medical road high rise

Chapter 445 Valve Infection
Chapter 447 Valve Infection
There was an incident two years ago. An AIDS woman went to a premarital examination with her boyfriend and was tested positive for AIDS.

However, the results of the premarital examination were not told to the man, only the woman knew.

After a whole year, when the company arranged a group medical examination, the man found out that he had AIDS, and then he knew that his wife had already had AIDS, so he sued both the premarital examination hospital and his wife in court.

This incident directly caused policy changes above, which shows the horror of AIDS.

This incident also caused a commotion in the emergency department. All medical staff became serious and took precautions that they might not normally do.

At noon that day, Ruijin Hospital urgently issued a notice, requiring all departments of the hospital to conduct self-examination, and must strictly follow the regulations for occupational protection.

90.00% of medical staff are disgusted with this kind of concealment.

As for those nurses, they were also given a holiday by the hospital. They went home to calm down and went to the psychology department every day to find a psychiatrist for counseling.

The hospital was also afraid that the little girl would be overwhelmed, after all, the waiting time for the test results was quite torturous.

The patient with blackthorn disease was also completely diagnosed, so Qin Feng directly referred the patient to the dermatology department. In this regard, the dermatology department is still more professional.

A week later, the nurse's test result was negative, not positive, which was a happy result. As for the woman, the hospital directly took her to court. The hospital won the case and the woman paid a nutrition fee to the nurse.

These were all brought by Qin Feng, which straightened up the waist of Ruijin Hospital and made it more protective.

At noon, Wang Jun came to look for Qin Feng.

"Xiao Qin, I have a patient here, are you free later? Come and help me take a look."

"Okay."

Qin Feng followed Wang Jun to the emergency ward. On the way, Wang Jun told Qin Feng about the patient's condition.

Patient, 62 years old, female.

Unexplained fever repeatedly for several weeks, and at the same time he complained of bone headaches all over his body. He was admitted to the hospital two days ago. Originally, Wang Jing suspected that it was a disease of blood, rheumatism and immunity.

Generally, recurrent fever and multiple joint pains should be alert to blood and rheumatism diseases.

After undergoing a series of targeted examinations, the patient's examination results did not support blood diseases, and diseases such as leukemia, lymphoma, and myeloma were ruled out.

"This morning, Director Zhao made a ward round and found that the patient had a new problem."

"What's the problem?" Qin Feng was also thinking.

"The patient's heart auscultated murmurs, and the mitral valve heard systolic murmurs, and at the same time..." Wang Jun said one by one.

Qin Feng nodded, and then looked at the patient on the hospital bed as well as her husband and son.

When the husband and son saw the doctor come in, they stood up quickly.

Wang Jun briefly introduced Qin Feng to the two of them. After Qin Feng nodded, he looked at the patient wearing an oxygen mask on the hospital bed.

Qin Feng took a stethoscope and listened to the patient's heart and lungs. There was an obvious heart murmur. Based on past experience, Qin Feng felt that the patient's mitral valve and even the tricuspid valve had problems.

Listen to the lungs again, there are moist rales, it is not clear whether it is pneumonia or heart blood.

"Director Wang, arrange for a Caichao to come over."

Wang Jun asked the students behind him to push the color ultrasound machine. After waiting for 5 minutes, the color ultrasound machine came over. Qin Feng turned it on and pointed the probe at the heart of the patient's chest.

Soon, through B-ultrasound, Qin Feng found that the patient's mitral valve had moderate regurgitation, other valves also had obvious lesions, and there were vegetations on the valves.

A normal heart valve should be clean and there should not be any vegetation. If there is vegetation, it means that the valve is rotten or infected. The vegetation is likely to be a bacterial mass.

Once the human body is infected, it will naturally have repeated fever.

At the same time, the patient's blood pressure is somewhat low, which is also related to the valve. The valve is like the door and window of the heart. If the door and window are broken, the heart will naturally not be able to pump blood normally, and the blood pressure will be low.

When blood pressure is low, the heart will automatically increase its efficiency, and it will exert excessive force, resulting in heart failure.

This is why older people are more prone to heart failure.

The patient's dyspnea is also due to a problem with the heart function. There is no good way to pump blood, resulting in blood accumulation in the pulmonary circulation, and the excess blood will partly enter the alveoli, causing pulmonary edema. The existence of pulmonary edema will seriously affect the The patient's oxygen uptake capacity, so the patient will experience hypoxia, shortness of breath, and wheezing.

The diagnosis given by Qin Feng is also very clear, that is, infective endocarditis.

She is not a blood disease, she is a heart disease, the reason for repeated fever is because of heart valve infection, as for the pain in the bones all over the body, it is the body's immune response caused by the infection, resulting in inflammation of more joints, so the patient will have bones all over the body manifestation of pain.

This led to Wang Jun's misjudgment, thinking that the patient had a disease of blood and rheumatism.

However, although the diagnosis came out, the patient's condition is still not very good, with low blood oxygen, low blood pressure, heart failure, pulmonary edema, and valve infection.

Any one of these can be tricky, let alone integrating them all together.

"The patient must undergo surgery, and the indications for surgery are obvious." Qin Feng said.

"But the operation is a bit difficult now. The patient is not fasting, which is risky. Moreover, the patient's heart function performance, even if carried to the operating table, the anesthetist may not dare to anesthetize it." Wang Jun worried.

This is not to doubt Qin Feng's technology, but to discuss the facts.

"Call the family members here first." Qin Feng said while standing outside the ward.

Wang Jun went to contact the technicians, and then found people from the medical office. The three parties formed a pre-operative talking group and fully communicated with the family members.

If the family members do not agree, the patient can only wait to die. If the operation is performed, there is still a chance of life.

"Do you have to have an operation?" the patient's husband asked with some concern.

"Yes, surgery is necessary. Without surgery, the patient may not survive for a few days. The patient's current condition..." Qin Feng explained.

When negotiating with family members, you must make things clear, otherwise those family members will think you are lying to him.

After half an hour of pulling and pulling, the patient's family finally agreed to sign the consent form for the operation, and Qin Feng temporarily suspended the consultation work.

Then find a large surgery room, squeeze out an operating room, so that Qin Feng can operate smoothly.

The location of the operating room in the hospital is the same as grabbing a parking space outside. If you don't prepare in advance, you may be able to wait until a week later.

At eleven o'clock in the evening, after the patient fasted for 12 hours, Qin Feng went to the operating table.

Fasting of food and water is too important for surgery, otherwise, it is easy to go wrong.

Looking for an ecmo machine borrowed from Xinwai, Qin Feng began to perform chest surgery and cardioplegia...

(End of this chapter)