Back to 1999: From operating surgeon to becoming a top doctor

Xiao Chenguang's words shocked everyone at the scene.

Can it be cured? How to cure it?

The patient had a fistula after colon cancer surgery, and now he has acute kidney injury. Even the blood creatinine that reflects the kidney clearance rate has soared to more than 600.

You know, the normal value of creatinine is only more than 100. Now it is directly six times higher, and it has reported a critical value. How to clear it?

Just as Xiao Chenguang thought just now, Shengli Hospital does not even have the most basic hemodialysis machine, let alone a blood filter.

What can I do?

"It's okay, just replenish fluids and flush the glomeruli." Xiao Chenguang said to the patient with a smile.

Flush?

Not only the patient, but also the medical staff present were confused.

This is not as simple as mixing milk powder.

Now the patient is so swollen, can the body withstand it if he is flushed with liquid? Will he be drowned directly?

Faced with doubts, Xiao Chenguang seemed very calm.

You should know that acute kidney injury can be divided into three categories according to the condition: prerenal, renal, and postrenal.

If it is renal injury, it is usually a problem with the kidney itself. This is the most serious and usually requires hemodialysis to treat.

Postrenal injury is mostly caused by obstruction of organs below the kidney, such as the prostate, urinary stones, tumors, etc., which is equivalent to the filtered water not being able to be discharged and returning to the kidney, causing damage, commonly known as the kidney being blocked.

As for prerenal, it is like the patient in front of you.

Because of colostomy dehydration, and the patient deliberately reducing intake for fear of edema, it causes insufficient renal perfusion and leads to inactivity.

This can be understood as the kidney being damaged due to long-term disuse.

In general, in this case, as long as the fluid is replenished in time and the normal function of the kidney is restored, it is still possible.

So, Xiao Chenguang asked for a piece of paper, and then took out the carbon pen that the nurse had just given him from his front pocket, and began to write the doctor's order.

"Follow this doctor's order and draw blood again in four hours to test liver and kidney function. By then, I believe creatinine will be below 300."

"The rest can only be slowly adjusted by drugs."

The nurse on the side took the doctor's order and took a look at it, with a face full of question marks.

"Doctor Xiao, I can understand the first doctor's order, but what is your second doctor's order?"

On the note given by Xiao Chenguang, the first one reads [Hydroxyethyl starch 130/0.4 sodium chloride injection 500ml, intravenous drip]

This is a colloid commonly used in hospitals, which can improve the patient's microcirculation, increase blood pressure, and increase blood volume.

The second one is full of chemical symbols, such as Nacl 2.56g, Kcl 1.5g, sodium citrate 2.9g, anhydrous glucose 13.5g, osmotic pressure: 245mmol/L.

With the nurse's exclamation, everyone curiously looked at the note, and then quickly retracted their heads.

As long as I move fast enough, no one will notice that I have read this note.

Although the things written on it are clear, when put together, they are beyond everyone's knowledge.

"This is the third-generation ORS rehydration salt, which is specially used for the dual effects of rehydration and antidiarrhea."

"It can not only shorten the duration of diarrhea, but also reduce prerenal renal damage, expand blood volume, and relieve edema symptoms."

The ORS mentioned by Xiao Chenguang has a simple formula, can be taken orally, and can promote gastrointestinal absorption. Therefore, in 1972, the first generation of ORS rehydration salt was recommended by the WHO as a drug for the treatment of acute diarrhea and dehydration.

The third-generation ORS rehydration salt used by Xiao Chenguang actually only announced its formula in 2002.

It's just that the patient needs it now, so Xiao Chenguang simply uses it.

After all, in this era, information is still too closed, and even the three major Internet giants are still in their infancy, so few people know about it.

"Uncle, you can use it without worry. These days, it is because you have taken in too little and excreted too much that the filtration rate of the kidneys has decreased, resulting in edema and kidney damage."

"Next, as long as you use the kidneys through fluid replacement, there will be no problem."

"Of course, you can only stay here for a while with peace of mind. After all, it takes time to repair the kidneys."

After Xiao Chenguang's patient explanation, the patient finally understood that his illness was entirely his own fault.

In fact, if he hadn't happened to meet Xiao Chenguang today, it is estimated that if he had delayed it for another two days, his kidney problem would not be as simple as it is now, with injections and medicine.

He just heard from the doctor that if the kidneys were damaged, he would have to go to the provincial capital for hemodialysis.

If he was lucky, he might be able to get the machine, but if he was unlucky, he might just have to wait for death there.

Thinking of this, the patient couldn't help but shudder.

He immediately held Xiao Chenguang's hand tightly and shook it.

"Thank you, thank you, Dr. Xiao."

"If I hadn't met you today, I'm afraid my illness would have been delayed. I never thought that kidneys would have problems if they were not used for a long time."

Faced with the patient's gratitude, Xiao Chenguang just smiled and didn't reply.

After all, the patient's words sounded a bit strange to Xiao Chenguang.

The ward rounds continued, and Xiao Chenguang's textbook diagnosis had completely conquered everyone.

Gradually, everyone began to take Xiao Chenguang's words as a benchmark and take corresponding measures.

And his modern teaching-style ward rounds were like opening a new door, which benefited everyone a lot.

As for the patients, they benefited a lot when they met Xiao Chenguang.

They gathered around Xiao Chenguang in an endless stream, vying to ask about their related diseases, hoping to get Xiao Chenguang's guidance.

At this time, even the atmosphere in the entire ward became lively.

......

"Oh, I'm still late. I told you not to drink last night, but you didn't listen. Now, the morning meeting of the general surgery department didn't take the handover shot. We have to come again when the time comes."

In the hall, Liao Changgong hurriedly walked towards the general surgery department.

While he quickened his pace, he kept scolding the cameraman next to him.

If he hadn't yelled last night that he had waited in the operating room for a whole day and hadn't eaten, and had to go out for a meal together in the middle of the night, he wouldn't be late today.

Facing Liao Changgong's endless rhetoric, the cameraman seemed to have gotten used to it.

He grinned, smiled honestly, and then carried the camera without saying a word, following behind Liao Changgong.

"Alas, a blockhead."

Liao Changgong also shut up when he saw this. He had just entered the corridor of the general surgery department and happened to see Xiao Chenguang and others who were still making rounds.

"Oh, not bad, I just happened to arrive at the general surgery department for rounds. Such a spectacular scene, record more, it will be convenient for editing later."

Liao Changgong immediately signaled the photographer to follow, and then walked quickly towards Xiao Chenguang.

But at this moment, a figure squeezed past Liao Changgong from one side with a fierce momentum, almost knocking him down.

"This man, he has no eyes, it's okay to touch me, but you broke the machine, can you afford to pay for it?"

Liao Changgong stood up and was about to accuse, but he saw the man suddenly turned back.

The red eyes seemed to be eating people, and he was scared and shut up immediately.

"What's wrong with this man, it seems like he is looking for trouble?"

Liao Changgong, who has many years of interview experience, can see at a glance that the man is full of anger.

It's just that he looks dusty, as if he just came back from another place.

This is the general surgery ward, a place to treat patients and save lives. What could make a person so angry?

Before Liao Changgong could come to his senses, the man suddenly stopped, came to the door of bed No. 5, and looked inside coldly.

Suddenly, he kicked the wooden door hard, making a hole, and then punched it twice, and the wooden door fell to the ground, making a muffled sound when it hit the ground.