Start From Emergency Doctor

Chapter 109

“what’s the situation?”

Zhou Yuan asked as he hurried to the obstetrics and gynecology department with Lu Chenxi.

Lu Chenxi’s face was very ugly, and said, “The two patients have been under surveillance and there is no problem. Just now, the older one started to have a fever and twitched all over!”

Outside the rescue room, the patient’s parents were crying.

They never expected that the child who had completed the skull separation operation would be pushed into the operating room again.

Zhou Yuan quickly changed his clothes, finished preparations before the operation, and entered the operating room.

“Zhou Yuan!” When Wei Lili saw Zhou Yuan, she didn’t know why she suddenly relaxed a little.

“The patient’s physical condition.” Zhou Yuan stepped forward and asked.

Wei Lili said: “Preliminary judgment, children with epilepsy!”

Zhou Yuan frowned.

Pediatric epilepsy is a common neurological syndrome with complex etiology and recurrent episodes in childhood. The clinical manifestations include recurrent muscle twitches and so on.

“High fever and whole body convulsions, we judged that it was caused by epilepsy in children!” He Jing probed the patient’s body temperature, her face changed slightly, “It’s already 39.5 degrees Celsius!”

The baby lying on the operating bed twitched, his lips were bruised.

This is a symptom of epilepsy in children.

But… I am not good at pediatric epilepsy. In this respect, I am definitely not as good as Wei Lili, and even not as good as He Jing, who came to study. Why do you come here?

Wei Lili seemed to see what Zhou Yuan was thinking, and said: “We have done routine blood, urine, and stool tests before. Blood biochemistry showed that the patient’s sugar, calcium, phosphorus, and electrolytes were within the normal range. Liver and kidney functions were not in the normal range. Abnormal, normal chromosomes…”

“Furthermore, I asked the patient’s parents. They have no family genetic history, so I basically rejected primary epilepsy!”

The so-called primary epilepsy refers to epilepsy in which no cause has been found, most of which are genetically related. This part of epilepsy patients accounts for about 20% of the total number of epilepsy patients, and is also called cryptogenic epilepsy or hereditary epilepsy.

The opposite is called secondary epilepsy, or symptomatic epilepsy, which has specific causes.

Zhou Yuan glanced at Wei Lili and said, “Do you mean that epilepsy in children is related to the brain?”

I just finished the skull separation operation, and I want to know that there is a high probability that it is a problem in the head, which is likely to cause postoperative complications.

Wei Lili nodded solemnly and said, “We suspect that it is the epilepsy in children caused by cerebrovascular disease!”

Zhou Yuan frowned: The most worrying postoperative complications still appeared.

This thing cannot be avoided by technology.

Sure enough, the skull separation operation for conjoined children is not so simple. Even if the operation is completed, it only means that a dangerous period has passed.

“EEG examination!” Zhou Yuan said.

The skull separation surgery gave Zhou Yuan a mastery of brain structure.

He now wants to confirm the cause of epilepsy in children. If it is a tumor, he can only immediately ask someone from the Department of Neurosurgery and Neurology to come for consultation and remove the tumor.(Read more @ wuxiax.com)

Wei Lili nodded: “It’s already ready, He Jing, you should get the order, it should be out.”

He Jing ran out quickly and came back soon.

“It’s epilepsy…” After reading the EEG, Zhou Yuan determined the type of disease.

“Single-light emission tomography and positron emission tomography are now performed!” Zhou Yuan said.

These two auxiliary methods are needed in skull separation surgery to detect cerebral blood flow and brain metabolic function respectively. Now it is just right to understand the changes in brain function and help locate epilepsy.

“Also… for cerebral angiography!”

Zhou Yuan said quickly.

Soon, the results came down.

“Children’s epilepsy caused by subarachnoid hemorrhage!” Zhou Yuan said.

Subarachnoid hemorrhage is a general term for the sudden rupture of cerebral blood vessels caused by various reasons and blood flow to the subarachnoid space. In skull separation surgery, because the originally symbiotic brain operates independently, a series of complications will occur. This is one of the most serious ones.

“Issue a critical illness notice immediately!”

“Inject nimodipine!”

“Give 6-aminocaproic acid!”

Zhou Yuan calmly gave a series of orders.

Nimodipine is a drug to prevent and relieve cerebral vasospasm, as long as it is to control the condition, and 6-aminocaproic acid is a hemostatic drug.

As Zhou Yuan said, he quickly walked out of the operating room, “You control blood pressure and intracranial hypertension as soon as possible! Contact neurology and brain physicians and ask them to come for consultation as soon as possible!”

Now he must get the blood angiography results immediately to confirm the cause of hemorrhage in the subarachnoid space. If it is really a rupture of the cerebral blood vessels caused by tumors, he must ask the neurology department for resection.

“Doctor, how is my child!”

Seeing Zhou Yuan hurried out, the patient’s parents ran up anxiously.

Zhou Yuan looked a little ugly, and said, “You need to sign the critical illness notice!”

The patient’s mother weakened her legs and slumped on the ground, her expression dull.

“Why…why! Hasn’t it been rescued? Why…”

The nurse quickly sent a critical illness notice, and the patient’s father picked up the pen, his hands shaking so much that he couldn’t see what was written.

Zhou Yuan quickly got the blood imaging results.

“Fortunately… it’s not an aneurysm or a ruptured blood vessel at the base of the brain.”

If the aneurysm ruptures, the situation will become very dangerous and life-threatening at all times. Even if you can save your life, you may become a vegetative person.

Fortunately, only the superficial cerebral blood vessels ruptured.

When Zhou Yuan hurried back to the operating room, Xiao Xuebo had already arrived.

“The blood pressure has risen back, and the intracranial hypertension has also been controlled.” He Jing said.

Zhou Yuan explained the cause again, and everyone was relieved.

Although everyone was relieved, it by no means meant that it was not dangerous.

Complications near the brain can be fatal to any one, but it is better compared to the others.

“Director Xiao, you come for the craniotomy, and I will stitch it up.”

Xiao Xuebo nodded.

The nurse then sent the informed consent form and critical illness notice to the family members.

A second craniotomy for a baby who has just completed a skull separation operation is dangerous, but in the face of this kind of postoperative complications that cannot be avoided with technology, it can only be done.

“Scalpel.” Xiao Xuebo cut through the artificial skin along the incision line Zhou Yuan drew.

Zhou Yuan had left the operating room and ran again for preoperative disinfection and so on.

“It’s almost done.” Xiao Xuebo said when he saw Zhou Yuan walk in with his hands raised.

Zhou Yuan: “Not bad.”

Hearing Zhou Yuan’s praise, Xiao Xuebo was overjoyed. Like the praised elementary school student, he smiled and said, “That is! I am also the director of brain surgery anyway!”

After saying this, Xiao Xuebo’s expression suddenly stiffened.

What a…

Lao Tzu is the director of brain surgery and was praised by an intern. I am so happy! !

Suddenly, Xiao Xuebo’s whole person was not well. .