The patient's husband stomped his feet and signed.

The patient also agreed.

No one can resist the fear of death.

After entering the ICU, Brother Hua basically didn't sleep much that night. The patient used a mask to inhale oxygen, and his breathing was pretty good, not too bad, and he wouldn't have to intubate the trachea immediately. So Brother Hua decided to wait a little longer.

The patient was frightened of the ICU scene, so Brother Hua had to keep comforting her, and coming here was just a transition. When the examination results came out and everything was clear, the treatment would be easier, so don't worry.

In the face of critically ill patients, only by expressing comfort and words can one be invincible. Of course, Brother Hua understands this.

However, when recalling the patient in front of me, the condition was so complicated that it was confusing. Brother Hua took nearly half an hour to finish her course of the disease and figure out the whole story. It is obvious that the patient is not ordinary pneumonia, nor does it seem to be tuberculosis, nor does it mean that the treatment of lung abscess is not good, so it is necessary to consider other reasons. However, diagnosis has never been the strength of ICU doctors. If the patient is a respiratory disease, then he still has to ask a respiratory expert for help. Unless the patient is a disease of other systems, ICU doctors may have some advantages because ICU doctors are relatively broad.

Fortunately, the patient's face mask was able to maintain it that night, without the need for tracheal intubation.

After hearing the news, the patient's husband finally let go of his heart.

The next day, Brother Hua reported the patient's condition to the doctor in the department. After listening to it, the department director pondered for a long time. Everyone was analyzing why the patient suddenly had shortness of breath. Is it a lung problem or a heart problem? Or are there both?

The analysis has no results.

After this result, I can no longer hold back the excitement. Granulation and multinucleated giant cells all indicate that it may be a granuloma inflammation change. This is not an ordinary infection inflammation, it is a very special chronic inflammation change.

At the same time, a set of rheumatism and immunity also came out. Anti-neutrophil cytoplasmic antibodies were also positive. Simply put, this is an antibody. This patient has an extra antibody in his blood. This antibody is a very unique antibody specifically targeting neutrophil cytoplasm. The existence of this antibody suddenly awakened Director Huang.

If the patient has this antibody in his body, it means that the condition is related to immunity. In addition, the patient's condition is basically clear. The patient is not pneumonia, lung cancer, tuberculosis, or ordinary lung abscess. Instead, he doesn't know the cause and condition (maybe it environment, genetics, immunity, etc.), the patient's immune system has changed, and some antigen-antibody complexes appear. These complexes may be deposited on small blood vessels throughout the body, causing inflammation of the small blood vessels and granulomas around them. How to understand granulomas? In fact, it is a nodular lesion formed by many larger cells (macrophages) under the influence of inflammation, just like skin hardening. In other words, problems may occur in the small blood vessels throughout the body.

This granuloma most likes to occur in the trachea, lung, nasal cavity, sinus, kidney blood vessels... Especially the lungs, nodules, lumps and even holes may form. If you look at CT alone, it is very likely to be confused with lung cancer, tuberculosis, lung abscess, etc. We know that lung cancer is caused by cancer cells, tuberculosis is caused by tuberculosis bacteria, and lung abscess is the battlefield of ordinary bacteria. This disease is caused by vasculitis lesions caused by autoimmune disorders, and the pathological mechanism is completely different.

This disease is called granulomatous polyangiitis. Director Huang said that there were countless annoyances in his eyes.

Although this granulomatous polyangiitis affects the whole body, it is still the most common effect of the nasal cavity, lungs, and kidneys. The patient told me a few days ago that sinusitis was uncomfortable in the nose. I was not at ease at that time, so I missed it. If I were alert earlier and had a rheumatism and immunity test as soon as possible, I might have diagnosed earlier. Director Huang said.

It seems that patients have little urine and the increase in creatinine are also caused by the disease affecting the kidneys. Brother Hua said.

It should be.

The two directors discussed and decided to treat granuloma polyangiitis. Use methylprednisolone and cyclophosphamide. Methylprednisolone is a glucocorticoid, which can be used to fight inflammation. Everyone knows that glucocorticoid is the strongest anti-inflammatory drug. Cyclophosphamide is an immunosuppressant and can naturally treat this type of disease.

The patient's breathing was slightly stable at this time, but it was still prolonged. The blood oxygen saturation was always around 92%, neither up nor down. If it was worse, Brother Hua would have to connect her to the tracheal intubation to her.

Brother Hua told her the treatment plan this time, saying that your disease is called granulomatous polyangiitis, which is a rare disease, but now we have a clear diagnosis and we have to use hormones to treat it.

The patient seemed to be completely disappointed, closed his eyes and just gasped. He didn't answer Brother Hua.

Brother Hua had no choice but to comfort her and said that when the treatment was not effective, the murderer was not found, and now it was clear that the disease was the case. The new drug would definitely be effective. Don’t worry, I dare to guarantee it.

But Brother Hua told his family that the condition is still serious and he needs to observe the treatment reaction.

The patient's husband heard that it was because of this disease, but then he thought about it and could only listen to the doctor. Besides, he did see everyone trying so hard to treat her, and there was no reason to doubt it.

In fact, regardless of whether the patient agrees to use hormones or not, Brother Hua will use them. As long as the family agrees, it is enough. But the patient is awake after all, so it will be better to get her consent.

In the end, the patient nodded and said faintly, if this time there was no effect, I would rather die...not treat it...

It was the first time that Brother Hua was shocked by the patient. Yes, for us doctors, this may just be solving a disease problem, but for a living patient, this process is a painful suffering.

Use the medicine as scheduled.

The next day, dramatically, the patient's breathing difficulties were immediately relieved.

The patient finally showed a long-lost smile. She had the most say in whether the treatment was effective.

By the fourth day, the patient could basically get out of bed and move, take off his mask, transfer out of the ICU, and return to the respiratory department.

Fortunately, Brother Hua’s promise was not disappointed.

Looking back at this patient, he was initially diagnosed with pneumonia, then suspected tuberculosis and lung cancer, and later considered lung abscess. He had undergone two branscopy and lung puncture, and finally diagnosed with granulomatous vasculitis... Along the way, the patient suffered and suffered. A irritable person, who was tortured by the disease, was obedient and had no temper, which was sad.

Fortunately, she came alive again. If granulomatous vasculitis can be treated early, most patients still have a good prognosis and it is difficult to cure it, but it is still possible to control the condition. However, if the diagnosis is not delayed and the diagnosis is not delayed and the treatment is not timely, the mortality rate will be as high as 90%.
Chapter completed!