medical road high rise

Chapter 82 Patients with Hypertension ([-])
Chapter 82 Patients with Hypertension ([-])
After Qin Feng greeted Dr. Zhong, he left directly and rushed towards the emergency department.

Entering the ward, when she saw Qin Feng coming in, the nurse quickly shouted inside: "The doctor from the vascular department is here."

The nurses are still very familiar with Qin Feng.

Although Qin Feng has only been here a few times, every time he was ordered to turn the tide in times of crisis.

In the emergency department, Qin Feng's reputation in the vascular department is definitely higher than that of any doctor in the vascular department, including Director Jin and Director Dong.

"Where is the patient?" Qin Feng asked.

"follow me."

The nurse took Qin Feng to the patient's bed. On the patient's blood pressure monitor, the blood pressure temporarily dropped to about 180-190mmhg.

"Have you given medicine to the patient? How many medicines?" Qin Feng looked at the doctor on the bed and asked.

"Nifedipine, verapamil, hydrochlorothiazide, reserpine." The emergency doctor looked back and found that it was Qin Feng. He pushed his glasses and said with a serious expression, "I have used all four types of antihypertensive drugs, but the antihypertensive drugs The pressure effect is not obvious and can only be maintained at around 190.”

"What about the patient's medical history? Is there any family inheritance?" Qin Feng glanced at the mercury sphygmomanometer, and subconsciously felt that such a high blood pressure was definitely related to the patient's medical history.

Some diseases are also divided into congenital and acquired. Hypertension has the possibility of congenital inheritance and is among the genetic diseases with a relatively high recurrence rate.

"There is a family genetic history. The women in the patient's family, including the mother and sister, all have high blood pressure. The mother died of cerebral hemorrhage due to high blood pressure. The patient's brother does not have high blood pressure, but the patient's brother's 28-year-old daughter has high blood pressure." Emergency Department said the doctor.

"Show me the heart rate."

Qin Feng took the electrocardiogram handed over by the emergency doctor and saw the detailed analysis above.

"Consider that the patient may have renal artery stenosis." Qin Feng combined with the suggestions given by other hospitals, the patient may have this condition, or secondary hypertension.

Because Qin Feng remembered that he had read an article about vasoconstriction during this period of time. When the vasoconstriction is severe, it may cause blood pressure to reach between 280-300, and may even break through the 300 mark.

The face of the emergency doctor changed. He had been considering secondary hypertension, but ignored the renovascular hypertension caused by renal artery stenosis.

Because this condition is atypical hypertension, it is inextricably related to the kidneys.

"Test the patient's serum electrolyte level and blood urea nitrogen level," Qin Feng said.

The emergency doctor quickly ordered the nurse to conduct auxiliary examinations, and the examination results came out quickly.

Qin Feng can basically confirm that the patient is suffering from renal vascular hypertension, which definitely requires immediate surgery. Hypertension is not a joke, and he may bleed to death at any time.

"Doctor Qin, do you know how to perform percutaneous transluminal angioplasty?" the emergency doctor asked.

What the emergency department was worried about before was that the patient's condition could not be diagnosed. After the condition is diagnosed, there are all treatment methods.

For example, renovascular hypertension is caused by blood vessel stenosis, and the solution is to dilate the blood vessels. The procedure is also called percutaneous transluminal angioplasty.

Qin Feng thought for a while and replied: "It should be okay."

This surgery is mainly related to angiography technology. As long as the stenosis of the renal blood vessels can be accurately found, this surgery can be completed through the catheter.

"Okay, I'll contact the general surgery department to perform nephrectomy." The emergency doctor was about to tell the nurse to go out and make a call.

Qin Feng stopped the emergency doctor directly, and said slowly: "I can do this operation. I am from general surgery. I can also do nephrectomy."

The emergency doctor took a look at Qin Feng and fell into a dilemma for a while.

This is the first time he has encountered such a situation. Generally speaking, other doctors do operations and consultations in as many departments as possible, so that the division of labor can be more detailed.

But like Qin Feng, there are still very few people who directly take over everything.

The emergency doctor remembered the advice of the director of his department, as long as it was Qin Feng's needs, he would agree to it, and Qin Feng would have no problem doing it.

The emergency doctor will contact the hybrid operating room, and the nurse will prepare heparin in advance according to the patient's condition, which is to avoid massive bleeding.

Qin Feng stood on the operating table, and Lu Shan stood quietly adjusting the dosage of the medicine.

"How long?" Lu Shan asked buzzingly wearing a mask.

"Two hours." Qin Feng gave an approximate time.

Lu Shan's anesthesia technique is the most suitable for patients, but it is not suitable for doctors. Patients who wake up after surgery only exist in a state of semi-anesthesia. Under general anesthesia, there are many people who take several hours to wake up after taking off the stage.

For doctors, there are all kinds of situations encountered during the operation. Except for the kind of doctors who are particularly confident, most doctors are not very sure about the timing of the operation.

This is also why, although Lu Shan's anesthesia skills are so good, the director of the anesthesiology department still dare not let Lu Shan take the stage casually, which puts too much psychological pressure on the doctor.

During Qin Feng's operation, Director Jin hurried to the emergency department with Zhao Qi. He came here just after receiving a call from Dr. Zhong.

But when he came to the ward, Director Jin was dumbfounded. There were no patients at all, so he asked the nurses at the nurse station.

"You said the patient in bed 04, he has already been arranged into the operating room." The nurse replied.

"Already gone to the operating room? Who is doing the surgery? Director Jia?" Director Jin asked.

"No, it's Doctor Qin."

"Doctor Qin?" Director Jin showed a puzzled expression on his face, and suddenly a figure flashed in his mind, asking urgently, "Is it Qin Feng from our department?"

The nurse nodded suspiciously. The doctor in her own department came to perform the operation. As the director, she should know about it. Why does Director Jin of the Department of Vascular Surgery have such an expression like eating a fly?

Director Jin clenched his fists and asked about the patient's condition. He took a breath when he learned that the patient had renal vascular hypertension.

This operation does require their vascular department to come and perform the operation, but the difficulty of the operation is extremely high.

In addition to percutaneous transluminal angioplasty, there is also vascular reconstruction. The patients are ordinary hypertensive patients, Director Jin is still confident.

However, after seeing the patient's medical records, Director Jin found that the blood pressure was as high as 280mmhg, and it was still on the rise. After taking antihypertensive drugs, the blood pressure has been maintained at around 190mmhg, which is obviously a case of secondary blood pressure.

The combination of secondary blood pressure and renovascular hypertension is not as simple as one plus one.

In medicine, these two situations are like installing two time bombs. If one detonates, the other will be detonated.

(End of this chapter)