Section 106

If you come a little later, you may develop acute renal failure.

They still understand kidney failure.

So I became scared immediately.

"Doctor! How should my son be cured? Is it curable? Does this... need surgery?"

The family members held their son very dear.

If there is any sign that something is wrong, I will keep asking.

Zhang Yi was not annoyed. He patiently wrote out the checklist and handed it to them and said:

"First draw blood and test urine to see if creatine kinase is high. Don't worry, it can be cured as long as treatment is timely."

The family members took the inspection sheet with confidence and took their son out for inspection.

More than half an hour later.

The family members came back with several checklists.

Zhang Yi took a look.

White blood cells, neutrophils, etc. are all fine.

But creatine kinase is as high as over 300,000!

Creatine kinase: 321946 (normal 25-200u/l)

Creatase isoenzyme: 2866 (normal 0-20u/l)

Lactate dehydrogenase: 13281 (normal 109-245u/l)

Myoglobin: 4003 (normal 28-72u/l)

Creatine kinase, creatine isoenzyme, and lactate dehydrogenase are all enzymes found in muscles.

Generally it will not rise.

Only muscle damage, inflammation, drug reactions, etc. will increase it.

It is a must-check item for rhabdomyolysis and myocarditis.

Myoglobin is found only in striated muscle and cardiac muscle.

Generally, only necrotic muscles release myoglobin into the blood.

After reading the checklist, Zhang Yi didn't hesitate.

A large number of infusion orders were immediately prescribed.

This disease requires a large amount of fluids to flush out the accumulated protein substances in the kidneys.

Chapter 84 Gallbladder pain is not necessarily cholecystitis, it may be roundworms

The treatment for rhabdomyolysis is in addition to large amounts of fluids and electrolytes.

Also lose mannitol.

Mannitol is used to dilate blood vessels.

A large amount of protein material accumulates in the renal tubules, and mannitol can have a certain dilation effect.

In this way, protein substances can be excreted from the kidneys in time.

Also correct alkaline urine.

Each hospital has different rescue indicators for rhabdomyolysis.

Some hospitals will choose to perform blood replacement once the creatine kinase level exceeds 300,000.

That is hemodialysis.

why.

Because creatine kinase is too high, it proves that there are too many protein substances in the blood.

Blood replacement can quickly purify and filter out impurities in the blood.

Prevent patients from sudden acute renal failure.

Kidney failure is very dangerous and can easily lead to death.

Therefore, some doctors perform blood replacement for safety reasons or to prevent medical accidents.

But Zhang Yi considered that the child was still a high school student.

And the urine output has not reached the point of oliguria or anuria.

(The accumulation of protein material in the renal tubules will prevent urine from being excreted. The more protein material accumulates, the less urine will be produced.)

Therefore, active fluid replenishment treatment can almost return to normal after staying in the hospital for a few days.

Chen Fang prescribed an infusion order and also arranged for hospitalization in the nephrology department.

Call number, next person.

Knock knock knock.

There was a knock on the consulting room door.

I thought it was a patient who came in, but I didn't expect it was Dean Qian.

Dean Qian walked in with excitement.

The two of them greeted Qian Zhenggang.

Qian Zhenggang walked directly to Zhang Yi and asked him:

"Zhang Yi, I just came back today and heard about your surgery at the Imperial Capital Ping'an Hospital! Is this true?!"

Zhang Yi nodded:

"it is true."

I saw the muscles on Qian Zhenggang's face trembling slightly.

Good guy!

Awesome!

He actually went to the imperial capital for surgery!

"Haha! It's amazing!"

Qian Zhenggang praised Zhang Yi a few words and then left the consulting room thoughtfully.

Um!

Looks like it's time...

The second patient.

He is a little boy about ten years old.

Behind him were two old people, who should be his grandparents.

Their clothes are quite simple.

A pair of very old-fashioned dark cloth shoes with some mud on the edges.

I saw this little boy walking in with a painful look on his face.

There were still wet tears on her young face.

"What's wrong, kid? Are you feeling sick in your stomach?" Zhang Yi asked softly.

The little boy nodded: "My stomach hurts..."

Zhang Yi glanced at it.

There are roundworms in the little guy’s gallbladder! !

Zhang Yi put on a pair of gloves and gave the little boy a physical examination.

While pressing the abdomen, ask:

"Kid, when did you start having stomach pain?"

"I've been having a dull pain for several days...it suddenly became very painful this morning..."

As he spoke, the little boy couldn't help crying.

Gallbladder roundworm is a kind of abdominal pain that is like a roof-like sensation.

It's hard for adults to tolerate, let alone children.

Zhang Yi took the boy's temperature, which was 38.4°C.

Have a slight fever.

Then he reached out and gently pressed the little boy's gallbladder area.

Immediately the little boy screamed in pain.

"Ouch...it hurts..."