Section 217
Therefore, various bone diseases, osteoporosis, etc. will appear.
These are a series of reactions in the body caused by kidney failure.
This patient now suffered from sudden ventricular arrest, which means the blood potassium level in his body exceeded the standard.
The first treatment method is to eliminate potassium ions as soon as possible!
But the kidneys have been damaged and potassium ions cannot be excreted from the urine, so dialysis is the only option.
Uremia is a collective term for late-stage symptoms of renal failure.
Hemodialysis is to filter harmful substances in the blood that cannot be excreted by the kidneys, and then re-infuse them into the body.
"Zhang Yi, how could this person die suddenly? Is it really an electrolyte disorder caused by renal failure?"
Zhang Yi nodded:
"Several symptoms are indeed very similar to renal failure when combined. It should be sudden death caused by high potassium after electrolyte imbalance."
After finishing speaking, Zhang Yi turned to look at his family members and asked:
"Did he urinate just now? Has a urine test been done?"
The girl cried and shook her head:
"No...no, I can't urinate...just a few drops."
"Are you his wife? Let me make it clear to you first. Although we have brought him back from hell, the situation is still not optimistic."
After the girl glanced at Zhang Yi, she kept crying.
While crying, he begged Zhang Yi to save people.
Just at this time, the patient's blood test results came out.
Blood routine:
White blood cells: 16x10?/l ((4.0-10.0)x10?/l)
Red blood cell count: 2.5×10^12 (3.5-5.5×10^12)
Hemoglobin measurement: 98g/l (normal male 130-170g/l)
After a series of blood tests, it can basically be confirmed that he is anemic.
Hemoglobin measurement is the main basis for confirming whether a patient is anemic.
For normal men, anything above 130 is considered normal, anything below 120-90 is considered mild anemia, 90-60 is considered moderate anemia, and 30 is considered severe anemia.
Kidney function:
Serum creatinine value: 588 μmol/l (50-120 μmol/l)
Glomerular filtration rate: 20ml/minin)
By looking at these two results, you can basically determine the degree of kidney damage and whether it is uremia.
(The values of urea nitrogen and uric acid are unstable and are easily affected by other factors, so the diagnosis of uremia basically only depends on creatinine and glomerular filtration rate.)
The normal glomerular filtration rate is per minute.
This young man is actually 20 years old!
If it is less than 15ml/min, it is considered end-stage renal disease, and one can only rely on hemodialysis to maintain life.
Electrolytes:
Potassium ions. (3.5-5.5mmol/l)
Sodium ion: 152mmol/l. (135-145mmol/l)
Chloride ion: 103.3mmol/l.
Calcium: 2.0mmol/l. (2.10-2.55mmol/l)
Increased potassium, sodium, and decreased calcium are electrolyte disorders.
Chen Fang took a look at the checklist and said:
"The potassium is already 6.8! In addition, the glomerular filtration rate is so low, the potassium will definitely not be excreted! How can I do this? I need to go for dialysis, otherwise this young man will be in danger."
The girl next to me started crying again and asked:
"Doctor, what's wrong with him? What's wrong with him? Is it serious?"
Zhang Yi glanced at the girl and said helplessly:
"The initial diagnosis is severe kidney damage, that is, kidney failure, inflammation, and there is a high probability that he is already in the uremia stage."
Chapter 167 The system, you idiot, really has yours.
"Wha... what? Urine... uremia?!"
Even those who have not studied medicine have heard of uremia.
You can't survive such a serious disease without a kidney transplant!
After thinking about it, the girl began to cry heartbreakingly.
While crying, she lay on the young man's body.
He was still murmuring:
"Woo...Liu Luo, wake up, wuwu...don't die...what will I do if you die..."
Zhang Yi quickly helped her up and comforted her:
"Don't get excited, he has been rescued now. The first priority treatment is to undergo dialysis as soon as possible.
Otherwise, if there are too many harmful substances in the body that cannot be discharged, it will only become more serious, and the same situation as before will happen.
Let's do this. You go to the payment office for admission first, and we'll arrange for dialysis right away. "
The girl sniffed and asked:
"Doctor, how much do you have to pay for this...?"
"Does he have medical insurance? Dialysis usually costs more than 500 yuan. If he has medical insurance, he can reimburse the bill."
“Yes, yes, we have medical insurance.”
"Then you don't have to worry. After calculating the medical insurance, you may only pay more than a hundred yuan."
The girl felt much more relieved when she heard Zhang Yi say this.
I quickly took my ID card to check in for admission.
Soon, Zhang Yi also notified the nephrology doctor to come down for consultation.
Those who came happened to be Bai Tang and Chen Feng.
"This is the patient's check list. Blood routine, liver and kidney function, hyperthyroidism and electrolytes are all abnormal. The preliminary diagnosis is severe renal damage, and uremia symptoms cannot be ruled out."
Zhang Yi handed the checklist to Bai Tang.
Behind him, Chen Feng glanced at Zhang Yi quietly and quickly lowered his head.
The gap is getting bigger and bigger. How can Chen Feng have the nerve to compare with others...
Just be a little transparent!
Just as he was talking, the patient's color ultrasound and CT results also came out.
CT showed no obvious pathological changes in the lungs.
But there are problems with color ultrasound. The size of the kidneys is smaller than normal, the cortex and medulla are unclearly decomposed and thinned, and the reflective intensity of the entire kidney is enhanced.
Zhang Yi handed the order to Bai Tang:
"The only thing we need now is the result of a urine test, but this guy can't urinate. However, just looking at the existing test sheet can confirm that he has kidney failure."
Bai Tang nodded while looking at the results:
"Chen Feng, please notify Wang Xia and ask them to bring the dialysis machine to the emergency room immediately. He will undergo dialysis first, and then he will be sent to the department for hospitalization after the electrolytes are restored."
"OK!"
After Chen Feng responded, he immediately ran to make a phone call.
Soon, the bedside dialysis machine and the family members who went to pay came over.
Bai Tang looked at the girl and asked:
"Are you a family member? His wife, right? Come here and sign. He is critically ill now, so you have to sign a critical illness notice."
When the girl heard this, her tears fell down again. After hesitating for a while, she said:
"I can sign, but...but I'm not his wife, I'm his girlfriend, and we're not married yet."
"What?" Zhang Yi was stunned. He just asked if it was his wife and she didn't deny it.
Bai Tang quickly urged her and said:
"In this case, you should quickly call his family. He is in a serious condition now. Do you know that he has renal failure? Chronic renal failure, and he has already developed symptoms of uremia.
The condition must be stabilized quickly, otherwise it will be very dangerous.