1novels Chapter 228 Ketoacidosis
Chapter 228 Ketoacidosis
The results of the inspection will come out soon.
Blood bicarbonate is less than or equal to 5mmol/L.
This is severe ketoacidosis...
Chen Dong frowned, as expected.
"Doctor, what's going on with me?"
He Wenwen's face was full of confusion, he couldn't understand any of the data on the list.
I don't know what disease I have.
Chen Dong said directly to Zhao Hua: "You go and inform the nurse station to send He Wenwen to the emergency room."
"emergency room?"
He Wenwen was dumbfounded when he heard these three words.
"Why didn't the doctor send me to the emergency room so well?"
"I'm not suffering from some terminal illness, am I?"
The patient has a certain right to know, and Chen Dong has no intention of hiding it from him.
"Your symptom is not gastric erosion but diabetic ketoacidosis."
Zhou Shanshan on the side was confused: "What is diabetic ketoacidosis?"
"Is this disease serious?"
Zhao Hua was a little dissatisfied that Zhou Shanshan interrupted Chen Dong: "Can you listen quietly?"
"Ketoacidosis is metabolic acidosis associated with the accumulation of ketone bodies. The most common cause of ketoacidosis is diabetic ketoacidosis, the other two are starvation ketoacidosis and alcoholic ketoacidosis Poisoned."
"And you have diabetic ketoacidosis."
Chen Dong said with a serious expression: "Patients with ketoacidosis may experience different degrees of disturbance of consciousness and coma in the late stage."
"How long has it been since you had a physical examination?"
He didn't even know he had diabetes.
He Wenwen was stunned and said, "It seems like three or four years."
Since he married Zhou Shanshan, Zhou Shanshan didn't allow him to have a medical examination.
The reason is because the physical examination is too wasteful of money.
Anyway, he didn't feel uncomfortable, Zhou Shanshan didn't think it was necessary to spend that unjustly money.
It's better to buy her two more clothes.
Chen Dong said helplessly: "When diabetes worsens, insulin deficiency leads to carbohydrate, lipid, and protein metabolism disorders. Not only does blood sugar rise significantly, but fat breakdown also increases."
"After the fat is decomposed into fatty acids, it cannot enter the normal decomposition pathway to provide energy, and is temporarily converted into the form of ketone bodies."
"That's why you have diabetic ketoacidosis."
Although He Wenwen didn't understand very well, he also realized the seriousness of this matter.
When he heard the bad news, he almost fainted.
"Don't panic."
The nurse on duty at the nurse station quickly pushed the bed in the emergency room over.
"Lie down."
Although He Wenwen felt that he was not so weak that he needed to lie down, he still chose to trust the doctor.
Zhou Shanshan on the side was not calm anymore: "My husband's illness is so serious?"
She wasn't worried about her husband's health, but she was afraid that these checks would drain her wallet.
This disease must cost a lot of money, and it is not worth spending so much money for a man.
Zhou Shanshan was really thinking about what reason to leave.
Chen Dong and Zhao Hua didn't focus on Zhou Shanshan either.
But when they came out of the rescue room, they found that Zhou Shanshan had disappeared.
"Where did the patient's family members go?"
Here are several agreements that need to be signed by the patient's family.
Because Zhou Shanshan had been sitting in the office just now, Chen Dong didn't pay much attention.
Who would have thought that she would sneak away.
He had just arranged He Wenwen's affairs.
He Wenwen's situation requires immediate fluid rehydration.
Rehydration therapy can correct water and electrolyte balance, lower blood sugar, and clear ketone bodies. It is also an important measure to correct shock.
At the same time, the biological effects of insulin can be fully exerted only after the effective tissue perfusion is improved and restored.The basic principle is "fast first, then slow, salt first, then sugar". For patients with heart and kidney insufficiency, excessive fluid replacement should be avoided.
So Chen Dong had to watch it himself, otherwise he wouldn't be at ease.
Nurse Xiaolan on duty in the nurse station saw this and said, "Doctor Chen, are you looking for that woman with heavy makeup and a short skirt just now?"
Chen Dong nodded: "Did you see her?"
"She just asked me about some patients, so I told her the truth."
"When she heard that the condition of ketoacidosis was very serious, she turned around and left. I couldn't even shout."
I didn't expect this woman to run so fast.
Chen Dong was going to laugh at Zhou Shanshan's coquettish manipulation.
"Go and call He Wenwen's other family members. He is in critical condition. Without his family's company, he will definitely not be able to stay in the hospital."
Zhao Hua nodded.
As a result, only Zhou Shanshan's phone number was left in He Wenwen's medical records.
However, He Wenwen himself is now in a coma, and they have no way of contacting his other family members.
Chen Dong gritted his teeth, forget it, he can't care so much anymore.
Rescue people first.
Chen Dong checked He Wenwen's current situation, and immediately said to Zhao Hua: "The situation is more critical now, and insulin must be replenished immediately."
Rehydration alone is no longer helpful.
Insulin is the key to the treatment of diabetic ketoacidosis. Reasonable supplementation of insulin can promote the body's utilization of glucose, reduce the breakdown of fat, reduce the production of acidic ketone bodies at the root, and improve symptoms.
"Insulin intravenously."
Short-term insulin needs to be given as a continuous intravenous drip.
Chen Dong opened He Wenwen's eyelids, and he could clearly see the edema of the optic disc.
He immediately frowned and said, "The patient has symptoms of cerebral edema."
This is also one of the accompanying symptoms of ketoacidosis.
Zhao Hua was taken aback for a moment, before he could even react: "What?"
"Don't just stand there, the patient's condition is very critical."
Really afraid of what to come.
He was just worried about whether there would be other accompanying symptoms.
Because there are many accompanying symptoms of ketoacidosis.
Unexpectedly, symptoms of cerebral edema appeared.
Chen Dong sighed slightly: "Mannitol."
Mannitol is the first choice dehydrating agent for the clinical treatment of cerebral edema after cerebral hemorrhage. 20 minutes after drug injection, the patient's intracranial pressure can be reduced by 50%. The drug achieves the strongest dehydration effect in 2 to 3 hours, and the effect can be maintained for 4 to 6 hours.
Now I can only use 20.00% mannitol to see if it can alleviate the symptoms of cerebral edema.
Otherwise, the diabetic ketoacidosis has not been resolved here, and the patient will fall into a coma due to cerebral edema.
Studies have shown that there is no significant difference in the dehydration effect of using 20% mannitol 250ml and 125ml once, but continuous use for more than 5 times can lead to the reversal of the blood-brain osmotic pressure gradient. Therefore, large doses and long-term use of 20% mannitol should be avoided in treatment. mannitol.
Therefore, Chen Dong cannot use mannitol for a long time.
If this does not work, other treatment options should be considered.
Chen Dong looked at Zhao Hua who was in a hurry and let him pass.
It's better for him to be more agile.
Zhao Hua secretly gave Chen Dong a thumbs up.
Your brother is still your brother!
No matter what time it is, it looks unruffled.
It seems that he still has to go back and practice more, otherwise he will be fine in this situation.
When Chen Dong said mannitol just now, he still hadn't realized it, what the hell was that?
In the end, Chen Dong found it by himself.
Zhao Hua admires Chen Dong from the bottom of his heart!