Chapter 483 Brother, you are a real man!

Director Xiao: "For those who work in the clinic, you should always remember one sentence: indicators are just indicators. They can assist in diagnosis, but they must not be used as the only basis.

Although there are no typical signs of acute pancreatitis on the patient's film, the clinical manifestations are completely consistent, and there is indeed slight exudation and edema.

The disease is progressive, and it is impossible to say that serum amylase and lipase will increase immediately.

The book will teach you that when pancreatitis occurs, these two enzymes will increase.

But in the clinic, you must consider that the patient is a living person and the disease is also in the process of development. Generally speaking, it takes two or three hours for the patient to detect an increase in amylase from the onset of acute pancreatitis, and it takes only more than an hour for the patient to get sick, see a doctor, and have an examination. Naturally, there is no change in the amylase indicator.

As for lipase, it is even slower, and there will be signs of increase one day after the onset of the disease.

If you are really interested in these indicators, take a blood test again now, and you will know everything clearly."

The chief doctor of the gastroenterology department nodded quickly.

The difference between an excellent doctor and a mediocre doctor lies in every little detail. The former deeply analyzes the mechanism and mechanism behind each disease, while the mediocre ones are more like cramming diagnosis, limiting the disease to a set of rules and regulations.

For example, elevated amylase and lipase are pancreatitis, and vice versa.

This is the standard answer in the exam, but the reality is too complicated. Elevated levels may also be cholecystitis, intestinal obstruction, gastric ulcer, etc., and decreased levels may also have caused acute pancreatitis, but it has not yet reached the time window for detection.

"Doctor Xu, do you have anything else to add?" Director Xiao asked happily.

He said everything he could say, and let's see how Xu Qiu teaches them!

"I gave a doctor's order before, fasting." Xu Qiu said.

Director Xiao said casually: "This is not very normal. The pancreas is a digestive organ. If you still eat at this juncture, the pancreas will continue to secrete digestive enzymes, etc., and the inflammation will progress rapidly."

Xu Qiu threw out a new test report, which showed a blood oxygen saturation of 94.

Director Xiao's confident smile suddenly froze, and the other gastroenterologists present were also stunned.

Ninety-four? !

The blood oxygen level was checked urgently before the shift was handed over, and it was still ninety-nine. How could it drop so quickly in just one hour!

How could the patient suddenly become hypoxic?

"What's going on!" Director Xiao's pupils trembled, and he suddenly realized that he had thought too simply about this patient and overlooked a lot of things.

He quickly called up the patient's film.

"This symptom is very similar to the onset of acute severe pancreatitis, and ARDS may occur, but... the patient's lungs have no exudation!"

ARDS, also known as acute respiratory distress syndrome, is an acute, diffuse inflammatory lung injury that occurs rapidly in a short period of time. It usually occurs after various pathogenic factors such as severe infection, trauma, shock, etc., among which acute severe pancreatitis is one of the main causes...

The mortality rate of acute severe pancreatitis is very high, reaching about half.

ARDS itself also has a high mortality rate, about 20% to 40%.

If ARDS is complicated by acute severe pancreatitis, it is like a sworn brotherhood with the three sworn brothers in Taoyuan, and no one can pull them back.

"It's going to kill me." Director Xiao felt a shudder.

I can't find it. Sudden hypoxia after pancreatitis can't cause ARDS, but the patient's lungs have no exudation at all!

There is not even slight exudation or edema in the pancreas, but it is completely normal, without any suspicious ground glass or infiltration.

In other words, the lungs of this female patient are even a little too healthy. Most people can find a few lung nodules, but her lungs are beautiful, and the lung performance of healthy people in the textbook is not a problem.

"Director, is there a possibility that the patient's lungs are actually fine?" The attending physician who had come to support him before made a bold guess.

Director Xiao waved his hand in disdain: "Pancreatitis + hypoxia, most likely combined with ARDS, if you don't understand, don't..."

Xu Qiu felt that if he didn't say anything, Director Xiao would lose face, so he interrupted him and said: "The patient's lungs are indeed not infected, the problem should be somewhere else."

Director Xiao's body trembled, he turned his head and patted the shoulder of the attending physician, "Not bad, it seems that the strict requirements on you have achieved certain results."

"Doctor Xu, the mask oxygen has been turned on, but the patient's blood oxygen is still falling."

Just then, Yunmei, who came from the ward, hurriedly reported.

"Still falling?"

Xu Qiu frowned and asked again: "What about other conditions, has the abdominal pain improved?"

"No, anti-inflammatory treatment was done, and analgesics were used, but the patient's abdominal pain is still very severe, and the breathing is getting worse. If this continues, I'm afraid he will be sent to the ICU!"

Everyone's face immediately became serious.

It was just abdominal pain last night, but the blood oxygen dropped rapidly today. The disease progresses so fast that ECMO may be called in a few hours.

That thing is simply a money-burning machine. The startup cost is 100,000 yuan, and the daily operating materials cost more than 10,000 yuan, and the medical insurance cannot reimburse it.

Xu Qiu also realized the seriousness of the situation and stood up and said, "Let's go to the ward."

Director Xiao and others hurriedly followed.

…

Less than a day later, when I saw the patient again, she was already somewhat unconscious, and was just mumbling in pain.

The man beside the bed looked haggard. When he saw Xu Qiu coming, a brief joy appeared on his face, and he immediately stood up, "Doctor Xu, please, save Yuan Yu!"

Yuan Yu?

Xu Qiu noticed the change in address. The other party suddenly called her by her real name, because the patient confessed to him yesterday?

"Can you still sign for her?" Xu Qiu's question was very tactful.

But the man still heard the meaning of the words, and his face was crying and laughing, saying: "Although we call each other boyfriend and girlfriend, we actually got married at the beginning of the year, otherwise how could we prepare for pregnancy... She also told me all those things."

"Yeah."

"I won't forgive her, but I can't easily let go of the relationship of more than ten years. I have been loving her throughout my youth, and all my imaginations of the opposite sex are directed at her. I can't let go.

So this time, just regard it as my farewell to my youth and this relationship. From the bottom of my heart, I hope to say goodbye to her while she is alive."

The man's eyes quickly turned red, and his voice trembled.

Being betrayed by the one you love is one thing, but it is a direct blow to a man's dignity that the one you love not only betrays you, but also gets pregnant with another man's child while you were apart for a few years. Yet she still calls him "husband" affectionately on the phone.