After the epidemic, I believe that everyone has a deeper understanding of the two words "health".
Sudden illnesses and outbreaks can crush countless families.
And the medical staff has been busy on the front line, and the human suffering, life and death that you can't see the most, they face every day.
For example, episode 2 of the doctor's observation documentary "My White Coat", which aired on Friday night, once again tells a thrilling story.
Severe stomach pain for more than 2 hours
But I couldn't find the specific pain site
At 9 p.m. on March 4, the emergency department of Shenzhen People's Hospital sent a 42-year-old male patient.
"The pain has been more than 2 hours, from more than 6 o'clock, after eating a lot of soybeans for dinner, it began to hurt..."
It was still during the epidemic, and the man and his wife who accompanied him to see the patient were wearing masks.
The man's eyebrows were twisted together, and he was already in pain to the point of paleness, fidgeting, and even his voice was weak.
Dr. Jiang Xizhi palpated on his stomach, but no matter which part it was up, down, left and right, the man said it hurt.
"It could be pancreatitis," Dr. Jiang speculated from experience.
Doctor Cai Wanna continued to ask, "Is it stinging or stuffy?" "The patient mentioned a tingling pain in the right chest.
When Cai Wanna reported to Dr. Jiang, she believed that "the first thing to consider is whether it is a heart problem."
Dr. Jiang looked at the examination report again, D-polydisperm 4.74, "quite high."
D-Dimordium is a residue of blood that is broken down after clotting. This indicator is high, indicating that there may be a large number of blood clots or blood clots in the body.
Common causes include deep vein thrombosis, diffuse intravascular coagulation, pulmonary embolism, acute myocardial infarction, cerebral infarction, etc., which require further investigation to be identified.
Dr. Jiang turned sharply and made a sharper judgment:
"This person wants to exclude the (aortic) dissection."
Aortic dissection
A disease that can kill at any time
The aorta, the largest artery that emanates directly from our heart, is responsible for sending blood throughout the body.
The aortic dissection, simply put, is that the inner membrane of the aortic vessel "pierced a hole", but the middle membrane is still intact, so a "dissection" is formed, and the blood does not stop rushing into the dissection, opening the blood vessel wall.
When the vascular membrane expands to its limit, it is like a piece of paper. At that time, even if you sneeze and defecate hard, you will say that if it is broken, it will be broken, and the person will be finished.
Therefore, this disease is also known as the "whirlwind killer", if not treated in time, it may be life-threatening!
In China, this disease is mainly caused by hypertension, and the incidence is high every winter and spring. Especially men who do not take medicine, have uncontrolled high blood pressure, and are about 50 years old, are most likely to get this disease. In addition, many men's hobbies of smoking and drinking are also a major risk factor.
Patients often have persistent, unbearable pain, mainly chest, back, or stomach pain. These are exactly the same as the situation of men!
Dr. Jiang quickly instructed the patients: "From now on, do not eat, water can not drink, this is very important!" ”
At this time, the doctor who was measuring blood pressure suddenly found that the blood pressure of the two feet was different, 160 on the left and 90 (mmHg) on the right, and this was the result twice.
The large difference in blood pressure in the extremities is one of the manifestations of aortic dissection, which affects the arteries on both sides of the body to vary in degree.
"It could be a mezzanine."
Dr. Jiang immediately decided to abandon the flat scan CT and urgently sent the patient to do a clearer enhanced CT.
The doctor read the film live in the CT room, and it was the aortic dissection! So he quickly called the cardiac surgeon for emergency consultation.
"What should I do?"
"Just listen to our arrangement!"
Cai Wanna told the man that now he should relax and not move, and he could not defecate forcefully, otherwise the blood vessels might rupture. But he was in a hurry.
"Intubate the urinary catheter!" Say goodbye to the sick! ”
Dr. Jiang asked Cai Wanna to quickly sign the urinary catheterization consent form and the critical illness notice to the family.
At this time, the man's wife could not be found, and it turned out that she was outside on the phone.
After finding her, the heart surgeon arrived and he communicated with the family:
"We tried our best to rescue him, but he was very ill, with a dissection and intestinal ischemia, and the mortality rate was 63 percent. The risk of surgery is very high and may not be saved. ”
The man's wife suddenly collapsed, took off her mask and cried:
The doctor told her to quickly put on a mask, protect herself, and immediately call other relatives to confirm.
After a while, seeing that she had not finished calling, Dr. Jiang took the phone and said to her son at a very fast speed: "(Your father) this disease is very dangerous, can not be delayed, must be hospitalized, do not do surgery must not have any hope." ”
"Are you going to have surgery right away?" "Yes, prepare now!"
After the family agreed, Dr. Jiang quickly contacted to arrange the operation.
"First get a painkiller, he can't move, make sure to calm him."
At this time, the eldest sister was still asking how her husband still hurt after the painkiller injection.
In order to make the family less flustered, Dr. Jiang calmly told her: "Just listen to our arrangement." ”
Seeing that she was at a loss to go through the hospitalization procedures, he took the initiative to help get the medical record book.
After 10 hours of surgery, the man finally saved his life.
"No one dares to say that there is a certainty
Can only say that everything is done and done to the best of my ability"
"There is a fifty percent hope that our whole family will support him in saving him."
In front of the hospital bed, this prime-aged man who had just walked on the edge of the ghost door and was recovering also silently shed tears.
Many people may not be able to empathize with them until they have a serious illness. The feeling of helplessness, of just wanting to cry, of "a blank brain", could not have been more real.
They also want to thank themselves for seeing the doctor in a timely manner. Stomach pain for two hours, immediately call 120 to the hospital, is very wise.
Here, too, I would like to give you a wake-up call:
People with high blood pressure in the family, especially middle-aged men, don't think that no symptoms are fine. Usually, you must take medicine according to the doctor's instructions, do not smoke or drink.
Otherwise, dangerous complications such as aortic dissection occur one day, and they may really die!
If severe pain in the chest, back or stomach continues to appear like a tear or knife cut, be sure to send it to the hospital in time. In the process, pay attention not to force, do not move, in case the aorta rupture is dangerous.
Although the aortic dissection is so dangerous, doctors will do their best to treat anyone who has a glimmer of hope.
Afterwards, Dr. Jiang sighed: "When the doctor is most afraid of others saying, 'You give me an explanation, you can't give me a thorough explanation'.
As this patient said today, 'You tell me if there is still a cure, and there is still a good chance'. But who dares to say how sure is this disease? No one dares to say. You can only do your best and do your best. ”
In this process, we have to admire the doctor's keen observation, accurate judgment, decisively carry out various examinations, and race against the clock to treat patients whose lives are hanging in the balance.
Cai Wanna also said that the most admired thing about Teacher Jiang was his quick and accurate judgment.
"I think this is the most valuable ability of emergency department doctors."
*The content of this article is a popularization of health knowledge and cannot be used as a specific diagnosis and treatment recommendation, nor is it a substitute for face-to-face consultation by a practicing physician, for reference only.
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