I can see the status bar

Chapter 536 Decision

This is not right, this is very wrong.No one goes from a low blood pressure of 55/85 to a high blood pressure of 90/155 in a matter of minutes.Sun Lien shook his head vigorously, and refocused on the electronic sphygmomanometer in front of him.He turned on the machine again, and the second test result was 94/156, with a little fluctuation, but still within the reasonable error range.

It can't be that the machine is broken, right?Frowning, Sun Li'en tore off the air cuff tied to the patient, and then tested it again on himself.Blood pressure is 75/125, and the sphygmomanometer is working perfectly.

"What's wrong?" The nurse who took Li Jianguo's blood frowned and asked, "Is there something wrong with the blood pressure monitor?"

Sun Lien shook his head, hesitantly said, "I think there is something wrong with this person." He went around the bed again, and tied the blood pressure monitor to Li Jianguo's right arm.

Blood pressure 57/90, still hypotensive.

Under normal circumstances, the blood pressure on the left side of a person's upper limb is slightly higher than that on the right upper limb, and the pressure difference is basically about 10 mm Hg.But such a huge pressure difference is definitely not a normal phenomenon.

"Push the B-ultrasound machine over." Sun Lien thought for a while, and quickly started the next step of the inspection, "Let the CT room prepare quickly, and send the person there immediately after the B-ultrasound is done!"

His expression became a little anxious, and Zhou Jun came over, "It's serious?"

"Very serious." Sun Lien took a deep breath behind the N95 mask, "I think this is an aortic dissection." He continued to raise his voice, "Let Xinwai send someone to the operating room to prepare!"

Aortic dissection is an acute cardiovascular disease with a high mortality rate.If left untreated, about 25% of patients will die within 24 hours of onset.More than half of patients die within a week of onset.The mortality rate after one month and one year after the onset is higher than 75% and 90%, respectively.However, if you receive aortic replacement surgery and take regular medication after that, the 10-year survival rate of patients is about 50%.

This is a horrible disease that is almost certain to die if left untreated, and half the chance of dying within ten years after active treatment.And Li Jianguo's situation should obviously be the most troublesome one.

Most of the symptoms of patients with aortic dissection are very obvious, and severe chest pain and tearing pain will make it difficult for patients to resist.While sweating profusely, almost more than [-]% of the patients felt a strong sense of near-death—a panicky and restless worry as if a catastrophe was imminent.

The onset of aortic dissection is due to a breach in the intima of the aortic wall, and the high-pressure blood that has just been pumped from the heart directly rushes into the breach, enters the middle layer of the arterial wall, forms a dissection hematoma and gradually peels off the aortic intima and media.The greatest risk of this serious cardiovascular emergency comes from the risk of aortic rupture that the patient will always face after the aortic layer is stripped.

If the aorta ruptures before the operation, the time left for doctors to rescue and treat it will be as short as seconds, and there are only a handful of successful cases of rescue after the aorta ruptures.Unless the patient is extremely lucky, after the heart has sprayed out the whole body of blood, it gets enough blood input, and the heart re-beats successfully.

For a healthy 20-year-old man, the aorta ruptures before surgery, and the mortality rate may be 99%.But if the patient is replaced by Li Jianguo, a 60-year-old who has suffered from stage III hypertension for more than ten years and also has hyperlipidemia, the mortality rate is absolutely 100%.There was no way he could have survived.

Therefore, Sun Lien directly opened a green channel for him, and reported the situation to Zhou Jun.

"B-ultrasound can be done on the road." After hearing Sun Lien's diagnosis opinion, Zhou Jun gave more positive instructions, "Send the person directly to the imaging department and do CTA immediately. Once confirmed, the operation will be performed immediately."

"I'll do what the family members talk about." Sun Li'en can't care about other problems now, aortic dissection is the most dangerous cardiovascular disease.The faster he moved, the higher the chance of Li Jianguo surviving.

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"Your father's condition is very bad, very bad, and he may die at any time." When Sun Lien rushed out of the emergency room again, Li Jianguo's son could not even find a place to sit down. "We now highly suspect that his disease is aortic dissection."

"It's not that I haven't even done the inspection..." Li Jianguo's son also looked confused, "I haven't paid the money yet..."

"The current evidence is very clear, but we will still do another CTA to clarify the symptoms." Sun Lien explained at the fastest speed, "If it is confirmed that it is aortic dissection, then an operation must be performed immediately to replace it with an artificial blood vessel. His broken aorta."

"Surgery must be done?" Li Jianguo's son looked embarrassed, "Can't this be treated with medicine?"

"His vascular injury is a physical injury that develops quickly, and it is not the type of infection that can be cured with antibiotics." Sun Lien tried to explain, "It is like a high-pressure plastic water pipe being pierced with a hot steel needle. A hole was made. The effect of drug treatment is to withdraw the needle. Under the action of high pressure, the hole will only get bigger and bigger, and there is no other way to go except to change the tube.”

Sun Li'en's explanation was very straightforward, and Li Jianguo obviously understood it.He asked cautiously, "How much... will this operation cost?"

"It's hard to say." Sun Li'en sighed, "If the operation goes well and the recovery is fast, you will probably need to prepare 20 to 30. The cost of the operation will be about 15, and the subsequent treatment and nursing will cost about the same amount."

For such a major operation, the operation fee itself is very expensive.Aortic replacement surgery, like atlantoaxial replacement surgery and liver transplantation that Sun Lien had seen before, was a fourth-level operation with the highest restriction.The operation is difficult, the risk is high, and the requirements for doctors are extremely high.At present, Tong Chunlai, director of cardiac surgery, is the only one who can perform aortic replacement in the Fourth Hospital.

Director Tong is not on duty tonight. When the heart surgery was prepared for the operation just now, the doctors of the heart surgery department were already calling for help—Sun Lien was not the only doctor who came to the hospital to save the day after staying awake in the middle of the night.Other third-line doctors often have this experience.

"The operation is very difficult, and there is a possibility that the patient may die due to deterioration of the condition or other complications after being on the operating table." Although a green channel was opened for Li Jianguo, before Tong Chunlai rushed to the hospital for the operation, Sun Lien There is still a chance to have a final communication with the family. "Your financial situation may be very difficult, so I still want to remind you-the operation is our attempt to give him a chance to survive. Aortic dissection is a very dangerous disease, and there are cases where people can't get out. Even After the artificial blood vessel is replaced, it is possible that people lose it due to various complications. If you want to continue the treatment, you must be prepared that you may lose money and money.”

(End of this chapter)