My medical skills add experience

Chapter 239 There are too many types of gastritis, the terrible Helicobacter pylori
"You take this to pay the fee, and after the examination, you can come here with the test results. After the examination, you don't need to queue up, just talk to the nurse outside and you will be let in."

Open the inspection application form and hand it to the patient.

In the past, paying a fee required a long queue, and it took half a day to pay.

Now with the rapid development of mobile payment, payment has become very convenient.

Hospitals no longer see long queues to pay fees.

"Thank you!"

After thanking the family members, they got up and walked out with their daughter.

Zhou Can opened the door for them and sent them out.

The next patient was ushered in again.

Clinics are always so busy.

Many people think that it costs hundreds of dollars to see a specialist with special needs, and at least an hour of detailed consultation is required.

In fact, when encountering a disease that is familiar to the specialist, it may take 10 minutes to finish the job.

In the case of difficult and miscellaneous diseases that cannot be diagnosed on the spot, the patient will be sent away according to the situation, or hospitalized for observation for further detailed diagnosis.

Therefore, there is really no need to register as an expert for common diseases.

Hanging up an account with a few dollars can also cure the disease.

The examinations and treatment plans are basically the same as those of experts.

"Director Shang, please help me take a look! I feel like I'm going to die!"

The patient is an old man over 70 years old with a ruddy complexion and a fatter body.

She was wheeled into the consulting room by a woman in her 40s.

After the patient came in, he kept humming, with a very painful expression.

"Don't worry, I will definitely give you a good diagnosis and treatment when you come to my place. I listen to you very well, and I don't look like someone with any serious illness!" Director Shang comforted the patient, and started a preliminary treatment for the patient. eye examination.

Also called inspection.

This is the first diagnosis that all doctors must make after seeing a patient.

"I don't have any major problems. Recently, I always feel stomach pain and bloating. After eating, it seems to come out of the mouth again. It's uncomfortable."

The old man hummed and introduced his symptoms.

The previous patient had abdominal distension and occasional mild abdominal pain, and felt full after eating a few bites.

The patient's symptoms did not appear in the abdomen, but directly in the stomach.

After Zhou Can heard about the symptoms, he looked at this interesting old man.

But he was muttering in his heart, this old man was full of energy, his face was rosy, and he didn't look like a serious illness.

But no one can say for sure, you have to do an inspection to know.

Employees of many units do physical examinations, and such things often happen.Looking at a very healthy person, the patient himself did not have any serious symptoms, and colleagues around him thought he was in good health.

As a result, the physical examination revealed advanced liver cancer, rectal cancer and so on.

Zhou Can has seen many such examples.

Therefore, it is difficult to determine whether the other party is seriously ill just by looking at it with the eyes.

While recording the patient's symptoms, Director Shang asked about the patient's disease history and whether there were other symptoms.

After understanding, in addition to bloating, stomach pain, and food regurgitation, the patient occasionally suffers from low back pain.

As for the patient in a wheelchair, it was a work-related injury many years ago.

At that time, an accident occurred in the factory, resulting in paralysis of the lower limbs.He has been traveling in a wheelchair since then.The old man also received a large amount of compensation.At that time, housing prices were not expensive, and the old man took the compensation money to build a front house and a house by himself.

What I think is that I will lose the ability to work in the future, but I can earn rent by renting out the facade and housing.

In this way, you don't have to worry about having no money to eat in the future.

In fact, God is very kind and took good care of this unfortunate old man.

The location of his self-built front house has gradually become a commercial center, and he has saved a lot of money by collecting rent over the years.The house is taking advantage of the rising wind of real estate, and the market value has been rising all the way.

In addition to bringing an annual rental income of 27 yuan to the old man, this self-built house is worth more than 700 million yuan.

Therefore, there is no need to worry about the old man's financial resources at all.

The middle-aged woman who pushed him to see a doctor was neither the old man's daughter nor any relative.

It was a nanny hired by the old man.

According to the old man's self-report, his wife has been dead for several years.Only one daughter married far away.His daughter and son-in-law's family is very rich and they own more than a dozen supermarket chains. They wanted to pick him up to live with him, but he was unwilling.

I feel more comfortable living alone.

Thinking about it, a 70-year-old person hired a 40-year-old female nanny to serve him 24 hours a day, so he must have lived a very comfortable life.

Life is guaranteed, there is no shortage of money to spend, and life is comfortable, so the old man is naturally afraid of death.

When my body was a little troubled, I hurried to the hospital.

This time I had stomach pain and bloating, so I directly registered a special expert account.

Anyway, the age is here, and he is very willing to spend some money on health.

"Director Shang, just tell me, is my disease stomach cancer? If it's cancer, I won't bother."

After the old man finished explaining all about his situation, he couldn't help becoming nervous again when he saw that Director Shang was pondering and didn't speak.

The female nanny leaned down and approached the old man to comfort him gently.

