N-M Chapter 190
Chapter 190
Chapter 190 Urine Crystals
Director Wu chuckled, “Yes, I don’t know if you can help me out and help me with this?”
Although Liu Xin has no good impressions of Director Wu, since he works in a field hospital, he needs to be responsible to the patients. What’s more, he now has a fairly in-depth understanding of kidney surgery. If necessary, Liu Xin also wants to add some practical experience. .
“Let’s go.”
“Good… good! Thank you, Doctor Liu.”
Director Wu originally thought Liu Xin would not agree, but he didn’t expect him to be so happy.
Follow the pace of Director Wu to the nephrology department.
“it’s him.”
In front of him was the intensive care unit. There was a man lying on the bed with various tubes in his body. There was no sign of awakening. Apart from a stable heart rate, he was almost indistinguishable from a vegetative person.
“Director Wu, you should have had a first visit, right? What do you think?”
Liu Xin looked to the side of Director Wu and asked. Director Wu nodded lightly and frowned: “It is true that the result of the first diagnosis is kidney sclerosis, but after measuring blood pressure, the effect after injection of many antihypertensive drugs does not seem to be effective. Obviously, renal atherosclerosis should not continue in this state. Urine and blood tests have been checked, and there are no other abnormalities.”
“Can I see it?” Liu Xin asked.
“Xiao Lan, go and get the report.”
Director Wu called the nurse in the intensive care unit to retrieve the examination report. After reviewing it, the result was the same as Director Wu said. There was no abnormality. It was impossible to judge the condition except that the urine crystallinity was higher than other symptoms.
“The results of CT and B-ultrasound are indeed renal cirrhosis, but will the degree of urine crystals be too high? Has the patient experienced urinary tube blockage after admission?”
Liu Xin read it all over and thought that the problem might be in urine crystals.
“The person was in a coma when they were sent, and they were connected through a tube. At present, the composition of urine crystals does not seem to be so exaggerated, and it belongs to the normal category.”
Director Wu explained that he would come to check every day. After Liu Xin thought about it, he immediately ordered the nurse Xiaolan next to him: “Nurse Xiaolan, you use a cotton swab to collect urine from the wall of the ureteral tube, every three hours, and after one day. Give me results.”
“good!”
Nurse Xiaolan turned and walked into the ward to start the collection. Director Wu on the side was puzzled: “Did you find anything? Would there be different problems according to different time periods?”
Liu Xin shook his head: “I’m not sure, it’s just a hunch, it depends on the result.”
Director Wu has no countermeasures, so he can only try first.
A few hours later, Liu Xin came to the intensive care unit alone. The nurse Xiaolan saw Liu Xin and immediately took out the test report for the whole day. When he saw the results of the urine test, he accidentally found urine crystals. Indeed, as he thought, it was resolved according to the time period.
“Observe for another day, and I will come back one day later.”
“Okay, Doctor Liu.”
Another day later, when Liu Xin came to the entrance of the intensive care unit, Director Wu happened to be there, and he was holding the report results of the day.
“Director Wu!”
Director Wu turned around: “Dr. Liu, you just came here. This is the inspection report that just came out. Compared with yesterday, it seems to have changed. Every day, urine crystals are all increasing, and they appear in time periods.”
Liu Xin didn’t need to read the report anymore and knew what he knew. He turned to Director Wu: “Director, I suspect that a large area of calcification occurred on the inner wall of the patient’s kidney, which resulted in a large number of crystals in the urine.”
“Kidney calcification foci? But I have seen the results of B-ultrasound and CT, and there is no reaction of calcification foci.”
Director Wu insisted on what he saw, and it was really hard to agree with Liu Xin’s guess.
“Calcification may be visible through imaging, but what if imaging is not possible?”
Liu Xin’s words left Director Wu puzzled: “What does it mean to be unable to perform imaging?”
“Look, in the test report, calcium oxalate and calcium phosphate are less of the crystalline components, and the most is urate. If it is only the waste liquid produced by the kidneys that is driven by ordinary calcification foci, urate will It’s impossible for such a huge amount of urate to appear in the weight.”
“So you think that the reason why the patient does not wake up is that excessive consumption of sodium chloride leads to a decrease in energy?”
Liu Xin nodded lightly, and Director Wu finally understood his intentions.
“That’s not the problem of our nephrology department.” Director Wu responded and looked at Liu Xin.
“Although the calcification foci appear in a large area and the sodium chloride cannot be decomposed are not the same part, they need to be completed by the two departments at the same time, and it is only speculation at present, and further verification is needed.”
“Hypochloremia?”
This is what Director Wu can think of.
“No, if it is hypochloremia, the effect of injecting normal saline is very significant. At present, it seems that normal saline cannot provide enough sodium chloride content in the blood. Even after injection, it will pass through the calcification of the kidney. It is excreted in the urine in a way of salting out.”
“Then…what’s the problem? Blood? Or hematopoietic organs?” Director Wu puzzled.
“Have the patient ever taken diuretics?” Liu Xin looked at him.
“I have taken it once, but the weight is very small.” Director Wu recalled.
“Then there are only two problems left. Cerebral salt loss syndrome is either hypothyroidism or tubulointerstitial disease, which is difficult to judge.”
Director Wu wondered again: “Then why there is no change in blood routine? If there is a decrease in blood chlorine content, shouldn’t there be no condition after the examination?”
“It means that the problem only occurs near the renal tubules, but it will not be an interstitial disease.”
Liu Xin walked around again. As the chief physician of the nephrology department, Director Wu felt that there would be such a big trouble this time. The cause of blood problems almost penetrated the whole body. It is as difficult as heaven to find the cause now. Liu Xin analyzed the results and overturned one by one at the end and returned to kidney problems.
“Then how do you explain that there is no result from the radiography machine?”
Liu Xin firmly believes that there is absolutely nothing wrong with the problem he saw. At least there is a problem with the urine crystal content. Now, as long as you find the cause of the whole problem, you can determine where the problem is this time.
“It’s not good, the patient has asthma!”
Xiaolan appeared suddenly.
Liu Xin and Director Wu looked at each other and walked to the ward. They saw shortness of breath and flushing on the bed. Director Wu immediately injected Beta 2 receptor stimulant. Fortunately, the asthma was relieved quickly. .
“Director Wu, didn’t it mention that the patient had asthma symptoms in the previous inspection report?”