自己是来请教弟弟的,曹昭静静地听弟弟先说。曹勇清楚自己二哥在想什么。或许曹昭是手里有个什么病人需要器官移植,否则不会说突然来问他有关这个脑死亡病人的问题。说来医生最不喜欢自己手里的患者死掉。站在这個角度上来说,曹昭为自己的患者焦躁,想让朱星活下来是很正常的心理。同理,他曹勇更希望小玉那孩子能活下来,毕竟是他在现场救治的孩子,并且主张送去方泽博一下能不能把这孩子救下来。只是有关学术问题,医生之间交流只能实事求是,绝不能被情感左右到。曹勇义正言辞地对自己哥哥说:“你知道国际上对器官移植的通则是什么。不说诊断标准的事情。器官移植病人的主治医生,即接受者的主治医生在器官捐献人的脑死亡判定上必须采取主动回避的行为。”“这我知道。”曹昭说。不是所有人能接受脑死亡这个概念的,加上国际上一些买卖器官不法行为的传言,导致这种事情在社会上属于敏感事件。弟弟说的通则正是为了规避触动社会大众的敏感神经。他要问,不可能去问方泽的医生。若是被媒体知道并曝光他和患儿在方泽的主治医生接触过,结果将不得了,会引起轩然大波的,到时候舆论尘嚣而上,怀疑他为了自己患者伙同方泽医生把孩子判定脑死亡好捐献器官将成为板上钉钉的事。既然如此,只能来问问弟弟了。作为朱星的主治医生焦急是肯定的,眼看孩子移植的窗口期一天一天在过去。谢同学安慰患者举的心脏辅助装置例子,真就是差不多的安慰话。心脏辅助装置,首先指的肯定不是ec,ec是改良后的人工心肺机。心脏辅助装置一般指的是心室辅助,这里包括左心室辅助右心室辅助和双心室辅助以及全人工心脏。现阶段研究的多是成人应用。比较成熟的儿童心室辅助在国外属于临床试验阶段,国内怎么可能批进来给患儿用。如果真不行,想上ec,首儿没有,只有手术室用的人工心肺机。那天魏同学觉得隔壁床孩子装的什么仪器高大上,实际上是由于魏同学没去过心内科和心外科实习,不知道那是iabp。像谢同学早前见过并且亲自参与过iabp手术现场,对此一点都不惊奇。仟仟尛説儿科使用iabp大多数是用在先天性心脏病术后心排出量低的患儿,也有用在少数心肌炎心肌病和等待心脏移植的患儿。为什么那天谢同学强调用心脏辅助装置而未谈及iabp呢。这是由于iabp的原理我们之前了解过,它不能主动辅助心脏,很依赖患者自身心脏的收缩。朱星患的是严重心肌病,心脏收缩能力本身问题很大,用iabp能起到的效果是十分之有限的。通过以上分析可以知道,这孩子一旦心脏收缩力衰到不行,医生可能将面临完全束手无策的局面。
<--di--!>
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