He is not talkative and is not very good at speaking, but when he really has to speak, every word he says definitely carries weight.
Fang Xueqing looked up and met the serious light in Song Xuelin's brown eyes, and nodded unconsciously.
The medical record was opened, and several doctors were studying it.
The patients' families outside are almost impatient and must get an explanation today.
"He is a patient with massive gastrointestinal bleeding." Fang Xueqing pointed out several key places in the medical record to the two young doctors. "He arrived at our hospital's emergency department three days ago. His main symptoms were vomiting blood and a large amount of bleeding. He was given a three-chamber two-balloon tube for compression and hemostasis. After a blood transfusion, his condition has stabilized slightly. The emergency CT scan report showed esophageal varicose bleeding, liver cirrhosis, and portal hypertension."
"Since there were no beds in the surgery department, the patient's condition has stabilized. With the consent of the patient's family, he was transferred to our internal medicine department for treatment." Doctor Ma then added the patient's situation, "In our internal medicine department, Director Zhang performed endoscopic esophageal varices treatment on the patient the day before yesterday, injected a sclerosant, and performed a ligation. Then last night, the patient suddenly became very irritable, and the reason was unclear. The vital signs are relatively stable, there is no further bleeding, no loss of consciousness, and pupil reflex and other tests are all normal. The family is very nervous and has been hoping to transfer to the surgery department for further surgical treatment."
Listening to what Dr. Ma said, it seems that we can first rule out acute cerebral hemorrhage and cerebral infarction and other brain-related diseases causing irritability? There is no sign of further bleeding. Indeed, the patient's condition at this moment is irritable, which makes people feel a little strange.
Fang Xueqing tapped her fingers on the medical record. She felt that the patient's strange reaction was beyond her experience as a professor, and she was a little confused for a moment. Turning around, she asked Song Xuelin: "Doctor Song, what do you think? Can this patient be sent to the surgery department for further surgery?"
After endoscopic treatment, emergency hemostasis is performed. If further radical cure is required, disconnection or shunting can be performed and the patient can be sent to the surgical department for traditional surgery. Interventional surgery such as TIPS transjugular intrahepatic portocaval shunt can also be performed.
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Therefore, after the surgery came for consultation, they said that elective radical surgery could be performed and asked the patient to wait. After all, the patient no longer had an indication for emergency surgery.
"Let Dr. Xie speak first." Song Xuelin said.
Why must this female medical student speak first? What is Song Xuelin thinking? Fang Xueqing didn't understand what he meant, so she looked at Xie Wanying and asked, "You are going to be a surgeon. How do you think this case should be viewed from a surgical perspective?"
"I personally think that the consultation report given by the surgery department yesterday makes sense. The patient's condition yesterday did not seem to be particularly urgent and he had to undergo surgery for esophageal varices." Xie Wanying said, "Yes, his bleeding is under control. Not only that, his initial hemoglobin was 97, which can only be considered mild anemia. I think the patient's family members in the emergency room said that the patient vomited a lot of blood at home, which was an exaggeration. Because when he arrived at the emergency room, the patient was conscious and the amount of bleeding should not be very large. Endoscopic treatment does not seem to cause too much bleeding."
"What do you mean?" Fang Xueqing and Dr. Ma heard a deeper meaning hidden beneath her words.
Xie Wanying said with a serious expression, "If the patient's condition worsens, he will have to be transferred to the surgical department immediately. Not to the general surgery department, but to the cardiothoracic surgery department."
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