My medical skills add experience

Chapter 292 You dare to take a step forward, Director Zhang's request for help
"Can Dr. Zhou share the basis for the diagnosis?"

Yang Chan still felt a little unbelievable.

The patient's symptoms were clearly rectal cancer, and the experts determined that the patient may have gastrointestinal cancer in the previous discussion and analysis.She can accept these arguments.

Because one of the biggest characteristics of gastrointestinal tumors is that the tumor is easy to metastasize downward.

For example, esophageal cancer, if it is not detected in time, it is likely to metastasize, and patients will develop gastric cancer, intestinal cancer and so on.

The ovaries are not part of the digestive system and are located in the female pelvic cavity, approximately behind the anterior superior iliac spine.

Although it is adjacent to the rectum, the pathology of the two is really different.

Even if the patient's primary tumor is an ovarian tumor, the uterus is most likely to be involved if it wants to metastasize.

"Well... the diagnosis of this case is mainly based on the combination of symptoms and clinical experience! The examination data only played an auxiliary role in the diagnosis. For example, the patient had abdominal distension for nearly five months, and had difficulty defecating, and Symptoms such as peritoneal effusion, behind these symptoms all represent lesions in one or more organs."

"Abdominal distension and difficulty in defecation. After first ruling out the possibility of colonic lesions, I reasoned in two ways based on clinical experience. Tumors in the rectum can cause difficulty in defecation and abdominal distension. But when I learned that the peritoneal effusion was found to be like a signet ring After receiving the cells, I immediately suspected that the rectum must not be the only one affected, and the stomach should also have lesions."

"After the examination, it was confirmed that there was a tumor in the greater curvature of the stomach. According to the conventional diagnosis, gastric cancer metastasizes to the rectum and rectal cancer occurs. This idea is feasible. But if you are more careful, you will find that the rectal tumor is quite large. The tumor in the greater curvature of the stomach is relatively small. In addition, the patient reported stomach discomfort in the last one or two months. I boldly believe that the tumor in the stomach occurs later than in the rectum."

Zhou Can gave her a detailed analysis of the diagnostic thinking.

All the other experts nodded their heads.

The eyes Yang Chan looked at him were also shining with splendor.

She really didn't expect to be able to make a diagnosis in this way.

"It is more common for gastric cancer to metastasize to the rectum, but it is relatively rare for rectal cancer to metastasize to the stomach. Therefore, I believe that stomach tumors are still not the primary lesion. As for why I suspect ovarian tumors, I rely on my personal clinical experience and some clues of pathology. Evidence. For women after the age of 40, the risk of ovarian lesions increases significantly. It happened that I have received three cases of ovarian cancer metastasis, which is why I made this bold determination."

Zhou Can went on to state some of his diagnosis basis.

Not to mention the experts present and Yang Chan, even the family members nodded in approval.

"Teacher, do you think this patient's abdominal and pelvic tomography and tomographic imaging can detect ovarian tumors?" Yang Chan now has no doubts about Zhou Can's diagnostic thinking, but she still has doubts about the diagnosis results.

"The ovary is a gonadal organ. Tumors occur in it, and the diagnosis is more difficult than that of pancreatic cancer. There is a certain probability that CT scans will find lesions, but there is also a possibility that the lesions will not be visible. Not to mention CT, even MRI has missed diagnoses, Possibility of misdiagnosis. Directly taking suspicious tissue for pathological examination is the gold standard for diagnosing the disease. Dr. Zhou Can is right, you can take part of the tissue through surgery for pathological biopsy.”

Zhang Bihua has so much diagnostic experience that it is difficult to diagnose with ordinary examination.

Suffice it to say how difficult it is to detect ovarian cancer.

After communicating with the patient and his family, the other party agreed to remove part of the tissue for biopsy.

There is no need for Tuya's experts to operate the surgery themselves, and the operating room of Xinxiang Women's and Children's Hospital is fully capable of this operation.

If there is no such surgical ability, it is impossible to become a powerful top three specialized hospital.

Zhou Can has performed extremely well many times in a row, and his status in the eyes of experts has also risen sharply.Experts who didn't know him before all looked at him with admiration.

Xinxiang Maternity and Children's Hospital has also begun to focus on this talented doctor.

The reporters have also discovered that this young doctor is unusual, much better than that returnee doctor.Consciously or unintentionally, they all began to stare at Zhou Can.

Mu Jie was the reporter who first discovered that Zhou Can was a big fish.

What worries me at the moment is how to quickly establish a good relationship with Zhou Can, so that Zhou Can is willing to accept her interview.

It's a pity that her beauty and coquettishness, which have been tried and tested in front of other men, seem to have no effect on Zhou Can.

This bothered her a lot.

Zhou Can ignored those envious or admiring eyes at all, and after helping to diagnose the patient, he returned to the emergency room again.

