Xu Qiu said: "Let's arrange a coronary angiogram first, and also prescribe some ibuprofen." "Ibuprofen?" He Hai was a little surprised. While other doctors were explaining the condition to the family members and asking for consent forms, He Hai was a little surprised and said: "You are so anxious to stop the pain?" "It's not just pain relief." "Oh? What else said...you mean, inflammatory pain?" He Hai is also a deputy director after all. In just two sentences, he immediately understood Xu Qiu's intention. Use ibuprofen for pain relief. More importantly, it is very effective for inflammatory pain.
Myocardial infarction is an organic disease, and its pathogenesis is coronary vasospasm. Pericarditis, pericardial effusion, etc. are pain caused by inflammatory edema and infiltration. Ibuprofen has a significant analgesic effect on the latter. Sure enough, soon after taking the ibuprofen, the patient moaned less frequently. The pain did ease a lot. However, myocardial infarction must be completely ruled out in the emergency department. As a doctor, you must not be imprisoned by your fixed mindset. Many diseases do not necessarily behave according to the textbooks. Wrong answers to the test paper will result in penalty points. The price of a patient's wrong diagnosis is life. Fortunately, family members and patients were very cooperative and signed informed consent forms. "Coronary artery examination can only rule out myocardial infarction. If it is pericardial effusion, pericardiocentesis is necessary... You may have to wait a few hours for the senior surgeon in our department to perform the operation." said the doctor who came for the extracardiac interventional examination. . Pericardiocentesis is a difficult operation. Although it is only a second-level surgery, clinically, most doctors do not want to and do not dare to touch it. The family members were a little anxious. Isn't it said that the condition is urgent? Why do we have to wait for several hours? When she was about to have an attack, Xu Qiu happened to come in. He said calmly: "It's okay. Leave the imaging and puncture to me." The extracardiac interventional doctor stretched his neck with doubts on his face: Shall I go? …
Outside the operating room. The family members were extremely nervous. The interventional cardiologist didn't go in after all, but he didn't go back to the department directly either. Instead, he fished for a while at the door. To avoid suspicion. He deliberately stood against the wall and fell asleep in this position. Fifteen minutes later, he woke up on time, turned around and returned to the department. There is a lot of work outside the heart. He rests here, and his colleagues have to work more. Fishing for fifteen minutes was the limit of his conscience. But his family members held him back: "Doctor, how long will this operation take?" The interventional cardiologist looked at his watch: "What's the rush? It's only been ten minutes, and there's at least half an hour left." The family member suddenly trembled and asked in a trembling voice: "What if we come out early?" "That means Dr. Xu's skills are good." "What if you come out now?" "Maybe the operation failed... Don't hold me back, our director is not so quick." The extracardiac doctor wanted to break free. But the hands of the family members are like iron pliers. He was a little angry, but when he turned around, he found his family members staring at the door of the operating room. Following the gaze of the family members, a handsome man was taking off his mask and hurriedly walking out. "Xu...Dr. Xu?!" Doctor Xinwai was shocked. When the family members saw Xu Qiu's hurried footsteps and thought of the doctor's words, their legs went weak and they knelt on the ground and cried loudly. Xu Qiu came over and wondered: "The operation was successful, why are you crying?" The family members were interrupted, with red eyes: "Huh? Huh?" The nurse on the side explained: "The coronary angiography confirmed that there was no coronary artery disease and ruled out myocardial infarction. Then Dr. Xu found that the patient's pericardial effusion was very large, so he quickly performed a pericardiocentesis. The operation was successful and the patient was out of the hospital. It’s dangerous!” Another young nurse patted her plump chest and said, "Yeah, I didn't expect the amount of fluid to be so large. If we wait a few more hours, the heart will be compressed and unable to pump blood, and it will be over by then... Fortunately, Dr. Xu Can do pericardiocentesis!” The cardiologist stood there, looking at a loss. Ten...fifteen minutes? Have coronary angiography and pericardiocentesis been done together? !
He glanced at Xu Qiu in horror, then rushed around the corner of the corridor and disappeared in the blink of an eye. The emergency department is scary. I want to go back to the cardiac surgery kindergarten... … Xu Qiu asked the nurse to explain the postoperative precautions to the family members, while she rushed to the observation room. There was certainly a reason why he was in such a hurry. System daily task interface, "Normal difficulty: Develop a plan for a high-difficulty chemotherapy session." A high school boy with a single egg is a God-given experience baby. When we came to the observation room again, the atmosphere here was completely different. The mother who was emotionally unstable before was now squatting on the ground in silence. My father stood in front of the hospital bed and sighed. When the attending doctor saw Xu Qiu coming back, he rushed over and said in a low voice: "Dr. Xu, the bone marrow is abnormal, the three lines are reduced, the blast cells are 37%, and the blast cells in the bone marrow are actively proliferating... The diagnosis is acute lymphoblastic leukemia! " "really." Xu Qiu's guess was not wrong. At this time, the squatting mother stood up. She stared and said with some despair: "Is it really leukemia?" Xu Qiu was very strict: "The current examination supports the diagnosis of leukemia." "Will it affect his college entrance examination?" Hearing this, the two policemen and the attending doctor all held their breath. It’s already here, are you still thinking about the college entrance examination? Xu Qiu didn't have much expression. He glanced at the mother and hesitated. I don't know if telling the truth will break her down. Xu Qiu said implicitly: "Now it is not a question of whether to take the college entrance examination or not. He must undergo bilateral irradiation therapy + DVP chemotherapy as soon as possible." The mother was very paranoid, with red eyes and a scary hoarse voice, and said: "You want to irradiate that part of him? Then how will he give birth to a baby in the future? Only one side is swollen, can you irradiate only one side?" Xu Qiu shook his head. Bilateral irradiation is the principle of radiotherapy for testicular leukemia. Just like when one side of an apple is rotten, mycotoxins such as E. coli have spread throughout the apple.
It doesn’t mean that if one breast is bitten, you can eat the other one. "Then how will he have children in the future?" The mother roared, rushed to the hospital bed, and asked the boy: "Why are you disobedient and telling you to play less games? I said there is too much radiation!" The attending doctor next to me was furious. Leukemia has stages of development. It first affects hematopoiesis in the marrow. The symptoms are anemia, bleeding, infection, etc. Later, it will infiltrate outside the marrow. Such as lymphadenopathy, hepatosplenomegaly, DIC, oral skin lesions, etc. Testicular leukemia is one of the extramedullary relapses. However, it usually occurs during the remission period of chemotherapy. However, This mother always believed that the child's discomfort was just too pretentious. He dragged his son to this stage by force! The attending doctor sighed: This is giving away his own child with his own hands... At this time, the silent father moved his throat and asked: "Doctor, tell the truth, how long can my son live?" Hearing this, the mother's eyes showed panic. She looked at her husband ferociously, and her next words shocked everyone present.
