, which is somewhat troublesome."

"Why don't you bring doctors from the departments of endocrinology, neurology, and pathology along with you. You, Professor Zhu, came all the way from the capital to our rural place like Ningyuan, why don't you bring a few more experts with you?" Liu Tangchun retorted, "At least two deputy high officers should be brought to help carry the luggage!"

Professor Zhu Minhua sneered twice, "Why should I bring someone there? Take it there for you to dig for fun? Let me tell you, Liu Tangchun, don't do this! I'll just go there alone, and you will carry my luggage!" , Zhu Minhua hung up the phone.There was only Liu Tangchun who was staring and ready to curse, but was unable to curse because the phone hung up.

(End of this chapter)