I can see the status bar

Chapter 552 Inspiration from questioning

Although Liu Baoguo claimed that he coughed so badly because he choked on water, the "lung infection" above his head was not telling a completely different story.

Patients are less willing to cooperate and not tell the truth.This makes Sun Li'en, a doctor, very confused - if you don't intend to listen to the doctor, then why come to the hospital?
Sun Li'en turned his head and saw Shen Qingmei standing at the door, then sighed, this President Liu probably came to the hospital because of Shen Qingmei's insistence.

The patient's cooperation is limited, but the diagnosis still needs to be done.Sun Li'en shook his head helplessly, and continued to conduct physical examinations on Liu Baoguo——since you don't want to talk about it, then I'll do the examinations bit by bit.Physical changes won't go unrevealed just because you don't want to cooperate.

After the physical examination, Sun Lien quickly discovered some problems.The most direct one was when he percussed Liu Baoguo's spine, he showed obvious percussion pain.

疼痛的区域，却不只是状态栏提示了有腰椎间盘突出的L5-S1节。而是L3-L5节腰椎。这个区域是做过CT扫描的，影像科的罗哥从L4-L5段看到了几个密度增高的硬化点。

Wait a minute... Sun Li'en took two steps back and became silent. It is common for cancer to show low-grade fever, and it is usually a long-term low-grade fever. Will bone cancer show intermittent fever?

After pondering for a while, Sun Lien decided to confirm his thoughts, "Xiao Guo, draw blood for Mr. Liu." He didn't intend to tell the patient directly about the specific inspection items.Saying "I suspect you have cancer" to a patient who does not intend to cooperate with the doctor at all, the other party is not in a hurry.

Although Liu Baoguo had reservations for some reason when answering the medical history, he was quite cooperative when the doctor was conducting the examination.After being drawn a full [-] milliliters of blood, Liu Baoguo asked helplessly, "Still drawn?"

"That's about it." Sun Li'en replied with a smile, he planned to use this little blood sample to toss and toss the laboratory.In addition to tumor markers, Sun Li'en also planned to complete all the tests for other infectious diseases of liver function.

"Next, I have a small test, please cooperate." Sun Lien asked Liu Baoguo to get off the bed and stand on the ground, and then put the pen in his pocket on the ground. "Can you pick up this pen for me?"

Liu Baoguo glanced at Sun Li'en in some confusion, then slowly walked to the floor where the pen was placed, supported his left knee with one hand, squatted down slowly, then straightened his waist, and reached out to pick up the pen that was not much ink. gel pen.

Bend knees and hips without bending over, positive reaction.Sun Li'en frowned slightly, this is not the result of a herniated lumbar intervertebral disc—unless Liu Baoguo's herniated lumbar intervertebral disc has developed to the stage of prolapse.

"Is this how you usually pick things up?" Before Sun Lien spoke, a female voice suddenly came from behind.Looking back following the voice, it was Lin Yanan.Instead of a white coat, she was wearing a running tracksuit—she looked more like a young woman who had just finished a night run than a doctor. "Do you have to put your hands on your knees?"

"This is Dr. Lin, an orthopedic talent in our hospital." Sun Lien quickly introduced, and looked behind Lin Yanan by the way, "Didn't Dr. Yuan come with you?"

"I asked him to eat slowly." Lin Yanan smiled, "Usually eat too fast and there is no fixed time, and it is easy to have stomach problems after a long time." She took out her work ID from her pocket while talking Hanging it around his neck, he turned to Liu Baoguo and said, "You haven't answered my question yet."

"Ah... yes." Liu Baoguo was stunned for a moment, then nodded and replied, "My waist has never been very comfortable, so it's easier to squat like this."

Once such a thing as joining in the fun happens, it means that everyone gathers together.Luo Ge from the Imaging Department also appeared outside the ward, holding two developed CT films in his hand, "Hey, are they all there?"

