Chapter 2076 Lethal Dose

For Boss Zheng who came uninvited, Linge is still full of hope.

Boss Zheng is indeed awesome, but is there any good way he can do this kind of clueless consultation? Hope to have.

Linge looked at Boss Zheng expectantly.

"I agree with Professor Gu's opinion. It is systemic lupus erythematosus, and the diagnosis is relatively clear." Zheng Ren said in a deep voice.

"Boss Zheng..." The director of the gynecology department was taken aback.

The doctors in gynecology and obstetrics are the same in smaller hospitals. Although there are different departments in 912, the gynecology department has a deep understanding of obstetrics.

The intrauterine intervention that Boss Zheng just completed is nothing less than a fantasy to obstetricians and gynecologists.

But that's not just spreading rumors, Boss Zheng is full of confidence, and even dares to perform live surgery directly.

This is a powerful person, even the director of the gynecology department of 912 has the deepest admiration and even awe for Boss Zheng.

In the same words, what Professor Gu said is an attitude. But when Boss Zheng said it, he changed his attitude.

The director of the gynecology department hesitated for a moment, instead of condescendingly scolding Boss Zheng, he put on a posture of listening attentively.

"I read the records of the course of the disease. After the application of immunotherapy, the patient developed symptoms of palpitation and shortness of breath.

Considering acute left ventricular insufficiency, after diuretic and cardiotonic treatment, the patient's asthma improved, but the palpitations gradually aggravated. The reexamination of UCG showed that the LVEF was 36%, and the pulmonary artery pressure was 35 mmHg. "

Zheng Ren didn't look at the medical records, and said with a smile: "So far, the diagnosis still considers systemic lupus erythematosus. There is no evidence that heart valves, cardiac conduction system, and coronary arteries are involved, so heart failure may be caused by systemic lupus erythematosus involving the myocardium. As a result."

"It can be treated according to systemic lupus erythematosus, and the patient's condition has worsened." The director of gynecology asked.

Ringer was also puzzled, and the doctors in the office were all puzzled.

"I have several considerations for the aggravation of cardiac function damage under the application of hormones and immunosuppressants.

First, the original treatment plan was not strong enough. I agree with Professor Gu's point of view that shock treatment can be given to save the function of important organs.

Second, water and sodium retention aggravate cardiac insufficiency after the application of hormones, and similar symptoms may also appear.

third,……"

Everyone in the room fell silent.

Rheumatic immune diseases are indeed difficult to diagnose and treat. Even experienced clinicians may not even have access to rheumatic immunity.

The related diseases are complex and have various treatments, which is why Su Yun said that he went directly to rheumatism immunization when he encountered an incomprehensible disease.

As for the high-level rheumatology and immunology doctors, most of them will stand on the mountain of medical technology, look down on other disciplines, and say contemptuously, "Do they also see a doctor?"

Boss Zheng, a doctor in the interventional department, sits here and talks eloquently, firm and confident, which is really confusing.

"There seems to be a problem with the lungs." Someone asked in a low voice.

"The patient's lung texture is obviously thickened, which is an imaging finding." After hearing the question, Zheng Ren said with confidence.

"At this time, we need to judge whether the thickness of the lung markings is a lung infection induced by the application of hormones; or the manifestation of systemic lupus erythematosus in the lungs.

Of course, I just took a look at the patient.

The patient was indwelling a nasogastric tube due to intestinal obstruction, but he still vomited and coughed. In addition, he was bedridden, administered corticosteroids, and had aspiration, so aspiration pulmonary infection cannot be ruled out. "

This is the whole story, and it is similar to what the professor of respiratory internal medicine said before, and it is suspected of avoiding the important and neglecting the minor.

But Zheng Ren changed the subject and said: "However, fever, pulmonary symptoms, and aggravated cardiac insufficiency occurred at the same time, and the high-resolution CT of the chest did not reveal a clear infection focus in the lungs. Anti-infection is ineffective, and it is more likely to be systemic lupus erythematosus. due to the activity."

"It is written in the medical records that the patient is suspected to have Raynaud's phenomenon. I think this is one of the basis for Professor Gu's judgment."

"If you're worried..." Zheng Ren began to search for the rationality of the clinical diagnosis.

Under normal circumstances, the diagnosis of rheumatic and immune diseases is relatively erratic, and it is best to do a cystoscopy to take a tissue biopsy for the patient's condition. But the urologist also said that the condition of the bladder wall was not suitable for biopsy.

The best way is to biopsy the kidney tissue.

"My suggestion is to convince the patient's family to do a biopsy of the kidney." Zheng Ren said firmly, "The problem can be determined after the biopsy."

Linge felt that a big black pot was overwhelmed towards him.

The reason for diagnostic treatment is because the family members of the patient believed that nausea, vomiting, diarrhea had nothing to do with the kidneys, so they insisted that it was a problem with gynecological surgery.

Want a biopsy?

If someone else said that a biopsy was necessary, Ringer would not believe it all. This kind of operation is a fuse that may lead to intensification of conflicts. Once there is no positive discovery, it is difficult to say how the emotions of the patient's family members will change.

But if Boss Zheng said that, Ringer began to think about how to explain to the patient's family.

"If the patient's family agrees to the kidney biopsy, the result is positive, and a more radical treatment can be used." Zheng Ren thought for a while and said, "Methylprednisolone 1 g, pulse therapy once a day + intravenous immunoglobulin 20 g, Treatment was once daily. This was followed by a 1.0 g pulse of cyclophosphamide and hydrocortisone succinate 300 mg daily."

This dose...

If the judgment is wrong, it is enough to die.

Linge looked at Boss Zheng with a sad face. Is the dosage so high?

Cyclophosphamide 0.2g was used for one day, and the patient's myocardium was severely damaged. But Boss Zheng actually gave a dosage of 1g, this... this...

It's not easy to explain.

Ringer's thoughts flashed, and he had to be more cautious when thinking of lethal doses of medication.

He raised his head and glanced at Boss Zheng, with a gentle and steady smile, which gave Linger almost unlimited confidence.

There was silence in the office. Professor Gu looked at Zheng Ren with a surprised look. This dosage was the most extreme dosage he could imagine.

Although he just said that a large dose of shock treatment is needed, Professor Gu knew that it was basically impossible for him to use such an extreme amount of medicine to the patient.

With this amount of shock treatment, generally after the biopsy confirmed systemic lupus erythematosus. Before that, Boss Zheng said with certainty the dosage...

This Boss Xiao Zheng's guts must be too big. Is he a doctor in the interventional department or an expert in rheumatology and immunity?

After pondering for a while, Ringer closed the notebook and forced a smile, "How about this, let the patient's family members go to the medical office, and I will discuss with them about the kidney biopsy."

Ringer was forced to be helpless.

It is estimated that there will be an arduous battle at the medical office.