Chapter 1008 Strange separation syndrome! Is encephalitis related to abdominal pain?

But everyone knows that this probability can be described as negligible.

The old experts who have been immersed in lung transplantation for many years are still powerless, let alone these doctors who are just starting out?

Medicine is a discipline that emphasizes experience and age. As long as you step into this field, no matter how stupid you are, after more than ten or even dozens of years of clinical experience, and if you have not been beaten to death by the patient's family, you basically have good clinical experience, enough to teach and educate people.

And the doctors in the famous knife competition may be able to achieve a great career in the future, but now they are too immature.

"Even Xu Qiulai may not be sure." The examiner shook his head and did not think Shi Lian had a feasible idea.

Compared to her, the examiner is more looking forward to the top hospitals such as Union Hospital, West China, and Qilu Hospital to come up with some solutions.

If we really talk about pioneers in the medical field, these medical halls are the real leaders, and advanced medical skills are often born from these people.

...

After announcing the details of the assessment, everyone in the venue fell into a brief shock, and the hall was silent for a while.

However, the silence was soon broken.

Since the content of the assessment cannot be changed, they can only do their best...

Those who can come here are all the best in their provinces, and their ability to adjust their mentality is naturally not bad.

Therefore, after only a few dozen seconds, everyone in the venue began to discuss.

Some people directly opened their laptops, searched for advanced solutions from other big names in the medical field, and tried to apply them to this patient.

The assessment does not require everyone to rely on existing knowledge. On the contrary, it is more about testing the adaptability of a doctor or a team of doctors.

In the real diagnosis and treatment process, doctors cannot fight alone.

When encountering difficult and complicated diseases, they often seek information.

Therefore, the last assessment of the famous knife competition actually restores the real clinical performance of each doctor to the greatest extent... When they really encounter a similar patient in the clinic, when they are already the highest-level doctors and there is no higher-level big name to ask for help, how should they deal with it?

...

"Should we jump out of the topic and consider single lung transplantation?" Not long after the discussion, a doctor raised a question.

For such terminal patients, the first factor to consider is always "staying alive".

The second is the quality of life.

Single lung transplantation has a short operation time, short cold ischemia time of the donor lung, low technical difficulty, and theoretically a higher success rate.

But another organ transplant doctor on the same team shook his head.

Contrary to common sense, double lung transplantation seems to be more dangerous than single lung transplantation, but the fact is just the opposite!

After years of research, the field of organ transplantation has made it clear that although double lung transplantation is more difficult to operate, it has incomparable advantages.

For example, in the case of obliterative bronchiolitis, the lung function reserve of both lungs is often stronger, so patients with double lung transplantation have a better chance of survival.

And in terms of postoperative management, patients with double lung transplantation are also more relaxed. For example, during the ventilator application stage, double lung transplant recipients do not have complications caused by excessive expansion of their own lungs, and can better survive the reperfusion injury period...

Therefore, now more than 80% of lung transplants, as long as there is a choice, basically do double lung transplantation.

For this patient, surgery is one of the difficulties, but postoperative management is even more fatal. Therefore, choosing a single lung transplant to reduce technical difficulty actually increases the risk.

Almost all teams are aware of this.

Therefore, double lung transplantation has actually been decided.

The following debates all revolve around the surgical procedure.

"It's a pity that it's not a segmental resection, otherwise thoracoscopy can be used..."

"Suddenly I feel that lung cancer removal is quite easy. Four-hole method, three-hole method, single operation hole method and single-hole method are available for you to choose, and now there is also video-assisted thoracoscopic surgery, which is simply too cool!"

"Is it possible to open the chest? But you can try to do a preoperative lung volume reduction first..."

Soon, someone mentioned a feasible idea.

Preoperative lung volume reduction is actually to remove extremely expanded and emphysema-infected useless lung tissue through surgery, so as to reduce the pressure on normal lung tissue and restore the elasticity of the lung and the volume of the chest cavity to a certain extent...

Using this method, lung function can be quickly improved, making a last gamble for transplant surgery.

"But this only increases the success rate of the operation from 1% to 1.5%."

As soon as this was said, the discussion stopped abruptly.

...

...

At this time, Linhai First Hospital.

After Hu Jingying was transferred to the Department of Neurology, more detailed examination data was sent to Xu Qiu's office.

He looked carefully and found that this patient who thought he was a mushroom, whether in medical history inquiry, physical examination or most auxiliary examinations, was consistent with anti-NMDAR encephalitis.

However, after doing a more accurate cranial MRI, plain scan and enhanced scan did not find too many abnormalities.

This made Xu Qiu a little surprised.

"If it is anti-NMDAR encephalitis, even if no infectious lesions are found, there should be gyrus swelling..." Xu Qiu judged.

The current situation is a bit strange.

The patient's performance is almost the same as anti-NMDAR encephalitis, and most of the examinations are consistent, but there is no suggestion in imaging.

This abnormality aroused Xu Qiu's vigilance.

He immediately got up and came to the ward where Hu Jingying was.

At this time, Hu Jingying's mental state was still not very good, and her eyes were a little dull, but because she had been given a tranquilizer, she did not show any manic behavior.

And it was sad that the nurse told her that since Hu Jingying was admitted to the hospital, she had not eaten a single bite of food.

If the nurse in the emergency department had not felt sorry for her, she might have been so hungry that she had hypoglycemia.

Xu Qiu nodded slightly without commenting.

It was not an exaggeration to say that Hu Jingying had come to this point and it was not an exaggeration to say that she had brought it upon herself... But Xu Qiu did not care about these things. To him, there was just a patient in front of him without any label.

"How do you feel?" Xu Qiu asked in accordance with the routine when he came to the bedside.

After a while, Hu Jingying came back to her senses. She turned her head to look at Xu Qiu, and a painful look appeared on her face.

After a long while, she said, "Doctor, can my child still be saved?"

Xu Qiu was silent for a while.

The nurse waiting next to her could not help but raise her eyebrows.

Now she is starting to care about her own child... What was she thinking about when she was happy earlier?

Xu Qiu did not mock, and said: "The progress of both children is not too late, and there is still a possibility of control... Let's talk about you, are you feeling uncomfortable?"

Hu Jingying's pupils flashed a trace of regret, and after adjusting her mood, she pulled the topic back to herself: "Uncomfortable, uncomfortable all over."

"Describe it in detail."

"I can't say it, just uncomfortable... My whole body is soft and uncomfortable everywhere, but it's not painful... But my stomach hurts." Hu Jingying said a lot intermittently.

Xu Qiu's attention was on the last point.

Abdominal pain?

Anti-NMDAR encephalitis can cause fever and headache, but there is no abdominal pain...Is this another disease? Or is it a clue to the real cause?

"Do an abdominal examination." Xu Qiu said immediately.