Of course, Luo Ge came to send the results of the CT examination, and he didn't talk too much nonsense, and directly handed over the film to Sun Lien and Lin Yanan, "I read it several times, and the nature of the increased density of L4-L5 is not clear, but there is no boundary Blurring or signs of erosion, at least not something...bad."

The three words "bad things" can refer to many things, but in the mouth of radiologists, this mainly refers to the lesion area that is "suspected to be cancerous".

Judging the nature of the tumor from imaging is generally based on whether the boundary of the lesion area is clear and whether the lesion area invades adjacent structures.Generally speaking, the more indistinct the boundary and the more invaded tissue, the more likely the lesion is malignant tissue.

Of course, there are many methods and schemes used to judge the nature of the tumor, and the boundary of the lesion area and whether other tissues are involved cannot be used as a complete basis.The final decisive judgment still depends on pathological examination.

"The possibility of tuberculosis is quite high." Lin Yanan and her husband had already exchanged the basic situation of the patient, and she made her own judgment after watching the film, "It may be tuberculous spondylitis. Although intermittent high fever is relatively rare, it is also possible. cannot be completely ruled out."

"If bloody tuberculosis spreads, it may leave traces on other body parts." As a radiologist, Luo Ge also understands how difficult it is to diagnose tuberculosis. "You can consider doing a PET scan."

"Or take the spinal fluid for a PCR test. Regardless of whether the detected bacteria are live or not, at least the direction can be clarified." Lin Yanan continued, "The treatment plans are all ready-made, as long as the diagnosis is confirmed."

It is not a routine practice for doctors to discuss diagnosis and treatment options in the patient's ward, at least Liu Baoguo looked a little nervous. "Tuberculosis? I've never been in contact with anyone with tuberculosis."

Shen Qingmei also frowned and said, "Mr. Liu has basically lived on the farm these years, and has little contact with outsiders. Tuberculosis...isn't it possible to spread it through contact with other tuberculosis patients?"

"This is not necessarily true." Sun Lien replied, "TB is considered a zoonotic disease. Dogs, pigs, cattle and other animals may be infected with tuberculosis, especially after cattle are infected with Mycobacterium tuberculosis, they may even be able to spread to humans. .”

"But there are no cows on my farm... I don't raise dogs, let alone pigs." Liu Baoguo was puzzled, but what the doctors said was very clear. He was probably infected with tuberculosis.But from where he was infected, Liu Baoguo really couldn't figure it out. "I have raised some goats, mainly for eating wild grass on the mountain."

"Sheep don't seem to have the ability to be infected with tuberculosis, right?" Brother Luo is not an expert in this area, and Lin Yanan doesn't know much about it.The two exchanged for a while, and suggested to Sun Lien, "Why don't we invite the doctors from the Department of Infectious Diseases for a consultation?"

Sun Li'en stood there thinking for a while, then raised his head and asked, "Mr. Liu, what kind of animals are there on your farm?"

"Animals?" Liu Baoguo counted on his fingers, "There are sheep, rabbits, chickens, ducks, and geese... Oh yes, I also dug two ponds, with silver carp and grass carp in them, maybe Some small miscellaneous fish and tilapia washed down from the mountain spring." He looked up at Sun Lien, "Other animals... there are at most voles and wild cats."

"Have you had any direct contact with these animals in the past year?" Sun Lien continued to ask. If it is true that according to what Liu Baoguo said, he had very little contact with outsiders these years, the possibility of being infected by other people is indeed very high. Low.In contrast, animals are more likely to transmit diseases, "I mean the experience of catching these animals directly with your hands."

"Yes." Liu Baoguo nodded honestly, he really felt a little scared, "At the end of last year, I killed a chicken myself, and even caught a few fish... Oh yes, at the beginning of this year The sheep gave birth to a lot of lambs, and I invited a veterinarian to vaccinate the sheep. Later, I saw that they were too busy, so I also vaccinated the lambs.”

Sun Lien's eyes widened, and he suddenly thought of a possibility that had been ignored all along.He looked at Lin Yanan, and asked with some uncertainty, "Could it be... brucellosis?"

(End of this chapter)