Lost at the start, the first surgery shocked the world

In the rescue room, Zhang Ming and Deputy Director Fang rescued the patient at the same time.

"In the summer, immediately give the patient a blood routine."

"Be quick!"

"Good!"

The nurse drew blood, and Summer took the blood and immediately rushed to the laboratory department.

"Little sister, hurry!"

"Quick!"

When the emergency doctor expedites, the laboratory department must immediately put down all the examinations and focus on expediting.

The results are usually out in 15 minutes, but the rush comes out in less than 10 minutes.

"Dr. Xia, report."

When I got the report in the summer, I focused on bilirubin and aminotransferases.

Bilirubin 70umol/L.

Aminotransferase 400 U/L.

Seeing these two values, Summer's heart sank.

Back to Gastroenterology.

The patient has been resuscitated, but the person's consciousness is not clear.

Zhang Ming is doing a CT on a patient.

Seeing Summer come in, he asked.

"What about bilirubin and transaminases?"

Summer's face was extremely ugly and she replied.

"Bilirubin 70, aminotransferase 400."

Zhang Ming: "What about the day of admission?" "Summer

:" On the day of admission, bilirubin 50, aminotransferase 900. "

Quiet!

In the rescue room, there are five doctors from the Department of Gastroenterology, plus Summer, Zhang Ming, and a few little nurses, more than a dozen people, and the entire rescue room is as quiet as a chicken.

It was silent for a full 5 seconds.

Zhang Ming spoke.

"What do you think of summer?"

Summer glanced at Deputy Director Fang and said calmly.

"The patient's condition deteriorated rapidly and he was confused, which should be hepatic encephalopathy."

When the liver is severely damaged, the body's metabolism is obviously disordered, and the ammonia in the blood will also be significantly increased, and high blood ammonia may lead to brain disorders, which is hepatic encephalopathy.

There is only one end result of hepatic encephalopathy.

Liver failure!

CT imaging out.

The patient's liver shrank, shrinking to one-third of its normal range, and on imaging, it looked 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 plasmapheresis, plus blood filtration, tracheal intubation, and put on a ventilator."

"As for the follow-up..."

, "Deputy Director Fang will look at it."

Zhang Ming rolled his eyes and said to Xia, "Let's go, let's go back to the emergency department." "

The patient is no longer in the emergency department.

For patients who are not in the emergency department, the emergency department can come to help in the event of an emergency, but in the end, it is up to the gastroenterology department to make its own decision.

Zhang Ming's face was cold.

Your own mess, fix it yourself.

After all, when grabbing patients, it's all blowing into the sky, and we can't stop it.

"Director Zhang."

"Wait!"

Deputy Director Fang chased him out, and every wrinkle on the old face was written 'Urgent, Urgent, Urgent'.

Zhang Ming glanced at him and said coldly.

"Is there anything else?"

Fang Yuan's face was ugly, and there was pleading in his tone: "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 can trust your medical skills."

"You can help me figure it out."

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, and because of his bold personality after all, his behavior in practicing medicine is also relatively bold, and sometimes, boldness often saves a lot of lives.

Glancing at Deputy Director Fang.

Turning his head to look at Summer, he asked.

"Xiao Xia, tell me what you think."

"How can this patient be treated?"

Summer pushed her glasses and said expressionlessly.

"There are three ways to treat liver failure."

"First, medication."

"Maintained with drugs such as insulin, human albumin, prebiotics, N-acetylcysteine, and hepatocyte auxin."

"Second, artificial liver therapy."

"A device made in a person outside the human body to remove harmful substances produced by metabolism and replenish biologically active substances made by the liver such as bile."

"Third, liver transplantation."

"It's the best treatment for liver failure."

"With the current situation of the patient, the first and second ways are no longer curable, and there is only one result after treatment."

"I have to have a liver transplant."

"Otherwise, the patient will die within half a month."

Deputy Director Fang's body shuddered.

As the deputy head of a department, the result... Why doesn't he know?

It's just that I don't dare to face it.

I hope Zhang Ming will give him a miracle.

Pity...... There are too few miracles in medicine.

After two minutes, Deputy Director Fang let out a long sigh and said quietly.

"Well... I would like to inform the patient's parents.

"Let them prepare for a liver transplant."

Zhang Ming and Xia turned around and left.

The matter of gastroenterology has nothing to do with them.

"Lao Zhang, wait."

Deputy Director Fang shouted and asked in a pleading tone.

"Can you follow up with this patient in the emergency department?"

"I'm a little worried..."

Before he finished speaking, Zhang Ming nodded.

"Yes."

"Xiao Xia, follow up."

"Okay." Summer nodded, and the deputy director of the other party said, "If you have anything, you can notify me."

Deputy Director Fang looked at the summer, his face was a little ugly.

Yesterday, Summer reminded him to watch out for liver failure in patients.

He didn't take it seriously at all, treating it as an ordinary jaundice treatment.

If the person had been sent to the ICU at that time, maybe the condition would not have deteriorated so quickly.

But, there is no if in medicine.

It's already happened, and I have to go on with it.

Notify the patient's family.

Family consultation.

Fitting blood type.

It took a whole day.

The next morning, Summer received a notice from the Department of Gastroenterology.

Hepatobiliary, gastroenterology, and emergency.

Consultation with three departments.

Inside the office.

Deputy Director Fang said: "The patient has acute liver failure, and the patient's brother is willing to donate his liver.

"Next, let's look at the plan of surgery."

"Pony, how sure are you about the liver transplant operation?"

Pony is the deputy director of the Department of Hepatobiliary Surgery.

Because he was younger, just in his early 40s, everyone called him a pony instead of an old horse.

Pony flipped through the medical records, his brow furrowed.

"75%."

"The patient's bilirubin is too high, and I'm worried about brain death during the operation, and the best case is 75%."

"If Director Zhang is willing to give me one help, Deputy Director Fang gives me two helps, and the two generals 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 have one operation.

It's just....

The 75% probability is somewhat low.

In acute liver failure, the survival rate is only 10%-30%, and the success rate of 75% has greatly improved the survival rate for patients.

But...... I watched the children grow up.

Deputy Director Fang is still not at ease.

He looked at Zhang Ming and asked.

"Director Zhang, how much success rate is there?"

Zhang Ming replied: "I am not a hepatobiliary surgeon, and I haven't done a liver transplant a few times, so I don't dare to talk nonsense." "

Okay....

Deputy Director Fang was entangled.

Zhang Ming turned his head to Xia behind him and asked in a low voice.

"Will you have a liver transplant?"

Summer nodded: "Yes."

"What is your success rate?"

Success?

Summer had never had a liver transplant, and 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 the other day.

One of these options can be studied Xi liver transplantation.

"Probably, 95%."

As soon as the words fell.

Brush Brush Brush!

In the conference room, everyone's eyes looked at him.

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author bacteria:

This case is a real case, a 22-year-old girl with liver damage caused by acetaminophen overdose and liver failure.

Acetaminophen tablets are commonly known as paracetamol. Taking too much can cause liver damage, so be sure to take it according to the instructions.

A few days ago, the author had a toothache, and because he saw this case, he didn't dare to take the medicine...

Please remember to pay attention to your body and do not take medicine indiscriminately.

Finally: the real case of the patient died because of liver failure and did not have time for a liver transplant.