sinovels Chapter 131 Acute Liver Failure
Chapter 131 Acute Liver Failure
In the rescue room, Zhang Ming and Deputy Director Fang rescued the patient at the same time.
"In the summer, immediately do a blood routine for the patient."
"be quick!"
"it is good!"
The nurse drew blood, and Xia Xian rushed to the laboratory with the blood.
"Miss, hurry up!"
"quick!"
When the emergency doctor is urgent, the laboratory must immediately put down all the examinations and focus on the urgent.
The results that usually come out in 15 minutes, come out in less than 10 minutes in a rush.
"Doctor Xia, report."
When I got the report in the summer, I focused on bilirubin and transaminase.
Bilirubin 70umol/L.
Transaminase 400U/L.
Seeing these two values, Xia Xia's heart sank.
Back to gastroenterology.
The patient has been rescued, but the human consciousness is unclear.
Zhang Ming is performing a CT scan on the patient.
Seeing Xia Tian come in, he asked.
"How about bilirubin and transaminases?"
Xia Xia replied with an extremely ugly face.
"Bilirubin 70, transaminases 400."
Zhang Ming: "What about the day of admission?"
Summer: "On the day of admission, bilirubin was 50 and transaminase was 900."
Quiet!
In the rescue room, there were five doctors in the gastroenterology department, plus Xia Tian, Zhang Ming, a few nurses, and a dozen people. The entire rescue room was as quiet as a chicken.
Quiet for a full 5 seconds.
Zhang Ming opened his mouth.
"What do you think of summer?"
Xia Tian glanced at Deputy Director Fang, calm and authentic.
"The patient's condition took a sharp turn for the worse, and he was confused. It should be hepatic encephalopathy."
When the liver is seriously damaged, the metabolism of the body is obviously disordered, and the ammonia in the blood will also increase significantly. Too high blood ammonia may lead to brain disorders, which is hepatic encephalopathy.
The final result of hepatic encephalopathy is only one.
Liver failure!
CT imaging out.
The patient's liver has shrunk to one-third of the normal range. On imaging, it looks more like the liver of a 7- or 8-year-old child.
Zhang Ming said immediately.
"The patient was transferred to the ICU for artificial liver plasma exchange, blood filtration, endotracheal intubation, and a ventilator."
"As for the follow-up..."
"Deputy Director Fang, let's do it."
Zhang Ming rolled his eyes and said to Xia Tian, "Let's go, let's go back to the emergency room."
The patient is no longer in the emergency department.
For patients who do not belong to the emergency department, in the event of an emergency, the emergency department can go to the emergency department to help, but in the end, the gastroenterology department must make its own decision.
Zhang Ming looked cold.
Your own mess, fix it yourself.
After all, when it comes to robbing a patient, it's so powerful that it's so arrogant that we can't stop it.
"Director Zhang."
"and many more!"
Deputy Director Fang chased out, and every wrinkle on the old face was written with 'jijiji'.
Zhang Ming glanced at him and said coldly.
"Anything else?"
Fang Yuan's face was ugly, and his tone was pleading: "I grew up watching this girl."
"Her parents entrusted her to me, a good child, I lost it, I am ashamed of their family."
"I trust your medical skills."
"Help me think of a way."
Zhang Ming has been in the emergency department all the year round, and his medical skills are higher than those of doctors in other departments. Moreover, because of his daring personality, he is also relatively daring in practicing medicine. Sometimes, daring often saves a lot of lives.
He glanced at Deputy Director Fang.
He turned his head to look at Xia Xia and asked.
"Xiao Xia, tell me what you think."
"How is this patient treated?"
Xia Tian pushed up his glasses and said expressionlessly.
"There are three treatments for liver failure."
"First, medication."
"Maintain with insulin, human albumin, prebiotics, N-acetylcysteine, hepatocyte growth-stimulating hormone and other drugs."
"Second, artificial liver therapy."
"A device made outside the human body that removes harmful substances produced by metabolism and replenishes biologically active substances made by the liver, such as bile."
