Never wanted to cause sepsis.

Causing pelvic infection

Necrotizing fasciitis

septic shock

Multiple organ failure

hemorrhagic shock

Xiao Yang (pseudonym) from Qingtian, Lishui, Zhejiang Province

Wandering on the brink of death many times,

After nearly 70 days of treatment, he finally recovered in the First Affiliated Hospital of Wenzhou Medical University.

Because the skin on the ass is broken.

19-year-old girl was sent to hospital for emergency treatment.

Xiao Yang, who is only 19 years old, originally suffered from systemic lupus erythematosus. During the practice of kindergarten teachers, she found that the skin of her right hip was damaged, and then she began to have symptoms such as fever and chills, but until she had symptoms such as weakness of both lower limbs, inability to stand and incontinence of stool, she still did not pay attention. She was sent to the local hospital for treatment by her family. After CT and other examinations, considering the serious infection and critical condition, he was transferred to the emergency room of the First Affiliated Hospital of Wenzhou Medical University at the end of June 2020 1 1.

Xiao Yang, who needs tracheal intubation at this time, looks pale and sleepy. Xiao Yang's father wondered: Isn't it just skin? Is it broken? How can it lead to such serious consequences? The doctor said it was all caused by lupus erythematosus.

After rounds, the doctor thinks that the skin injury of the right hip is just the tip of the iceberg, and the infection of deep tissues such as pelvic cavity is the key point, which needs to be cut and drained as soon as possible.

Xiao Yang received emergency debridement of perianal necrotizing fasciitis under the general anesthesia of the chief physician of colorectal and anal surgery. During the operation, malodorous pus was discharged about 100ml, local necrotic tissue was removed, and drainage tube was placed. After the operation, Xiao Yang was admitted to the Emergency Intensive Care Unit (EICU).

Sepsis refers to organ dysfunction or failure caused by imbalance of human response after infection. In other words, in the process of resisting infection, the human body became confused, injured itself by mistake, and caused damage to organs such as kidney, lung, liver and heart, and further developed into septic shock, which is septic shock.

The rescue treatment took nearly 70 days.

Twice. From where? The gates of hell? Front pullback

Xiao Yang, who was in septic shock after operation, had cold skin, blue lips and a heart like a horse barking. Blood pressure is still so unsatisfactory under the maintenance of high-dose norepinephrine needle; Breathing is still very rapid under ventilator maintenance ventilation; There is so little urine that is more precious than gold; The monitored blood gas analysis shows that the inflammatory factor storm is still so sour and severe, which leads to multiple organ dysfunction syndrome (MODS), involving circulation, respiration, kidney, liver, blood, muscle and nerve, immune system and so on.

Xiao Yang's life is in jeopardy. After reporting the illness to Professor Lu again, the doctors in the emergency intensive care unit took a series of measures, such as hemodynamic monitoring, bedside continuous renal replacement therapy (CRRT) and adjustment of ventilator parameters. Pull a life back from the cliff by force.

Subsequently, the vital signs of Xiao Yang's ECG monitor gradually stabilized and people woke up. At this time, blood culture suggests a variety of bacterial infections, and the test results suggest that the patient has systemic lupus erythematosus. The EICU team once again formulated an individualized treatment plan to adjust the precise treatment of antibiotics, immunotherapy and active organ support therapy. Combine medical care with nursing care to realize refined treatment and nursing care. Xiao Yang's breathing, circulation, kidney and other indicators gradually returned to normal. After being admitted to the hospital 1 week, he successfully left the ventilator and pulled out the tracheal intubation. After admission 10 day, the hemodialysis tube was successfully removed and the blood purification treatment was stopped.

Severe infection and malnutrition left Xiao Yang in a state of severe anemia and thrombocytopenia for some time. Hemoglobin is only one-third of the normal value at the lowest, and platelets are even less than one-tenth of the normal value at the lowest, which is very dangerous and may cause massive bleeding and life-threatening at any time. However, even with repeated platelet transfusion, Xiao Yang's condition could not be effectively improved.

Considering the existence of systemic lupus erythematosus in Xiao Yang, after consultation and adjustment of the treatment scheme in hematology department and rheumatology and immunology department, the anemia state has been greatly improved and platelets have returned to normal.

I thought Xiao Yang saved the day, but I didn't expect a second sudden hemorrhage and hemorrhagic shock from the perianal wound on June 5438+February 65438+March 65438+February 22. The medical team gave blood transfusion and infusion treatment, and asked the interventional department to do emergency DSA. The diagnosis was that the right internal iliac artery and the right external iliac artery were bleeding respectively. After embolization by spring coil, it turned to safety.

With the concerted efforts of Qi Xin, Xiao Yang finally saved the day and his vital signs were stable. At the end of 200211,after nearly 70 days of rescue treatment, Xiao Yang recovered and was discharged.

The doctor reminded that if people with immune system diseases have to receive regular treatment, they should pay special attention to the infection of skin damage, which is easy to worsen.