I can see the status bar

Chapter 683 Observation

"The patient's condition is not particularly ideal, mainly due to lack of cooperation." Professor Zhang Zhifu has obviously been here for quite a while.According to him, when the patient was admitted to the emergency department, Professor Zhang was there. "Since he was just sent here, he has been very irritable."

In all fairness, any patient who is forcibly brought to the hospital by his comrades in the police is unlikely to be emotionally stable. —Especially after seeing the shackles that bound each other's limbs.But Cao Zhiquan's problem is obviously not just "irritability".

The whole emergency room was filled with Cao Zhiquan's howls.Even though the doctor on the side had injected him with 2ml of diazepam intravenously, he was still howling in horror and anger.

Anyone with normal judgment ability can make a judgment from Cao Zhiquan's howl that "this person has a problem with his brain".Normal people would not shout "I'm not sick!" and "Someone is going to kill me!" in the hospital. More importantly, normal people would not suddenly stop shouting after a few minutes and then twitch once.

Sun Li'en observed Cao Zhiquan for a while and then shook his head, "This kind of manic situation is not suitable for our department..."

The Comprehensive Diagnostic Center currently has enough doctors but not enough nurses.Once encountering a manic patient like Cao Zhiquan, the manpower of nurses becomes even more scarce - not only because there are not enough nurses, when taking care of such patients, of course the first choice should be male nurses, but now the male nurses in the comprehensive diagnosis center There is only one nurse, Xiao Guo.

Relying on other female nurses to look after this 44-year-old patient is prone to various risks and problems.That's why Sun Li'en made such a statement.

"The shortage of nurses is a problem that can be solved." Professor Zhang looked at Sun Lien and said seriously, "His condition may be the one that is difficult to solve." paper, "This patient may not be as interesting as I thought at first - I only knew that he was prescribed citalopram by the psychiatric diagnosis center, but I did not see the diagnosis from the Jingwei Center. Their diagnosis was 'somatic barriers'."

When Cao Zhiquan was sent to the Fourth Hospital, he didn't even have an ID card on him.It was only after the police comrades obtained his fingerprints that Cao Zhiquan's identity was confirmed.The doctors of the Fourth Hospital obtained his diagnosis information by virtue of this identity information, and it was only 10 minutes ago.

Somatic disorder?Sun Lien frowned, which was different from what the status bar said.

Somatization disorder is a term that has only begun to be widely used in recent years. It is the name of a syndrome with variable symptoms.Patients with somatization disorder themselves are extremely concerned about their physical condition and seek repeated visits to the doctor.Most of the results of doctors and relevant medical examinations were "safe and sound."Even if there are occasional tests that support the patient's condition, these tests cannot explain why the patient is so distressed and anxious-most of the time they are only very mild and early-stage lesions.Such lesions generally do not cause any serious reactions.Even "discomfort" should be minimal or nonexistent.

If it is not somatization disorder, then what is it that caused Cao Zhiquan to be diagnosed as "somatization disorder"?Why did the doctors at the Jingwei Center believe that his problem came from a spiritual level rather than a real physical disease?
"The Jingwei Center does not use the same system as ours. I have asked our doctors. They said that the staff of the medical office should check the medical records." Professor Zhang responded to Sun Lien's question, "The detailed cases can be passed. It will take a while to get it..." He looked at Sun Lien's deeply furrowed brows, and asked tentatively, "Do you want to admit this patient?"

"Yes." Sun Li'en nodded, he was a little worried about the patient's condition.At least from the prompt in the status bar, it can be confirmed that "somatization disorder" should be a misdiagnosis. Cao Zhiquan is indeed sick, and this disease has not been taken seriously by doctors.After multiple diagnoses and examinations, the doctors who really did not find out the problem finally gave Cao Zhiquan a diagnosis of "somatization disorder".

If left alone, Cao Zhiquan will definitely not get the treatment he deserves, and at the same time, he will continue to receive wrong treatment as his depression develops further.When the time comes with a strong sedative, he will stop shouting and screaming, but the original disease will not improve, but will continue to worsen-antidepressants are not effective for subacute dementia and generalized muscle spasms. There will be no therapeutic effect.

Professor Zhang Zhifu looked curiously at Cao Zhiquan who was lying on the hospital bed, still shouting.He didn't quite understand what had changed in Cao Zhiquan that Sun Li'en suddenly decided to take him in.But at least Dr. Sun didn't look like the kind of doctor who would accept a patient he couldn't handle because of the advice of a superior doctor.