"Third, liver transplantation."
"It's the best way to treat liver failure."
"In the current situation of the patient, the first and second methods are incurable, and there is only one result after treatment."
"Only a liver transplant."
"Otherwise, the patient will die within half a month."
Deputy Director Fang shuddered.
As the deputy director of a department, the result... why didn't he know?
Just, dare not face it.
Hope Zhang Ming will give him a miracle.
It's a pity...there are so few miracles in medicine.
After a full two minutes, Deputy Director Fang sighed deeply and said quietly.
"Okay... I'll inform the patient's parents."
"Let them prepare for a liver transplant."
Zhang Ming and Xia Xia turned their heads and left.
The matter of gastroenterology has nothing to do with them.
"Old Zhang, wait."
Deputy Director Fang shouted and asked in a pleading tone.
"Can you follow up this patient in the emergency department?"
"I'm a little worried..."
Before he could finish speaking, Zhang Ming nodded.
"Can."
"Xiao Xia, follow up."
"Okay." Xia Xia nodded, and the deputy director said: "If you have anything, you can notify me."
Deputy Director Fang looked at Xia Xia with an ugly expression.
Yesterday, Xia Xia reminded him to pay attention to the patient's liver failure.
He didn't take it seriously at all, treating it as an ordinary jaundice treatment.
If people were sent to the ICU at that time, perhaps the condition would not have deteriorated so quickly.
However, medically there is no if.
Things have already happened, and we can only bite the bullet and go on.
Notify the patient's family.
Family discussion.
Test blood type.
It took a whole day.
The next morning, Xia Xia received a notice from the Gastroenterology Department.
Hepatobiliary Medicine, Gastroenterology, and Emergency.
Three department consultation.
Inside the office.
Deputy Director Fang said: "The patient has acute liver failure, and the patient's big brother is willing to donate the liver."
"Next, let's study the surgical plan."
"Pony, how sure do you have a liver transplant?"
Xiao Ma is the Deputy Director of Hepatobiliary Surgery.
Because he is relatively young, in his early 40s, people call him a pony instead of an old horse.
The pony turned over the medical records and frowned.
"75%."
"The patient's bilirubin is too high. I'm worried about brain death during the operation. The best case is 75%."
"If Director Zhang is willing to give me one assistance, Deputy Director Fang will give me the second assistance, and the two generals will help, the success rate should be higher."
The crowd laughed.
Liver transplantation is a major operation, and it is normal for two or three directors to work in one operation.
only……
The 75% probability is somewhat low.
In acute liver failure, the survival rate is only 10%-30%, and the 75% success rate has greatly improved the survival rate for patients.
But... I look at the grown-up child by myself.
Deputy Director Fang was still worried.
He looked at Zhang Ming and asked.
"Director Zhang, what is the success rate?"
Zhang Ming replied: "I'm not a hepatobiliary surgeon, and I haven't done liver transplants a few times, so I don't dare to talk nonsense."
All right……
Deputy Director Fang was confused.
Zhang Ming turned his head to the summer behind him and asked in a low voice.
"Can you do a liver transplant?"
Summer nodded: "Yes."
"What's your success rate?"
Success rate?
Xia Xia had never done a liver transplant. When asked about the success rate, he really didn't know how to answer, but he pulled out two alternative surgeries from the Ender bottle a few days ago.
One can choose to study liver transplantation.
"Probably, 95%."
The voice just fell.
Brush brush!
In the conference room, everyone's eyes turned to him.
————————
Author bacteria:
This case is a real case, a 22-year-old girl who suffered from drug-induced liver damage and liver failure due to an overdose of acetaminophen.
Acetaminophen tablets are commonly known as paracetamol. Taking too much can cause liver damage, be sure to take it according to the instructions.
A few days ago, the author had a toothache due to bacteria, and because I saw this case, I dared not take the medicine...
Please remember, pay attention to your body and don't take medicine indiscriminately.
Finally: The patient in the real case died because of liver failure and did not have time for a liver transplant.