Those years when I hung up and upgraded in the hospital

Chapter 29 Pharmacology and Physiology (Please collect and read)

Long Quan said nothing, while Luo Su and Qin Chaowen looked at each other.

However, considering that Fang Yun's score on the basic theory of surgery is as high as 76 points, it is estimated that the basic theory of internal medicine is not bad, so some particularly detailed things are their blind spots.

"Thrombi may be divided into two types. One is the thrombus caused by the deposition of fibers by thrombin, which is also our common thrombus. Generally, low molecular weight heparin, nadroparin calcium or rivaritaban, an anti-thrombin drug, is used. , there will be better results.”

"The same goes for warfarin."

"But in fact, there is a kind of blood clot called white blood clot, which is simply a blood vessel blockage caused by platelet deposition. Such blood clots cannot be removed by some of the above drugs that only target thrombin."

"Sometimes, we use aspirin for preventive anti-thrombotic treatment, which can only prevent thrombosis deposition, but surgical thrombosis is mostly caused by abnormal coagulation function..." Fang Yun explained the reason.

In summary, it may be that the medicine is not suitable for the patient, but many people do not realize it.

And if the patient does not develop thrombosis after surgery, then the two preventive anticoagulant drugs are almost the same.

It's not deep vein thrombosis or arterial embolism, it's just capillary blockage, which cannot be detected by color ultrasound.

"Aspirin has a risk of bleeding. What if there is serious local bleeding after taking it?" Longquan is relatively conservative and still has some resistance to drugs like aspirin.

In orthopedic trauma surgery, similar drugs have not been used for a long time.

"Seeing blood is not necessarily a bad thing. At least the blood circulation is clear and can effectively fight inflammation. After the infection is controlled, it is not difficult to stop the bleeding."

"The contraindications for aspirin are those who have recently undergone major surgery, but major surgery on non-internal organs, so even if bleeding occurs, we can see it with the naked eye."

"It's controllable." Fang Yun directly explained the reason why aspirin was banned during recent major surgeries.

"In other words, can I try it out?"

"I think we can give it a try. The drug distribution of piperacillin and sulbactam sodium is mostly in the tissues. Even if it is used for bleeding, as long as part of the drug reaches the nearby tissue fluid, the space for bacterial reproduction and settlement will be limited."

"If it cannot continue to reproduce, then after this batch of bacteria dies and lyses, the infection may be controlled. This is my thinking."

"It's up to you, Director Long, to make the decision. After all, I don't have enough experience." Fang Yun said honestly.

Fang Yun had never encountered a similar case at Longxian Second People's Hospital before. He just explained the pharmacology more clearly through theory.

Whether it can be used or not, the decision lies with Longquan.

"Use it for a few days first. Remember to come over and observe the wound at any time. If you notice bleeding or an increase in bleeding, you must go to the operating room immediately."

"I'll discuss it with the patient's family to see if they can accept such a risk." Long Quan agreed.

Fang Yun nodded: "Thank you, Director Long."

"There's no need to thank me. Her son is doing well in the county and has complicated relationships. No matter how you talk to him, you still can't avoid asking me directly why."

"Instead of causing more troubles, it would be better for me to talk to him myself. This is a very common thing in the county."

……

After Long Quan left, Luo Su and Qin Chaowen looked at Fang Yun, and their expressions changed slightly.

"Xiao Fang's basic skills are very solid. I just searched and found out that the classification of blood clots is really very different."

"But this seemed to be about physiology before?" Qin Chaowen himself didn't know how to do it, but now is the information age.

"It's discussed more in pathology."

"White blood clots are mostly mural thrombi, which are also places where germs tend to accumulate, Brother Wen." Fang Yun replied with a smile to Qin Chaowen.

At present, surgical infectious diseases cannot find a suitable solution, and Fang Yun can only explore solutions from the perspective of pharmacology. At least having a new solution is an attempt.However, after Fang Yun finished his reply, Xu Dong added: "Aspirin actually has another advantage, that is, it is an anti-inflammatory and analgesic in itself. All wounds have non-infectious inflammation, even if they are infected."

"Reducing inflammatory factors will reduce the formation of local pannus, and the nutritional supply of bacteria will also be affected."

Xu Dong started pushing from the beginning, and his skill was not that strong.

But after the complete plan came out, when he recalled the theory inside, it was quite solid.

But Fang Yun understood what he meant: "Aspirin is a non-selective non-steroidal drug. The patient is an elderly woman. I will also pay attention to the protection of the gastrointestinal tract. Thank you Xiao Xu."

Xu Dong was very sensible and waved his hand quickly: "Brother Yun, you must have thought of it, I just mentioned it."

Luo Su and Qin Chaowen looked at each other, and then Luo Su said: "If you two can stay, then we will be happy as a team."

Fang Yun and Xu Dong were also helpless.

In fact, it would be great if there could be no competition and everyone could work together.

But in this way, the number of people is relatively heavy, the financial burden is aggravated, and the number of patients still cannot be increased.

……

Time flies by.

Three days later, when Fang Yun was changing the dressing, he saw blood on the stump. Seeing the blood, Fang Yun and the old lady were both a little happy.

The old man asked: "Doctor Fang, am I half healed after seeing the blood?"

Fang Yun was carefully wiping the wound: "Half is a bit exaggerated, but a third is still possible. A small amount of blood leakage can bring anti-inflammatory drugs to the bacterial gathering place. In fact, it is discarded first and then taken." A way of thinking.”

"Grandma, we can look forward to it. If the follow-up anti-inflammation is effective, that will be great. Even if we go to a big hospital, it will be relatively simple."

Fang Yun also noticed that although there was blood oozing, there was already some blood in the area, and the pus spots on the stump of the wound were also decreasing.

The disease comes like a mountain and disappears like a thread. Now we just wait to starve the existing bacteria to death or die of old age.

In fact, many people misunderstand anti-inflammatory drugs.

Directly killing existing bacteria is nonsense, as it usually only kills their offspring.However, the lifeline of a single bacterium is not long, and there are still a large number of white blood cells and monocytes in the body to engulf it.

It is the role of anti-inflammatory drugs to make bacteria become orphans, and after they all die of old age, their successors will become sterile.

But there is no need to explain these.

At this time, his son also came on leave. Looking at the faint blood stains on the gauze, he asked: "Doctor Fang, my mother's wound is bleeding again. It should be okay, right?"

"It doesn't matter if you bleed a small amount, it's not a major hemorrhage. Our human body can make up for the loss of such a small amount of blood." Fang Yun explained, "In exchange, the blood supply nearby will be smooth."

"Okay, thank you Dr. Fang. Director Long is full of praise for you. Including the former Director Chen, we also fully support you. If you can cure my mother, our whole family will be grateful for your kindness." He held his fists in his hands and his voice was choked with sobs.

He should also be a filial person.

"Brother, this is my job. It's hard to say yet. It's not good to be too optimistic in advance. You can only wait and see." Fang Yun didn't want to be lifted up and then fall to pieces.

"What the hell, I've been disappointed so many times. Even if I'm disappointed again, I won't blame you, Doctor Fang." He was very sensible.

After a while, other family members of the old man also arrived...

(End of this chapter)