"Your lucky star is shining, you will be fine, just put your heart in your stomach! Even if there is any problem, I will always stay by your side and take good care of you."

In front of so many doctors, the nanny and the old man spoke in a particularly intimate manner.If there is no one, I'm afraid it will be even more presumptuous.

Zhou Can has seen some similar gossip on TV and online.

The female nanny covets the property of the male employer, strives to please the male employer, and then marries him, transforming from a nanny to a hostess.Then use various methods to get the male employer to transfer the property to her name.

At that time, once the male employer dies, she will own the property alone.

Even, some female nannies are more ruthless.As soon as the real estate and money are in hand, there are some who directly break up with the male employer.

Zhou Can couldn't help feeling worried about the old man.

Looking at this situation, the old man is afraid that he will be sad about the beauty pass.Most of them will be deceived.

"Huihui, it's better for you to treat me better." The old man was very satisfied with the attitude of the female nanny.

Director Shang didn't test a few young doctors this time, and directly issued an examination application for the patient to go for the examination.

After sending the patient away, he signaled Zhou Can not to let the patient in yet.

"Do you know what disease that patient was suffering from just now?"

Director Shang asked all the doctors under him.

"Doctor Huang, tell me."

This time, I asked the attending physician directly, which shows that the patient's disease is difficult to diagnose.

"It should be gastric ulcer, gastritis or something like that!" Huang Xinggui had obviously diagnosed the patient's disease secretly.

According to the symptoms described by the patient, it is indeed very similar to gastritis.

"What's your diagnostic opinion?"

Director Shang asked several young doctors calmly.

"I dare not jump to conclusions. I have to read the inspection report before I can make a diagnosis."

Qiu Chengyu's answer was basically tantamount to admitting that he could not diagnose the patient's disease.

In case of a wrong diagnosis, it is easy to be slapped in the face.

It is most advantageous to use this vague statement.

"I think it should be gastritis!" Xie Lin's diagnosis agreed with Huang Xinggui's.

"I think it may be a problem with the duodenum." Luo Jingyi can blame the duodenum for any disease, and it is estimated that she had a grudge against the duodenum in her previous life.

Zhou Can was the last to speak.

This time it was really not that he wanted to be the last to speak, but that the old man's disease was very difficult to diagnose.

Just relying on some symptoms without any inspection basis, it is really difficult to draw conclusions.

"Doctor Zhou, I believe you have already diagnosed the disease of the previous patient. The disease of the latter patient is somewhat challenging. Please tell me your diagnosis opinion!"

Director Shang asked him with interest.

In this case, it's not easy for Zhou Can to spoil Director Shang's interest.

I had to bite the bullet and replied, "When you and Luo Jingyi were conducting a physical examination on the patient just now, I noticed that the patient had unusual eczema. Moreover, his paralyzed lower foot and ankle were somewhat swollen. The chaotic private life of the female nanny led to eczema. I thought about it later, it should not be."

These words made the two young female doctors blush somewhat.

Although they are all 25-year-old girls and may have been in love long ago, they still feel embarrassed to hear such sensitive topics.

"Combined with the patient's occasional lower back pain, bloating, stomach pain, food reflux and other symptoms, I suspect that the patient may have eosinophilic gastroenteritis."

This is a fairly rare disease.

Patients will show symptoms of various gastrointestinal diseases and experience various discomforts in the body.

This abnormal infiltration of eosinophils can lead to an inflammation-like response in the gastrointestinal tract.But it is different from ordinary inflammation.

Diagnosis is possible only if the diagnosis and treatment experience is extremely rich, or if the diagnosing doctor is meticulous, has profound basic medical knowledge in this area, and has rich clinical experience.

"The clinical manifestations of this disease include three types: mucosal type, muscular layer type, and serosal type. The patient did not experience intestinal obstruction, and the muscular layer type can be ruled out. The patient did not have a large abdomen like a drum, ascites was mild, and the serosa type It can also be ruled out. The patient mainly presented with abdominal pain, nausea, vomiting, and mild diarrhea, so I boldly speculate that he is likely to be infiltrated by the mucosa of the digestive tract, which belongs to the mucosal type.”

Zhou Can further diagnosed and analyzed the patient's disease type.

The chain is interlocking, the logic is rigorous, and the medical knowledge revealed is also extremely profound, which makes other doctors admire him very much.

Especially the two young female graduate students, when they looked at Zhou Can, their eyes were shining brightly.

The attending physician, Huang Xinggui, was amazed.

At this moment, he was surprised to find that Zhou Can's diagnosis level seemed to be better than his indication.

At first, I thought Zhou Can's level of diagnosis and treatment was at the level of a resident doctor.

Now it seems that I really underestimated him.

They didn't know Zhou Can's brilliant record in other departments.Especially in the last month of general surgery, it really killed the Quartet, and successfully helped Mr. Liu diagnose a number of extremely difficult and complicated cases.

