Doctor: I picked up attributes in the hospital

Chapter 297 Super Difficult Stereotaxic Operation

"There are too few clinical cases of Naegleria fowleri infection, and the only literature currently available is not of great significance for reference in treatment."

Zhao Heng said.

This is destined to be a difficult process for the treatment of Naegleria fowleri infection, a rare disease. Medicine is an empirical discipline. In many cases, the treatment of patients is based on past experience.

There must be enough clinical case samples and a lot of exploration before an effective treatment plan can be formed.

"According to the only literature available at present, the use of antibacterial drugs to treat Naegleria fowleri infection is actually very limited. The intracranial pressure of patients will continue to rise from the onset of onset, and they will soon enter deep coma. Within the first week or so of illness, death occurs from respiratory and heart failure."

After a pause, Zhao Heng said again.

The course of the disease progresses rapidly, and there is currently no very effective treatment, which is the most difficult place for Naegleria fowleri infection.

"Yes, but what's more tricky is that Naegleria fowleri infection causes swelling in the brain and increases intracranial pressure, which puts enormous pressure on the patient's skull. The pressure will force the connection between the brain and spinal cord to be separated, and once this happens, the mortality rate is as high as 97% or more, which is why Naegleria fowleri is called a brain-eating worm."

Liu Ziang also said with a solemn expression.

As an authority in brain surgery, he still has some knowledge about this deadly parasite.

The biggest difficulty for patients infected with this parasite is the intracranial pressure. Once the pressure is unbearable and the brain and spinal cord are separated, the patient will basically die.

"It's still diagnosed. The treatment will be based on Xiao Zhao's plan first. The follow-up treatment plan will be decided after consultation with the expert group of the hospital."

Liu Shangming said with a final word that he was also very headache when he encountered such a difficult emergency as soon as he took office.

But the good thing is that Naegleria amoeba does not have the characteristics of human-to-human transmission. The only chance to be infected with this parasite is that there are also people in the target waters.

Although there is no human-to-human transmission, according to the 4 tourists on Jeju Island, how many people have been in contact with the target waters, and how many of them have been infected, just thinking about it for a while still makes people feel scalp numb.

The most important thing is that this is a deadly parasite that currently has no specific medicine to treat it. If this news is revealed, it will cause great panic.

"Director Gao, you and I will preside over a hospital committee later. Xiao Zhao, you and Director Liu will make a diagnosis as soon as possible."

After a pause, Liu Shangming calmly gave instructions to Gao Jun, Zhao Heng and Liu Ziang.

Although this matter was sudden and tricky, it did not scare the experienced Liu Shangming.

"it is good."

Gao Jun, Zhao Heng, and Liu Ziang all nodded. They were all happy to see Liu Shangming become the dean.

To be more realistic, after Liu Shangming became the dean, everyone generally reported that life is much better than before.

After Dean Liu Shangming and Gao Jun left, Liu Ziang said to Zhao Heng in a deep voice, "Student, be prepared, this will be a tough battle."

"Senior, is it true that the patient infected with Naegleria fowleri has not been cured in China?"

Zhao Heng frowned and asked, this Liu Ziang is an authority in brain surgery, if he says he doesn't have one, then he really doesn't.

If at least one of them was cured and survived, it would be of some reference value. If none of them survived, it would be really tricky.

"It's still the same sentence, the sample is too small. There are only 10 confirmed cases reported in China, and all of them died without exception. There are more than 100 cases reported abroad, and three survived. This is a statistical problem, not treatment issues."

Liu Ziang thought for a while and said.

No matter how high the fatality rate is, there will always be a patient who survives with extraordinary talents. For example, HIV, which everyone has heard of, has become immune to this virus.

"Then let's make a diagnosis first. The operating room should be ready for minimally invasive surgery."

Zhao Heng said.

At present, the treatment plan he proposed can temporarily stabilize the patient's condition, and things have to be done step by step.

"Well, let's go."

Liu Ziang also nodded.

After a while, the two came to the prepared operating room.

After changing the surgical gown, Zhao Heng saw that the patient had been sent to the operating room.

And in the operating room, a high-magnification microscope has been prepared, and after the materials are prepared, on-site testing will be done.

"Student, let's start."

Liu Zi'ang's expression froze, and he said to Zhao Heng.

This time the minimally invasive surgery biopsy can only be performed by the two of them, and the others have such high technical skills.

It is difficult to take a biopsy from the brain without any impact on the brain. Just thinking about it for a while makes people feel scalp numb.

"Ah."

Zhao Heng also nodded. Although this operation was only a minimally invasive biopsy, he had to concentrate and be prepared.

Brain biopsy is a minimally invasive operation for the diagnosis of brain lesions. This operation is performed under local or general anesthesia in the operating room. During the operation, the diseased brain tissue, blood vessels or dura mater (covering the brain) are removed. outermost membrane).

Brain biopsy can be divided into craniotomy and partial lesion biopsy or stereotaxic brain biopsy. This time, for this patient with Naegleria fowleri infection, the method to be used is that the damage is small and surgical complications occur. Targeted brain biopsy with low and high diagnostic yield.

Stereotaxic technology, similar to the GPS system used in cars to guide the car to its destination, and stereotaxic brain biopsy, which uses a biopsy needle to reach deep in the brain for sampling.

"Student, your sense of three-dimensional space is better than mine. Let me help you with the positioning this time."

Liu Ziang said.

Although Liu Ziang, who is a super genius, is a little reluctant to admit it, Zhao Heng's sense of three-dimensional space is indeed better than his.

This sense of three-dimensional space, for surgeons, to put it simply, can form a three-dimensional view of the patient's local anatomy in the mind of the chief surgeon through imaging examinations, and then follow the three-dimensional view in the mind to find out the completeness of the patient according to the picture. Some kind of extremely complex operation.

Forming a three-dimensional image of a target in the brain, something that only computers can do, is actually something that very few people can do, but there are relatively few such people.

"it is good."

Zhao Heng nodded. He thought so too. When picking up and fusing the experience of other doctors, it was not until recently that Zhao Heng discovered that in the process of fusing experience, certain talents from other doctors would also be fused to a certain extent.

As a surgeon, he has this sense of three-dimensional space, more or less.

Now, after many fusion enhancements, Zhao Heng doesn't know if there will be any surgeon in China who is better than him in terms of three-dimensional sense of space.

Therefore, it is safest for Zhao Heng to do the positioning. After working with Zhao Heng for a long time, Liu Ziang deeply understands this point.

(End of this chapter)