Back in 2002 as a doctor

Ecchymosis on both lower extremities, in Liu Wei's impression, only patients with shock will have similar symptoms.

But the patient's blood pressure is very stable, all right!

What the hell is going on!

In an instant, various cases of medical malpractice appeared in my mind.

Li Qinghua was also dumbfounded. This operation was originally "show off" to Zhou Congwen, but who would have thought that abnormalities would appear in the patient before he was lifted onto the flat car after the operation.

"Don't worry." Zhou Congwen said calmly, "Old Liu, give methylprednisolone 80mg and push it intravenously!"

Liu Wei immediately handed over the mask to the assistant, but Zhou Congwen had already walked over and took over the mask.

He raised the patient's jaw and inhaled pure oxygen through the mask.

After the methylprednisolone bolus was injected and observed for a few minutes, the patient's blood oxygen saturation continued to rise.

Only then did the air in the operating room relax a little bit.

Li Qinghua stared at the reticular ecchymosis on both lower limbs of the patient. What he was most afraid of was that the patient would develop complications such as dic.

However, 1800ml of blood is not enough to dic.

"Shen Lang, call home and prepare a small intensive care unit." Zhou Congwen said, clasping his mask with both hands.

"Oh." Shen Lang turned around and ran to make a phone call.

"Congwen, are you okay?" Li Qinghua asked in a low voice, a little confused.

He really wanted to hear the word "nothing" from Zhou Congwen's mouth, but the patient's state was weird, how could he be okay.

"It's okay." Zhou Congwen said with certainty.

"..."

Although they got the answer they hoped for, both Li Qinghua and Liu Wei felt a little unreliable.

What's wrong with the patients, how can they be all right.

Chapter 0450

Zhou Congwen didn't explain too much.

Observed after 15 minutes of pressurized oxygen inhalation through the face mask, the blood oxygen saturation was maintained at 95%, and the skin ecchymosis was relieved.

Seeing the skin ecchymosis gradually fade, Li Qinghua and Liu Wei's hanging hearts were relieved, but they were still hanging in mid-air.

As for why...

They all glanced at Zhou Congwen in unison.

Let's talk about it later, since Zhou Congwen said so, don't waste time on the operating table, it's meaningless.

After reducing the oxygen flow and observing for a few more minutes, the patient's blood oxygen saturation was still stable, so the patient was sent back to the small intensive care unit of the thoracic surgery department.

Just like when rescuing the patient, Li Qinghua ran to ask for the elevator, and the journey was unimpeded. The patient was awake, able to communicate, and clearly speaking.

After being sent to the small intensive care unit, none of the people left, especially Liu Wei, who called Corey and said that he would be back a little later, so he insisted on staying.

He was very worried about the patient's accident, and his eyebrows were filled with worry.

After three and 10 minutes of observation, the skin ecchymosis on both lower limbs of the patient gradually disappeared, and Zhou Congwen smiled, "Let's go to the office."

Li Qinghua nodded, and several people came to the office.

"Congwen, what's going on? I was scared to death." Li Qinghua entered the office, took off his calm mask in the ward, and revealed an anxious expression.

The same goes for Liu Wei, who sat on the bed in the director's office blankly, staring at Zhou Congwen, waiting for him to say what happened.

Zhou Congwen was young, but his quick and clean rescues left a deep impression on everyone.If you have any problems that cannot be solved, you can go to Zhou Congwen directly. This is a skill, and it has nothing to do with age.

"Reticular ecchymosis is not too common. It is a disorder of skin vasomotor function caused by various reasons, leading to spasm of arterioles and precapillary sphincters, dilation of capillaries and small veins, and blood stasis."

"If we can meet one case, it can be regarded as..." Zhou Congwen paused helplessly when he said this.

I don't know if it is a good thing or a bad thing.

To put it better, with myself, Li Qinghua and Liu Wei have seen each other, and I can patiently wait for the patient to stabilize.

If I'm not here, I'm afraid that they will rush to give medication in a hurry.

"Xiao Zhou, how did you come here?" Liu Wei asked blankly.

"Autoimmune diseases such as systemic lupus erythematosus, diseases with increased blood viscosity such as polycythemia vera, nervous system diseases, catecholamines, and amantadine drugs can also cause skin ecchymosis."

