Physician's Day 丨 Your recovery is the best gift we received

Cover reporter Zhou Jiayi

Recently, the 16 -month -old child smiled (pseudonym) because of yellow eyes, yellow skin, and yellow urine. He came to Longtan Hospital of the Second People's Hospital of Chengdu from Ganluo County to Longtan Hospital of Chengdu. Disciplinary joint) team treatment, currently recovered well after surgery. This is also the first patient with congenital bile duct expansion of the diversified patients in the hospital.

"Little Yellow Man" is in danger and urgently needs surgery

Homes in Ganluo County is only 16 months old. Like the dolls of the same age, it is lively and active. Recently, his mother found that Xiaoxiao's eyes were not only yellow with yellow beads, but also yellow skin, and even her urine was yellow. So, he immediately took a smile to the Ganluo County Hospital. The test results showed that Xiaoxiao laughed and biliary redness was high. The results of the CT were shocked: the bile duct expansion and the pancreas were occupied.

"I have no symptoms except for those yellow hair yellowing, and I get sick?" The anxious smile came to the Longtan Hospital of the Second People's Hospital of Chengdu to seek medical treatment with the anxious smile. On the 28th, the hospital urgently smiled for the hospital through the green channel.

Director Li Guangkuo's team of Director Li Guangkuo immediately conducted an admission physical examination and related inspections of the team of Director Li Guangkuo. The normal range of serum total bilirubin is 5.13-22.24 μmol/L, and the total serum total bilirubin of the smile is as high as 280 μmol/L, which is 10 times higher than the normal value. It is a pathological jaundice. The biliary tract is abnormal, the disease will be aggravated, and the biliary tract infection can be perforated, leading to liver failure and endangering children's life.

Through a series of examinations, the preliminary diagnosis is congenital bile duct cysts dilatation, abnormal bilir pancreas condensation, and bile tubeitis. The hospital immediately launched the MDT team. It consists of experts from the second department (liver and gallbladder and pancreatic surgery), pediatrics, intensive medical department, anesthesia surgery department, imaging department and other departments to discuss the condition and determine the "advanced anti -inflammatory treatment, periodic surgical removal of the bile ducts of the lesions of the lesions of the lesion of the lesion of the lesion of the lesion of the lesion. , Reconstruction of the biliary "treatment plan.

MDT experts are on the battlefield to offer good strategies

When I was admitted to the hospital, in addition to the skin scleral yellow dye, it was also accompanied by lung infection, biliary inflammation, abnormal liver function, and low hemoglobin. Try to control the amount of bleeding, "said Li Lei, deputy director of the pediatrics.

Preoperative anti -infection treatment also encountered various problems: 16 months old smiling blood vessels are extremely fine, which brings difficulty in infusion and blood drawing. Operation; Xiaoxiao's parents are compatriots of the Yi people. They can only conduct simple Chinese exchanges. Smile does not understand Chinese. Doctors and nurses are accepted and treated in a way.

After a week of anti -inflammatory anti -inflammatory and liver treatment treatment, "the physical condition of smiling is good, and the option surgery is set on August 5."

Pediatric surgery is more accurate and strict compared to conventional adult surgery operations and anesthesia requirements during the operation. "The bleeding during the operation is controlled within 20ml." Director Li Guangkuo said.

What is the concept of 20ml of bleeding? "Children's bile tube cyst infection is difficult to control before surgery, liver function damage is severe, the coagulation function is extremely poor, the surgical trauma is long, and the risk of bleeding during the operation is extremely great. According to the physical quality of the child's 12kg 850-900ml, anemia before the children's operation, the maximum allowable blood loss in the operation is about 95-100ml, and the bleeding during this operation is only about 20ml, far exceeding expectations, it is not easy. "Zhu Bo, deputy director of the Department of Anesthesia Department." Explanation, "In addition, the child's combined congenital arterial catheter is not closed, and improper anesthesia drugs and blood transfusion and hydraulic can affect the recycling function and anesthesia of the child, which requires extremely accurate anesthesia management." In the end, experience 6 experience 6 An hour of surgery, Xiao Xiao was launched in the operating room and entered the postoperative monitoring of the intensive care unit.

Carefully take care of Ankang after surgery

The success of the operation is only half successful, and the monitoring after surgery is also critical.

The assessment of the cardiopulmonary function of the child after surgery is very important. After several hours of surgery, coupled with the presence of the inflammation of the respiratory tract before surgery, the child has more endocrine with the vitality of the airway and needs to help discharge sputum intermittently. Director Hu Qionghua and Captain Hu Chaoa in the Department of Critical Medicine have extensive experience in patients after nursing. They took turns to absorb phlegm and pat their backs. In the end, the pus was sucked out. smooth.

"In the intensive medical ward, the general family members do not come in to accompany. We consider that the children are younger and do not understand Chinese." Director Hu Qionghua said. "We have specially made a single room for children. Under the premise of the protection, let the children's dad enter the ward to accompany, and arrange the Yi nurses and sisters to strengthen communication with the family members of the children. "

"For a 16 -month -old child, the participation of pediatrics is not only before surgery, but also the pediatric team also participates in patients' postoperative medication, analgesic sedation, liquid therapy, nutritional therapy and organ function maintenance." Said Liu Li, director of pediatrics.

Under the careful care of 3 days, the child smiled and moved back to the general ward. The family of three reunited, the smile on the bed was no longer the "little yellow man" with yellow eyes and yellow skin before. He gradually had a happy and healthy childhood like a normal child in the recovery.

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