The pregnant woman, who was pregnant with her five-month-old baby, touched his heart deeply.

After the patient's signs stabilize, the first six hours are the critical period.

"Doctor Pang, is there anything unusual about her condition?"

Zhou Can asked politely.

He was not familiar with Dr. Pang, so he couldn't speak as casually as he did with Deputy Director Shi.

"good!"

Dr. Pang's tone was a little cold, and there was no smile on his face.

Zhou Can had long noticed that something was wrong with her mood.

For example, the pregnant woman was rescued in the morning. She is also a member of the crisis management team. She should have followed Zhou Can as an assistant, but she didn't.During the rescue, she did what she did, without any intention of focusing on Zhou Can.

After the pregnant woman's signs stabilized, Dr. Pang did not stay with Deputy Director Shi and Zhou Can to guard the pregnant woman, but evacuated directly with Director Zhang and others.

Until later, the patient with rectal cancer treated by Director Zhang had a complicated etiology and was difficult to diagnose, so Zhou Can had to rush over to participate in the consultation.

Deputy Director Shi came forward to invite Dr. Pang over.

After Dr. Pang came, when Zhou Can handed over to her, her attitude was as cold as it is now.

There is no obvious confrontation with Zhou Can.

It's just lukewarm, with an indifferent attitude.

Although Zhou Can felt a little unhappy, he didn't say much.

She is an attending physician in the Department of Obstetrics and Gynecology. Compared with Zhou Can, a young and trained doctor, she is considered an experienced doctor.

"If there's nothing else, I'll go first."

Dr. Pang left a sentence and walked directly outside the emergency room.

The two nurses looked at it with weird expressions, but they didn't speak.

Nurses never get involved in conflicts between doctors.

The status of the two is different, and there is no way to mix them.

"Wait! Director Shi stays in the outpatient hall for consultation. I am the only doctor here to guard the pregnant woman. In case of an emergency, I will be caught off guard. If Dr. Pang is not urgent, please stay and take care of the pregnant woman with me." A pregnant woman. The first six hours of fat embolism is an extremely dangerous period, and accidents may happen at any time."

Zhou Can spent several months in the Department of Critical Care Medicine and knows how fragile human life is.

Say no, it's gone.

"I also need my help in the outpatient clinic! I don't think there is anything wrong here. Doctor Zhou can handle it anyway."

Even though Zhou Can asked her to stay, she still refused.

And the words are a bit weird.

Zhou Can is not stupid, he knows why she has such an attitude?

It was nothing more than the fact that the deputy team leader didn't choose her, and was chosen by Zhou Can, a rookie whose rank was not as good as hers.Now it is equivalent to letting her, an old comrade with a higher rank, listen to Zhou Can's orders, and she feels unhappy.

"If Dr. Pang insists on going to the clinic and something happens to the pregnant woman, who will bear the consequences?"

The smile on Zhou Can's face disappeared.

If you are shameless, then you can't blame him for using his status to oppress others.

High emotional intelligence doesn't mean you can't offend others.

Rescuing patients requires the full cooperation of the entire medical team. If Dr. Pang is not subdued, if she plays with her temper during the rescue process, it is no joke.

"Ha, Dr. Zhou brought people here to rescue, should others bear the consequences? Besides, as long as the doctor fulfills his duty of rescue, where does he have any responsibility?"

Physician Pang smiled.

"In the case of this pregnant woman, she is already relying on a ventilator to support her life. In case of a dangerous situation, does Dr. Pang think that only one person can handle it?"

Zhou Can stared at her and asked.

The tone this time was no longer polite, but the tone of a superior questioning a subordinate.

It will definitely make Dr. Pang feel uncomfortable, so there is no way.

When she was happy, Zhou Can couldn't.

"If the rescue is ineffective because of your absence, and the higher-ups hold them accountable, who do you think should be held accountable? That's all. If Dr. Pang feels that the future doesn't matter, just leave. As long as you dare not get me as the deputy team leader With permission, take half a step out of the emergency room, and I will tell the doctor what to do."

Zhou Can pressed her directly with harsh words.

I still don't believe in this evil today, let's see if she has the guts?
There is an old saying that evil does not suppress justice, but there is a premise that the righteous party must be brave and fearless.

Otherwise, the more honest you are, the evil side will only think you are easy to bully.

Dr. Pang was so threatened by a junior doctor. In addition to Tuya's two nurses, there were also doctors and nurses from Xinxiang Women's and Children's Hospital.

Her face turned red with anger, and her eyes became extremely fierce.

Zhou Can just looked at her with cold eyes, but his face was calm.

The eyes of the two met and confronted.

"Go if you have the guts, don't hesitate!"

Zhou Can has already seen flinching from the depths of her eyes.