"..."

Liu Wei was helpless, it was as if Zhou Congwen hadn't said what he had said.

"Let me summarize from the beginning, the patient underwent thoracoscopic resection of pulmonary bullae lesion + thoracoscopic pleurodesis under general anesthesia today, and the anesthesia operation went smoothly.

However, after the extubation, the blood oxygen saturation decreased, the blood pressure increased, and the heart rate increased; then symptoms of reticular ecchymosis appeared on the skin of both lower extremities. "

"There are several possibilities. The first is that extubation stimulation leads to bronchospasm and reduced pulmonary ventilation. In addition, the patient's own poor lung function causes hypoxemia. Hypoxia can reflexively excite the sympathetic nerves."

"The second option is not considered for the time being, because the operation time is long, the temperature in the operating room is low, and the body temperature is not protected during the operation, resulting in a low postoperative body temperature of the patient. Low temperature will cause skin vasospasm and sympathetic nerve excitement.

Our operation time is only four to 10 minutes, which is impossible. "

"The last possibility is sputum suction and extubation stimulation, which can also cause sympathetic stimulation."

Liu Wei wanted to cry but had no tears.

Is it wrong to operate carefully by yourself and suck the sputum well during extubation?

Zhou Congwen looked at Liu Wei's expression and smiled, "Old Liu, it's okay, I'm just talking about a possibility. You've done a good job, very good."

Liu Wei was a little frustrated, and tried his best to grin, but he didn't smile, which was a bit like Li Ran.

"Stimulation of the sympathetic nerve increases the patient's heart rate and blood pressure, and the increased heart rate leads to a shortened diastolic period of the right heart, and systemic blood stasis in the veins.

At the same time, the sympathetic nerves are highly excited, and a large amount of catecholamines are released to cause strong contraction of skin blood vessels and spasm of blood vessels, resulting in skin microcirculation disturbance and blood stasis, resulting in reticular ecchymoses on the left chest wall and lower extremities. "

"However, similar situations are rare, so don't worry about it." Zhou Congwen sighed.

Don't worry, it's okay to comfort Liu Wei with these words, but Zhou Congwen is a student under the leadership of Boss Huang, and he always has bad ideas in his mind.

Even if he is as strong as his own boss, he still feels...

This is a historical limitation, Zhou Congwen comforted himself.

Perhaps after decades or hundreds of years, many of the problems doctors face now will disappear.But at that time, doctors knew more and had more troubles.

"Is there a way?" Liu Wei asked a nonsensical question.

Zhou Congwen said with a smile, "It is said that intraoperative application of dexmedetomidine can reduce extubation-related complications."

"Is that so..." Liu Wei was a little at a loss.

Zhou Congwen patted Liu Wei on the shoulder, and repeated comforting words, "It's nothing old Liu, you've done a good job."

The comforting words were just comforting and had no essential effect. Liu Wei was still a little depressed.

But after all, he is an old anesthesiologist who has seen the world and has a strong self-regulation ability.

Soon, Liu Wei said with a smile, "If you say that we can't do it in this line of work, men are afraid of choosing the wrong line of work, and women are afraid of marrying the wrong man."

"Hahaha." Zhou Congwen laughed, it was true.

"It's useless to learn more things. The basic sciences are just like that and haven't been developed yet. How can we avoid all the complications in clinical practice."

"Well, you're right."

"Let's take one step at a time. My timid operation cannot avoid accidents. By the way, a while ago, there was a patient in the People's Hospital who was awake during the operation, do you know?" Liu Wei began to gossip.

The scientific name for so-called intraoperative sobriety is intraoperative awareness.

This is an extremely terrible, even cruel situation. Hearing what Liu Wei said, Zhou Congwen sighed deeply.

"Did you know during the operation? What operation?" Li Qinghua asked.

"Neck enlargement surgery for thyroid cancer." Liu Wei also sighed, "The People's Hospital is also in a daze. The patient does not leave the stage after the operation, and keeps crying when he wakes up. He is so frightened that he is out of his mind."

"The patient won't react to the outside world, but in fact his consciousness is clear, and the surgery is one after another, like Ling Chi... It's really scary." Li Qinghua put himself into it, and shuddered involuntarily.

