Section 216

These are all renal failure, that is, the systemic reaction caused by kidney strike!

"Oh my, after hearing what you said, I also think it is renal failure!"

When the two were thinking, the patient with gastric ulcer came in with a check list:

"Doctor, my results are out. This is the gastroscopy result, and this is the blow test."

Zhang Yi took the check list and looked at it.

The two pictures of the stomach on the gastroscopy list showed two small sunken ulcers in the wrinkled stomach bend.

Carbon 13 breath test, 30 minutes DOB value> 23.0.

Carbon 13 is positive as long as it exceeds 4.0.

So this person is a gastritis infected by Helicobacter pylori, and then slowly developed into gastric ulcer.

Helicobacter pylori is not incurable. Combined with antibiotics, the symptoms will be relieved a lot after taking it for half a month.

Also take drugs to inhibit gastric acid.

Helicobacter pylori will accelerate gastric acid secretion, which will cause ulcers.

Insist on taking medicine and take good care of the stomach, and ulcers can still be cured.

After prescribing medicine for the patient, the patient left.

Until noon when he was about to go to lunch, the young man with renal failure had not returned.

This made Zhang Yi a little worried.

From Zhang Yi's perspective, this man was indeed suffering from renal failure.

It was still chronic renal failure, and the atrophy of the right kidney was more serious than that of the left kidney.

I don't know how this young man could be so patient in the early stage? !

He actually waited until he had severe hematuria before coming to the hospital for treatment.

Alas!

The more I thought about Zhang Yi, the more I felt sorry.

This young man... is not easy to treat!

Suddenly, when Zhang Yi and Chen Fang walked downstairs of the inspection building and were about to go to the cafeteria.

A cry suddenly came from the second floor:

"Come on, doctor! Help, someone fainted!"

Chapter 166 Sudden death! Rescue quickly

Zhang Yi and Chen Fang looked at each other.

This voice...

Why is it a little familiar?

It seems to be the voice of the girl in the clinic this morning.

I didn't even bother to eat lunch.

Zhang Yi and Chen Fang hurried to the second floor.

As a result, it turned out to be the young man with kidney failure and the girl who came to the hospital with him.

The young man was lying on the ground with his eyes closed!

The girl was squatting on the ground and shouting: "Woo woo... Doctor, come and have a look! He fainted!"

Zhang Yi rushed forward with a brisk step.

He found that the young man's carotid artery pulse disappeared and he did not respond to calls.

He suddenly suffered ventricular arrest!

That is, sudden death!

He must be rescued quickly!

Zhang Yi said to Chen Fang while doing cardiopulmonary resuscitation:

"Push the stretcher to the emergency room quickly! This person is in ventricular arrest!"

Chen Fang also borrowed a stretcher from the ultrasound room next door.

The two lifted the young man onto the stretcher, and Zhang Yi pressed and ran after the stretcher.

"Quick! Make way! Please make way!"

The family members passing by saw this situation and consciously made way.

On the other side, the doctor on duty in the emergency room heard the hurried footsteps and the sound of the wheels of the stretcher from a distance.

When he looked outside, he saw that it was Assistant Zhang and Doctor Chen who were pushing the patient to the emergency room.

The staff on duty then consciously pushed the rescue medicine cart over.

"Oxygen, ECG monitoring, and intravenous access are all on!"

"One epinephrine, one lobeline and one dexamethasone!"

Zhang Yi immediately ordered after entering the emergency room.

"Okay!"

As soon as Zhang Yi spoke, the two nurses in the emergency room immediately took action.

After the medicine was injected, the heart rate and breathing increased significantly.

But the heart compression cannot be stopped.

We have to persist until the boy recovers his heartbeat and breathing.

"Add another lidocaine!"

"Okay."

Six minutes later, the rescue was successful.

The boy's heart resumed its autonomous beating.

Zhang Yi also breathed a sigh of relief.

Renal failure does cause sudden death.

And the cause of sudden death is hyperkalemia.

The kidneys have two main functions, one is filtering function and the other is endocrine function.

The urinary system of the kidney is like a sieve of the human body.

After the blood passes through the kidneys, the metabolic waste inside, such as urea nitrogen, creatinine, uric acid, etc., will be excreted from the body with urine.

Substances such as protein and fat will remain in the body.

The bad ones will be sieved out and the useful ones will be left. This is a normal kidney filtering function.

However, when kidney failure occurs, the filtering function is impaired, creatinine, uric acid and urea nitrogen cannot be excreted, and the long-term accumulation of these things will cause acidosis, edema, increased blood uric acid, and electrolyte disorders in the human body.

Among them, the accumulation of potassium ions that cannot be excreted will cause hyperkalemia.

(Hyperkalemia is very likely to cause arrhythmia and sudden death.)

The next is the endocrine function.

When the kidneys are damaged, they will secrete a substance called renin.

Originally, renin is secreted normally and will not cause harm to the human body under normal circumstances.

But once the kidneys are damaged, the blood flow to the kidneys decreases, and the endocrine nerves of the kidneys are disordered, renin will be secreted in large quantities without control.

When renin is high, blood pressure will also increase, thus becoming renal hypertension.

(The reason why this patient has high blood pressure at a young age.)

In addition, the kidneys will secrete erythropoietin under normal circumstances.

Once the kidneys are damaged, erythropoietin decreases, and erythropoiesis disorders lead to anemia, which becomes renal anemia.

(The reason for this patient's anemia.)

In addition, the kidneys have an important endocrine function, which is to activate vitamin D3.

Most of the vitamin D3 in the human body is synthesized through ultraviolet radiation.

(The content of D3 in food is very low, so it is better to get some sun exposure frequently.)

After vitamin D3 is produced, it first undergoes the first round of activation in the liver.

Then it undergoes the second round of activation in the kidneys. Only after the activation of the kidneys can the vitamin D3 be truly biologically active.

It can participate in the body's metabolism, enhance immunity, and promote calcium absorption.

When the kidneys are damaged, active vitamin D is deficient and calcium absorption is poor.