Yantai Yuhuangding Hospital helps critically ill patients ＂return＂ on the line of life and death through multidisciplinary treatment.
Qilu Evening News Qilu Yidian reporter Sun Shuyu correspondent Li Chengxiu Li Lingfeng
The brightly lit intensive care unit, the ticking sound of instruments and the hurried steps of medical staff constitute 24 hours for each ICU patient. Under the seemingly calm appearance, there are hidden moments of life and death, just like what Lv Li (pseudonym) experienced a week ago.
When the name of Lv Li (a pseudonym) is mentioned, the doctors in many disciplines of Yuhuangding Hospital in Yantai are worried. On November 25th, they pulled the 24-year-old critically ill patient who had just become a "mother" back from the line of life and death, and tried their best in the speed of life and death caused by "abdominal pain".
Thrilling: she was seriously hospitalized, and her many indicators were life-threatening.
What’s wrong with Lv Li (a pseudonym)?
"Severe metabolic acidosis with respiratory alkalosis decompensated, severe lactic acidosis, hyperkalemia, multiple organ dysfunction (heart, kidney, liver, blood) …" These awkward professional terms were written in her case at the same time. The reporter learned from the mouth of Li Meifeng, deputy chief physician of ICU that just taking out one of them has reached the level of "critical illness", each of which is life-threatening.
In the hospital bed, the impression of Lu Li (pseudonym) still stays on the night of abdominal pain. "The whole stomach hurts, causing pain all over the body. Later, my legs became soft. I thought it was a bad stomach, but I didn’t think it was so serious." Returning from the line of life and death, her spirit is gradually recovering. After seeing the reporter, she can even stretch out a complete smile. What supports this smile is the unremitting efforts of doctors from many disciplines in the hospital.
"Generally speaking, she is a severe hemolysis with spleen rupture, and her scientific name is PNH (paroxysmal nocturnal hemoglobinuria) with spleen rupture." Li Meifeng said. Recalling the process of treating Lv Li (a pseudonym), she repeatedly mentioned three words "thrilling", "risk" and "unity".
On November 23rd, Lv Li (pseudonym) was admitted to the Department of Hematology, Yuhuangding Hospital, Yantai with a rare case of "severe hemolysis".
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On November 25, her condition deteriorated sharply, and the most obvious symptoms were acute wheezing and dyspnea. Her breathing frequency reached 40-50 times per minute, which was four times that of normal people, and she was quickly transferred to ICU for treatment. Liang Yafeng, the chief physician of ICU, quickly mobilized the command, and Li Meifeng, the deputy chief physician, and Li Ling, the attending physician, gave him rescue treatment such as tracheal intubation, mechanical ventilation, deep vein catheterization, bedside CVVH, etc. From 10: 30 a.m. that day until 6: 00 a.m. the blood gas was checked every two hours, and the treatment was constantly adjusted. Finally, Lu Li (a pseudonym) was rewarded with good news that her environmental indicators were normal.
Major: Multidisciplinary consultation, doctors looking for "hope for life" for her.
Not relieved, ICU doctors found that Lu Li (pseudonym)’ s abdominal pain and bloating continued to worsen, and hemolysis remained severe. "Is it mesenteric arteriovenous embolism leading to intestinal necrosis, or abdominal bleeding? It is necessary to improve the abdominal enhanced CTA to clarify the reasons. " Chief physician Liang Yafeng did not dare to delay for a moment, and mobilized the team to do their duties. Li Meifeng persuaded her family members and quickly started the green passage in the hospital. The doctors trotted all the way to send Lu Li (pseudonym) on the ninth floor to the examination room on the second floor with ventilator, oxygen bottle and monitor. The examination process that originally took one hour was all over in just 20 minutes, and the diagnosis of "intestinal necrosis caused by mesenteric arteriovenous embolism" was ruled out.
Then, what is the reason that leads to the progressive aggravation of abdominal pain and the non-coagulation of abdominal puncture? The patient’s hemoglobin and platelets are still declining dynamically, and the situation is critical. In order to clarify the cause, the ICU of Yuhuangding Hospital in Yantai immediately started a multi-disciplinary consultation, including Li Meifeng, deputy chief physician of ICU, and Li Ling, the chief physician of Department II of Gastroenterology, Wang Yuanli, chief physician of obstetrics, Liu Yinghui, deputy chief physician of hematology, Sun Lichen, chief physician of hepatobiliary surgery, and Sun Fubo, attending physician, immediately rushed to the ICU for case discussion. The result of the discussion is-do laparotomy immediately!
This means that both doctors and patients will face great risks, and patients will suffer from massive bleeding, shock and even death if they are not careful. Outside the ward, the family members who heard the news were crying, and they didn’t know how to choose.
Looking at Lu Li (a pseudonym) in the hospital bed, Li Meifeng couldn’t calm down for a long time. She was anxious to persuade her family again: "She is still so young, only 24 years old. She just gave birth to a child and became a mother. The child needs to be fed. Only by laparotomy can we further clarify the cause, and she will have a chance. If she doesn’t do it, there is really no hope."
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Rescued: face the risk and rescue with all her strength. She recovered and transferred to the general ward.
Finally, with the consent of the family members, the chief physician of gastrointestinal surgery Gong moved forward quickly and walked into the operating room without hesitation under great risks and pressures. After laparotomy, it was found that Lu Li (pseudonym) spontaneously ruptured her spleen. Immediately, Sun Lichen, chief physician of hepatobiliary surgery, took the scalpel and performed splenectomy. Happily, it is precisely because of the highly responsible spirit, exquisite technical expertise and seamless close connection of doctors in various disciplines that Lu Li (pseudonym) was finally pulled back from the line of life and death.
When the reporter saw Lu Li (a pseudonym), she had been transferred to the general ward, and the news spread from every doctor who had heard of her and treated her, and everyone was happy for her recovery.
Chief physician Liang Yafeng told the reporter an episode. On the morning after the operation, she heard that Sun Lichen, director of hepatobiliary surgery, had received seven or eight phone calls early in the morning, all of which were concerned about the situation of Lv Li (a pseudonym). "The doctors who have contacted this patient in the whole hospital are very concerned, because she (the patient) is so young and has just given birth to a child for less than a month. Everyone is paying attention to the surgical results and wants to know if she has survived." Liang Yafeng said, "Thanks to Deputy Chief Doctor Li Meifeng, her effective communication with her family made the operation go smoothly and gave patients more hope for life."
It can be seen that the recovery of Lv Li (pseudonym) is the result of the joint efforts of doctors in the whole hospital. In this thrilling and risky treatment, they used the spirit of unity and cooperation and superb professional skills to overcome difficulties, save lives, preserve the integrity of a family and retain maternal love for a little life who just came to this world.
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