You must know that many of those cases were caused by patients who had been seen by experts and famous doctors in many hospitals, but the cause could not be found out.

In the end, they were all diagnosed by Zhou Can.

When he was still an intern, Zhou Can had an extraordinary talent in pathological diagnosis.

After nearly two years of regular training and study, rich experience in clinical diagnosis and treatment, so many chief physicians have taught them all.In addition, he later frantically supplemented basic medical knowledge.

In the end, his diagnostic level rose steadily.

Up to now, on the surface, it is at the attending level.The actual ability is not weaker than that of the deputy chief physician.

Even in diagnosing some difficult and miscellaneous diseases, his clear and unique diagnostic thinking is better than that of the chief physician.

"Teacher, do you think Dr. Zhou's diagnosis is correct? It sounds like that!"

While Xie Lin was full of curiosity about this young Gui Peisheng, she also felt a little admiration.

The pathology of this old man is quite complicated, but the symptoms are extremely common.

Diagnosis is very difficult.

She thought that the patient might have gastritis, which was the same diagnosis as the attending physician Huang Xinggui, but she was not confident at all.

This is like looking for a job. It is obviously just an ordinary degree and very little work experience.One company said they could pay her [-] yuan a month.In this case, people with a slightly normal mind will put a question mark in their hearts.

"My initial diagnosis is gastroenteritis, but after listening to Dr. Zhou Can's analysis, I agree with Dr. Zhou's point of view. The patient's disease is probably really eosinophilic gastroenteritis, not a simple common disease. Gastroenteritis."

Director Shang is honest enough.

Even in front of the students, he did not cover up or put gold on his face.

Instead, he told the students frankly that his original diagnosis was only gastroenteritis, and he was not as accurate as Zhou Can.

"Dr. Zhou's diagnostic ability is so strong! I have to learn from you in the future."

Xie Lin looked at him with admiration.

When she found out that Zhou Can's diagnosis was more accurate than that of her teacher, she was shocked beyond imagination.

"Hey, I'm just a blind cat bumping into a dead mouse, and I happened to catch up. Besides, the final diagnosis won't be known until the patient has finished the examination. Now it's just a discussion."

Zhou Can didn't dare to steal the limelight in front of Director Shang.

Self-effacing is the most appropriate response.

"Anyway, anyway, I just think you are great. I must learn more from you in the future and ask for more advice. By the way, the teacher said that you have diagnosed the disease of the first patient. Can you tell me what the young girl got? What is the disease?"

She took the opportunity to ask about the diagnosis of the first patient.

This time, the other two graduate students also pricked up their ears.

They also want to know the answer.

"Uh... Let me first declare that my diagnosis is not necessarily correct, it is just my personal opinion. The symptoms of the first patient, combined with her existing information, are very similar to atrophic gastritis caused by Helicobacter pylori infection .”

Zhou Can gave his own diagnosis.

This disease is relatively common.

Especially in a well-known hospital like Tuya, it is often possible to receive such patients.

Helicobacter pylori is also a major killer of gastric cancer.

"So it's this disease, no wonder you can prescribe three inspections in one go! Oh, I suddenly realized that after studying with the teacher for so long, I still can't do anything."

Xie Lin patted her head lightly, with a naive look.

It made Zhou Can and the others all laugh.

A young girl with good looks can indeed bring a certain amount of happiness to a man when she is cute.

The reason why this world is beautiful and makes men linger, is precisely because of the happiness that female compatriots bring to male compatriots.

The coldness and warmth in the world, to the extreme, is nothing more than a word of love between a man and a woman.

To this famous philosophical saying, one more sentence should be added, if there is no woman in the colorful world, there will be only the world without flowers.

"Doctor Zhou, can you tell me how you diagnosed that young female patient with Helicobacter pylori infection?"

Luo Jingyi has always been very quiet and shy, except for answering Director Shang's questions, she hardly speaks.

At this moment, I couldn't hold back the strong curiosity in my heart, so I took the initiative to ask Zhou Can a question.

"Maybe my nose is better! She opened her mouth and yawned. Although she blocked it with her hand, the bad smell in her mouth after Helicobacter pylori infection was still very obvious. After listening to her symptoms, I synthesized her Based on medical history and other information, it is judged that she is likely to be infected with Helicobacter pylori."

After Zhou Can finished answering, he hesitated for a while.

He continued, "I think her mother should also be tested for Helicobacter pylori. The smell when she speaks is worse than her daughter's."

This kind of thing must not be said in front of the patient.

Because it hurts self-esteem.

Now there are only a few of them discussing with the doctors, Zhou Can has no worries.

Helicobacter pylori is somewhat contagious.

Especially a family, because they eat together every day, it is easy to infect each other.Not to mention the couple.Basically, as long as one party has this disease, the other party cannot escape.

(End of this chapter)