When doctors have a simulated operating room

The patient was not allowed to bleed for a long time.

Xiao Long shook his head: "No, Director Kang said to observe for one night. If there is no bleeding tonight, don't do it. If there is still bleeding, check it tomorrow morning."

Zhang Yi exhaled lightly and said:

"Doctor Xiao, my suggestion is to check it now! This patient can't wait. Who can bear the repeated bleeding?

There is indeed only more than 20 milliliters of bleeding in the drainage bag at this time, but there is no guarantee that there will be heavy bleeding later.

So quickly draw blood for the laboratory to check whether it is a coagulation gene defect!"

Zhang Yi spoke in a loud tone.

Xiao Long was stunned.

"Check it now?" Xiao Long said in a daze.

"Yes, check it now, check it quickly.

Although the family members said that there has never been unexplained bleeding, as doctors we have to be cautious.

What if he is hemophiliac!"

Looking at Zhang Yi's small leader look, Xiao Long felt a little unhappy.

You are awesome, but you haven't been in the hospital for a few days, right?

This leader's airs come out? ?

Oh!

Forget it!

I am just a small doctor, and Zhang Yi is a serious leader in the future.

I... better not offend him.

"Okay, I will give a doctor's order and ask the nurse to draw blood."

The results of the genetic test usually take four or five days to come out.

During this period, we can only try to control the patient's wound so that it does not bleed.

While giving medical advice, Xiao Long muttered quietly:

"I'm really confused. If it's hemophilia, why has this person never had unexplained bleeding before?

Bleeding while brushing teeth should be very common.

But this patient has always been healthy and had no problems before admission. Oh... this is strange!"

The next second!

He suddenly raised his head again!

"Oh, right! Could this person... have a subclinical coagulation gene defect?!"

Coagulation gene defects are also classified.

Severe, moderate, mild and subclinical.

Take hemophilia A as an example.

Severe hemophilia A means that the content of FVIII gene factor is the lowest, which can be less than 0.01U/ml (100%).

In contrast, the symptoms of severe patients are also the most obvious, such as spontaneous recurrent bleeding, internal organs, joints, skin, etc., and the mortality rate is very high.

The symptoms of moderate patients are lighter than those of severe patients. There will be spontaneous bleeding, but most of them will bleed heavily after trauma.

Mild patients basically do not bleed spontaneously, but bleed only after trauma.

Subclinical type, which is the mildest type.

The symptoms of this type of patients are not obvious since birth, and there will be no spontaneous bleeding or bleeding when brushing teeth.

They will only bleed abnormally after surgery or major trauma.

This type of patient is the most difficult to detect coagulation gene defects.

Just like this Wang Bin.

There has never been any symptoms of hemophilia, and he has always been healthy.

There is nothing wrong with the basic examination for admission.

So it is difficult for doctors to consider this point.

Unexpectedly, he came to the hospital to cut a small hemorrhoid, which led to three operating rooms.

This situation is too rare!

Thinking of this, Xiao Long also got excited!

After instructing the nurse, he quickly said to Zhang Yi:

"I guess it might be hemophilia, but it's the rarest subclinical type!

This type is the least likely to be discovered and is also a relatively mild type.

But if the bleeding cannot be stopped, it will be life-threatening."

Zhang Yi turned his head and glanced at Xiao Long, who was excited, and said calmly:

"That's why I asked you to check it quickly to see which type of coagulation factor is missing."

Xiao Long laughed twice.

Although the results are not out yet, Zhang Yi can think of this as soon as he arrives, which shows that his brain is really fast.

If it weren't for Zhang Yi's reminder, Xiao Long actually wouldn't have thought of this.

"Okay, then you guys go ahead, I'm leaving get off work first. If you need anything later, you can come to the cardiac surgery department to ask for my help.

By the way, if this patient keeps bleeding, I suggest you take a gamble."

Xiao Long frowned: "What do you mean?"

"Let's bet that this patient has hemophilia, transfuse FVIII's blood and FIX's blood together to see if it can stop the bleeding."

Xiao Long stared at Zhang Yi in shock, and saw Zhang Yi leave the emergency department with his hands in his pockets after he finished speaking.

He was so hungry that he went out to eat something to fill his stomach.

Behind him, looking at Zhang Yi's slightly tall and handsome back, Xiao Long couldn't help saying:

"Good man, you can bet on this..."

Of course, Xiao Long said so.

But if the patient continues to bleed, he will still do what Zhang Yi said.

Because all the methods have been tried before.

The whole emergency department has tried all the available methods, including interventional hemostasis, but it still doesn't work.

Then we can only consider rare diseases.

If there is a big bleed at that time, we can only ask the blood bank to prepare this special blood for emergency.

If it works, it means that the bet is right.

If it doesn't work, then their doctors have really tried their best.

Although the patient has bled several times since being hospitalized, they are also trying to find the cause and trying to rescue him.

The patient was indeed admitted to the hospital for hemorrhoidectomy, which caused all this.

But the essence is not because the hemorrhoid surgery was not done well, but because of the unexplained bleeding on the patient.

Xiao Long turned around and went back to the office.

A doctor who was working overtime quickly told Xiao Long:

"Director Kang called and asked you to quickly order a doctor to check the coagulation gene. He said he would be at the hospital soon."

Xiao Long nodded calmly:

"I have already done it. The nurse has drawn blood and sent it to the laboratory."

"That's good. I heard Director Kang's tone was quite anxious on the phone."

"It's okay. The amount of bleeding is not large and can be controlled. You can leave work quickly after you finish it. It's almost nine o'clock."

"Okay, I'll leave right away."

...

Ten minutes later, Kang Yanming rushed to the emergency room.

Kang Yanming, wearing a casual down jacket and cotton slippers, rushed to the hospital after receiving the call.

The family members sitting outside the emergency room glared at Kang Yanming and were too lazy to say hello to him.

Kang Yanming didn't care about so much and went straight to the emergency room.

As soon as he came in, he looked at the bed in charge of patient 3 and found that he was bleeding again.

But it's not much at the moment, about 30 milliliters.

"Director Kang, this is the CT and colonoscopy results that just came out. Another mesenteric blood vessel ruptured and bled!"

Seeing Kang Yanming coming over, Xiao Long immediately presented the test he had just done.

Kang Yanming looked at it and asked:

"Have you done the coagulation gene?"

Xiao Long nodded: "It has been done, the one just now..."

Seeing Xiao Long hesitant to speak, Kang Yanming turned his head and looked at him and said:

"What happened just now? Why do you stop talking halfway? Say whatever you want!"

"Zhang Yi came to the emergency room just now. He said he suspected that this patient had hemophilia."

Kang Yanming narrowed his eyes slightly, frowned and asked:

"What is Zhang Yi doing in the emergency room? When did he come? Is he here specifically to see patient Wang Bin?"