A woman who is close to 40 years old, a stable job is too important to her.She saw strong confidence and fearlessness in Zhou Can's eyes.

"What can you do if I leave?"

She was still a little unwilling, and tested Zhou Can's reality at the end.

There is a blatant conflict with Zhou Can today, and it is certain to lose face.

If she could win, not only would she be able to vent her anger, but she would also be able to save her so-called face.

So, she is testing.

"My deputy team leader asks you to stay at the scene and be ready to rescue the pregnant woman at any time. If you insist on leaving, you will not listen to the order of the superior. I will report your work attitude to Director Zhang immediately. It is her responsibility to deal with Director Zhang. Maybe you think you are an old comrade and have some contacts in Tuya Hospital, but this is not enough to save you. Even, you may not even be able to keep your job."

Zhou Can spoke very straightforwardly.

It's really not to scare her, but he really has this strength.

The attending physician who is nearly 40 years old has limited potential no matter how strong he is.Compared with a monster like Zhou Can, it's really not even a star.

"Can't I go out and go to the toilet? Hehe, I was just joking with Dr. Zhou just now!"

After a few seconds of fighting between heaven and man, she forced a smile on her face and decisively confessed.

As Zhou Can decided, she couldn't afford to gamble.

And she's completely unreasonable.

"It's okay to go to the toilet. I know Dr. Pang is joking, but I didn't take it seriously."

Zhou Can talks nonsense when he sees people, and talks nonsense when he sees ghosts.

The originally tense atmosphere suddenly warmed up.Both of them reconciled as if they had never had a quarrel.

Of course, this is only the surface.

Reconciliation is easy, but too difficult as before.

With this quarrel and confrontation, it is estimated that Dr. Pang probably hated Zhou Canji in his heart.

So what?

Just like when Zhou Can was working in the emergency department, he beat Dr. Lu to death. Finally, when he was strong enough, Dr. Lu took the initiative to bow his head and repair the relationship between the two.

Today's Zhou Can is countless times stronger than before.Dr. Pang bowed his head to him, and it would only be faster to take the initiative to find him to repair the relationship.

For adults, what is face?Benefits are the most important.

Offending Zhou Can will affect her promotion and evaluation in Tuya, and even affect her deputy senior evaluation, so ask her if she can stand it?

After Dr. Pang left, the older nurse Chen Qingling didn't say anything.

After all, Ji You was younger, and said to Zhou Can in a low voice, "It's Dr. Zhou who is so good, and he calmed her down. She is usually in the obstetrics and gynecology department." Ji You wanted to go on, and Chen Qingling pushed her quietly.

In the unit, it is most taboo to speak ill of colleagues behind their backs.

It is very easy to cause trouble.

She subconsciously glanced at Chen Qingling, who gave her a wink, so she didn't say any more.

From Ji You's words, it's not difficult to hear that Dr. Pang must be domineering in his daily actions.

"You're not afraid of being heard by her if you speak ill of her?"

Zhou Can asked Ji You with a smile.

"I'm not afraid! Doctors and nurses are two systems, and she has no control over me."

She said she was not afraid, but there was a bit of fear in her eyes.

Doctors at the attending level have the ability to deal with any nurses they want.

Not long after, Dr. Pang came back after using the 'toilet'.

His complexion looks much better than before.

Eyes are not eyes and noses are not noses like before.

A 40-year-old woman is much more powerful than a 20-year-old girl.The temper can be contained or released.

……

Around three o'clock in the afternoon, Zhou Can's cell phone rang.

This time, Director Zhang Bihua actually called.

"Hello, Director Zhang, what instructions do you have?"

Zhou Can greeted him respectfully.

Physician Pang next to him heard the call from Director Zhang, and immediately pricked up his ears to eavesdrop.

It could be seen that she was somewhat nervous.

Afraid that Zhou Can would make a small report on her.

"Xiao Zhou, how is the situation there?"

"The signs of the pregnant woman have been stable, but the blood pressure still fluctuates a bit, and I dare not take it lightly." Zhou Can replied truthfully.

"Can I smoke for a while? The diabetic patient who drank too much yesterday, after treatment, his condition has improved. But this is only a temporary treatment. To cure her disease, I am afraid that all the experts will have to do a medical treatment on her together. Consultation, sort out the condition and find out the real cause."

Director Zhang also saw Zhou Can's ability, so he relied so much on him.

"Are you going to your place now?"

Zhou Can asked.

"Well, the family member is in the outpatient hall now. He told me that the patient's condition has improved, and he is very happy. He also told me that his family is quite difficult, and he hopes to use this opportunity of expert consultation to completely cure his wife's illness. good."

Director Zhang Bihua is very kind-hearted, and like most chief physicians, he always thinks of patients from the bottom of his heart.

(End of this chapter)