When doctors have a simulated operating room
Chapter 750
The transparent liquid medicine was quickly injected from the syringe.
The nurse's movements were also very quick. After injecting the medicine, she immediately connected the liquid tube hanging on the rack.
Zhang Yi's pressing action never stopped.
All the doctors around looked at Zhang Yi silently.
Kang Yanming frowned, and he looked at Zhang Yi's insistent look, and his heart was full of emotion.
He had planned to give up the rescue.
But looking at Zhang Yi's serious look, he couldn't help but be moved.
Will there be a miracle? ?
Will the miracle really always favor Zhang Yi? ?
This is multiple organ failure!
This is not a disease that can be cured simply by medication and CPR.
Unless Zhang Yi is really possessed by a god!
Otherwise, this person will never wake up!
Even if he really wakes up...
To put it another way, even if he really wakes up, he can't go into the operating room if his blood pressure can't be raised.
The prerequisite for any operation is the patient himself.
Only when the patient's own conditions are sufficient for the risk of surgery can he go to the operating room.
If the blood pressure has been below 90 or hovering around 90.
Even if such a patient goes to the operating room, he can't withstand the first cut.
Zhang Yi's operation is indeed like a god's help.
Almost no one in the entire Union Hospital can compare with Zhang Yi's operation.
But no matter how good the operation is, if the patient's own conditions are not good, it is also difficult for a good cook to cook without rice.
Take Zhao Xiaolong for example.
If he can really wake up, I'm afraid it's just a flash of life.
As long as the test results are not out, it will be impossible to determine whether he has pheochromocytoma.
Even if he is treated as a pheochromocytoma now.
But who knows which receptors this pheochromocytoma stimulates to secrete?
Alpha receptors? Or beta 1 receptors? Or beta 2 receptors?
Or all of these?
Different situations require different drugs.
First of all, the kidneys secrete a powerful neurotransmitter and hormone, which we call adrenaline in medicine.
Through the interaction with alpha and beta receptors, it plays a wide range of physiological effects.
On alpha receptors, adrenaline mainly causes vasoconstriction and increases blood pressure.
On beta receptors, adrenaline mainly causes an increase in the frequency and strength of heart beats, and can also cause vasodilation.
Originally, the two receptors and the body were good friends who were in a mutually balanced, mutually interactive, and mutually beneficial future.
But now it has changed!
Pheochromocytoma has appeared!
This bad guy has broken the beautiful balance between the two receptors and adrenaline in the body.
It destroys the friendship between alpha and beta receptors and adrenaline!
It may increase the number of alpha receptors, which will cause a sharp increase in blood pressure.
At this time, alpha receptor blockers are needed to inhibit its secretion and regulate the balance of vascular tension.
It may also increase the number of beta receptors, which will lead to an increase in heart rate!
At this time, beta receptor inhibitors are needed to inhibit secretion and prevent myocardial infarction.
Each possible treatment method is different.
And these two are completely different directions.
One may cause high blood pressure, and the other may be myocardial infarction or hypotension.
Once the wrong choice is made, it will only accelerate the patient's death.
That's why Kang Yanming finds it difficult!
Too difficult!
A life is in front of you, and the fork in the road is in front of you. Choose left or right?
Whether left or right, this is extremely stressful for doctors.
If the patient dies due to misjudgment.
Even if other colleagues don't say it and the family members don't care, for the doctor himself, this will be a lifelong psychological shadow.
What's more, Zhao Xiaolong's family members look so difficult to mess with. What if he really died in the emergency room.
I'm afraid that the emergency room will not have a quiet day for a long time.
Alas!
Everyone sighed silently in their hearts.
But they had to admire Zhang Yi's words and deeds.
He is really a good doctor.
Although they had repeated it countless times in their hearts.
But seeing Zhang Yi's persistence again...
They couldn't help but sigh: Zhang Yi, you are really a good doctor!
At this moment, Zhang Yi didn't know how the people around him saw him.
He only knew to rescue first!
Persist first, and once there is improvement, he will immediately send the person to the operating room.
However, before that, he had to gamble again.
The problem that Kang Yanming thought of was actually thought of by Zhang Yi.
What is the patient's pheochromocytoma?
Which receptor is secreted?
Is it α? Or β?
Zhang Yi was thinking while rescuing him.
All the test results about Zhao Xiaolong in his mind, from B-ultrasound reports to blood sugar values.
All flashed through Zhang Yi's mind one by one.
An increase in α receptors will cause the patient's blood pressure to increase...
Zhao Xiaolong has low blood pressure, which means that it may secrete β receptors...
However, there are also examples of lower blood pressure in very rare cases of increased α receptors.
α, β...
β, α...
Zhang Yi even asked the system for its opinion.
But the system's reply was:
[Please judge by yourself, there will be generous rewards for successful treatment~]
Zhang Yi: ...&%*¥#*! !
Okay.
Zhang Yi can only make his own decisions.
That's right.
Isn't this a good way to train yourself?
Just be careful, because every decision that follows can determine Zhao Xiaolong's life or death!
Think, analyze, judge, and finally come to a conclusion.
In just a few minutes, Zhang Yi's brain was working at high speed.
Finally, in a slightly solemn atmosphere, Zhang Yi suddenly raised his head and said:
"Add another set of medicine, 10 mg of propranolol hydrochloride, mixed with 100 ml of 5% glucose solution, intravenous drip."
As soon as this was said, everyone instantly knew Zhang Yi's choice.
He chose to use β-receptor inhibitors!
No matter how you choose, the result is life and death.
It is better to calm down and analyze and judge to give the most correct answer you think.
Anyway, no matter what the result is, Zhang Yi will take it.
Propranolol hydrochloride is a β-receptor inhibitor. If used to treat pheochromocytoma, it needs to be dripped three to four times a day.
"Prepare two more isoproterenol!"
The most common rescue drugs are norepinephrine, epinephrine, and isoproterenol.
Among them, norepinephrine is an agonist of α receptors, which means that it can bind to α receptors, but is not very interested in β receptors.
Epinephrine can bind to both receptors.
Isoproterenol is not interested in α receptors, but can bind to β receptors.
Generally, when rescuing, the type of epinephrine to be used will be determined based on the patient's condition.
For example, Zhao Xiaolong now.
Zhang Yi has decided to use a β receptor inhibitor, which means that the pheochromocytoma in his body secretes β receptors.
In other words, he now has a lot of β receptors in his body.
Although propranolol can play a certain inhibitory role in this case, the side effects are also quite large.
So other epinephrines cannot be used as rescue drugs at this time.
Isoproterenol must be used.
"
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