"If the operation is performed in this state, the patient will clearly feel every cut, ligation, and electric burn. Alas, there is no relevant statistical data in our country. The data in the United States is more than 60000 cases per year. know."

"!!!"

"so much!"

Both Li Qinghua and Liu Wei were stunned.

More than 6 cases, how could there be so many!In their opinion, intraoperative awareness is a very rare situation, neither Liu Wei nor Li Qinghua has encountered a single case in so many years.

Chapter 0451 Liu Xiaobie has kidney failure?

"Knowledge during the operation is too scary." Li Qinghua was stunned suddenly, "Why do we have to talk about this topic?"

Zhou Congwen shrugged, indicating that he didn't know either.

Anesthesiologist Liu Wei sighed, "Work carefully...Xiao Zhou, this kind of situation is very rare today, isn't it?"

"Yes." Zhou Congwen smiled, "It's like the probability of being hit by a car while walking on the road..."

"Stop!" Liu Wei stopped Zhou Congwen.

He didn't want to hear what was dead or alive.These words were too unlucky, Liu Wei stood up and prepared to go back and take a bath to get rid of the bad luck.

After a good operation, Liu Wei even wanted to use iodophor to disinfect himself when encountering subcutaneous ecchymosis on the lower limbs of the patient after the operation.

After sending Liu Wei away, Zhou Congwen returned to the office and sat down silently watching Shen Lang and the others work, recalling the situation encountered during the operation in his mind.

This kind of low-probability event is indeed extremely rare, and there is no way to solve it. All hope lies in the progress of basic disciplines.

For example, basic subjects such as physiology and biochemistry that no one paid much attention to when they were in school.

But when Zhou Congwen thought about these things from his previous life to this life, he didn't have too much emotion. He always felt that he had forgotten something, but he couldn't remember it all the time.

This feeling is very weird, Zhou Congwen's memory is not bad.

Although he was not the kind of person who looked at monuments on horseback in his previous life before the system, he never memorized phone numbers, and he could basically memorize books he had read once or twice.

With the system, it is even more powerful.

So he especially hates this feeling.

What is the matter?Zhou Congwen squinted his eyes to see people coming and going outside, and Shen Lang, Li Ran, Liu Di and the others were working.

Zhou Congwen's hands were not idle when he was thinking about things. A pack of No. [-] wire was knotted on the handle of the drawer, one by one, and the number of wires became less and less.

But the more he wanted to know what it was, the more he couldn't remember it.

When it was time to get off work, Zhou Congwen unknowingly drained a pack of No. [-] wires.

"I'm going home." Seeing that Corey was not busy, Zhou Congwen stood up to say hello to Shen Lang.

"Go, go." Shen Lang was already exhausted, and he slumped on the chair and answered Zhou Congwen.

Writing medical records by hand is very tiring, Zhou Congwen is aware of Shen Lang's fatigue.But if he wanted Zhou Congwen to help share the burden, he wouldn't do such a stupid thing.

Changing clothes and going home, Congwen was still thinking all the way last week.

When he walked downstairs and saw Liu Xiaobie eating candied haws on the balcony of the landlady's house on the first floor, Zhou Congwen was suddenly stunned.

He remembered something was wrong!

After returning home for almost 24 hours, I didn't see Liu Xiaobie go to the bathroom!

Because of that inexplicable dream, Zhou Congwen has been thinking wildly in his subconscious, which is something he didn't think of.

It turned out that Zhou Congwen didn't want to take Liu Xiaobie back. Girls in the city have never seen what a dry toilet looks like.

In the previous life, Zhou Congwen had a graduate student under him, and he took his girlfriend back to his hometown and had a fun time.

He and his girlfriend met their parents, who were very satisfied, and a young couple drank happily.As a result, the girls got high after drinking, but the highs that the fragments can go.

If you were in the city, you can imagine what would happen next. It would be a paid plot, or VIP×10, and the entire book would have to be blocked if it was sent out.

However, in the countryside where the boy came from, the ending turned into a dumbfounding one.

The girl was going to the bathroom. The boy saw her staggering and went in with her, but was kicked out.

Until he heard a "plop", he hurried in, and saw that the female ticket was not squatting properly, and fell into the dry toilet...