"Then accept it." After a few seconds, Zhang Zhifu said seriously, "This patient's situation may be more complicated, Dr. Sun, you may have to work harder."

"In this line of work, hard work is a common thing." Sun Lien replied with a smile, he turned around and looked at Cao Zhiquan who looked a little tired on the hospital bed because of the gradual effect of diazepam, and said, "As long as there is a good result, then It’s not hard work.”

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By the time Cao Zhiquan was admitted to the inpatient department of the Comprehensive Diagnostic Center, it was already one o'clock in the morning the next day.

Cao Zhiquan's wife and son rushed to the emergency department around [-]:[-] p.m.Sun Lien and Professor Zhang Zhifu received the mother and son together.

"How long has your father been... uncomfortable?" It is Sun Lien's job to ask medical history, and Sun Lien himself is relatively good at finding evidence to support the judgment in the status column during the inquiry, "Did he have a relatively large personality change?"

"My dad used to have a good temper." Cao Zhiquan's son was dressed in a style that fits the young man's positioning, with a slightly killer style in his clothes.But when it comes to speaking, there is no "spiritual" temperament unique to "spiritual guys".Anyway, listening to him, Sun Lien felt that the young man in front of him was even a little shy. "When he was working on the construction site, many workers said that he had no temper and would not get angry no matter how much he joked. Even if some people joked too much, he just told others not to do it... He has never been popular with anyone Face."

"But then there was an obvious personality change?" Sun Lien continued to ask, "When did it start?"

"It's been... two years?" Obviously, Cao Zhiquan's son is not sure when his father's personality began to change. "In the past year, it was particularly obvious, because he lost his temper because of a little thing. Last time, because I closed the door with a little strength, he slapped me twice."

The change is definitely noticeable enough.Sun Li'en lowered his head to record, wondering whether this change was caused by "subacute dementia" or "high signal of diffusion weighted imaging of the whole brain cortex".

"Why did you go to the Jingwei Center?" Sun Lien asked in a different direction, "Have you been checked in other hospitals before? Why did you go to the hospital? What problems did you check?"

"My dad first went to the hospital because he felt dizzy and his memory was not very good." Cao Zhiquan's son replied, "Since he came back from Dongjiang Province for a year, he felt dizzy very easily. In the past, he liked to talk to me about the things at work, but after that time, the things he said were inconsistent. Sometimes he said that he was a mason over there, and sometimes he said that he was a support board , and even said that he was actually going to work as a chef on the construction site... I asked him what happened, and he lost his temper. But he remembers the past very clearly. "

Memory loss, irascibility, and possibly mild delusions.Sun Lien stopped writing for a while. He felt that the delusions and irritability in this part might be question marks. This is not necessarily because of Cao Zhiquan's illness, but also because of his emotions after his memory went wrong. fluctuation.

Professor Zhang sat quietly at the side, and he was observing Sun Lien's questioning and recording methods.And he observed something very interesting.

Sun Li'en only said eight sentences and asked eight questions so far.But every question was answered with certainty.This is rare in clinical practice.

When taking medical history clinically, the most frequently heard answers are "no", "no" and "don't remember". This is the most common situation of clinical inquiry.The patient had no underlying disease in the past, no history of surgery and blood transfusion, no medical history... All in all, it should be normal to get a negative answer.

However, Sun Lien did not choose the simplest and most routine inquiry. He straightforwardly started from the patient's symptoms and asked the patient's family members related questions.At the same time, I got the most direct and very valuable answer.This way of asking is very different from clinical practice.

More importantly, Professor Zhang couldn't figure out why Sun Li'en asked the important clinical symptom of "personality change" for the first time.He is very sure that Sun Lien did not know Cao Zhiquan before, and the Fourth Hospital has not received any relevant case reports from the Jingwei Center.But Sun Li'en asked this point...and why?Or, why?
"As for the examination... I don't know very well. When I went to the Affiliated Hospital of Ningyuan Medical College a few times before, I was still studying in other places. Later, when I went to the Jingwei Center, I went with me, but the doctors at the Jingwei Center didn't know what to do. Let my mother and I come into the consultation room. I don’t know exactly what tests were done.” Cao Zhiquan’s son gave an “unsure” answer for the first time to the following questions.

(End of this chapter)