My medical skills add experience

Chapter 593 Treat first and then investigate, the despised general

Hospitals are equally afraid of criticism.

Whether it's surgery or ward care, medication, diagnosis, there's always room to find fault.

However, when encountering such super VIP patients, the hospital is very vulnerable, and there is no other way to go except to fully cooperate and strive to provide the best service.

Of course, if the top management of the hospital insists on trying to die, then there is no taboo.

The girl, who was only five years old when she was a child, has had a fever for nearly a month and was hospitalized in the Provincial Children's Hospital for eight days.

The main complaints on admission were fever, abdominal pain, and blood in the stool.

To be honest, it is rare for children to have blood in their stools.

Considering the young age of the patient, the Provincial Children's Hospital conducted screening for genetic diseases, and found no relevant genetic disease history in the patient's family.

The child had a large amount of blood in the stool. When he was admitted to the hospital for treatment, the whole person had already shown a state of severe blood loss, almost in shock.

Provincial Children's Hospital provided emergency blood transfusion for the children.

At that time, the child's blood pressure was only 81/35mmhg, which was a very scary low blood pressure.

Under normal circumstances, it is an ordinary family, and the child has been sent to the hospital for treatment when he is so sick.But the family of the BOSS of the Bureau of Health and Family Planning is very special. The child was born to him and his ex-wife.

The work is busy on weekdays, and the burden of taking care of the children almost completely falls on the stepmother and the nanny.

Now that this kind of thing happened, that stepmother must be to blame.

As for how people deal with it, that is a family matter.

When the child was admitted to the hospital for physical examination, his body temperature was 39.6°C, his pulse rate was 110 beats/min, and his respiration was 28 beats/min. He was in a trance and appeared to be severely anemic.

In fact, if the blood pressure is so low, it is already severe anemia.

When the receiving experts examined the patient's body, they found that the skin and sclera had no yellow staining, no rash and bleeding spots, no superficial lymph nodes were enlarged, the neck was soft, and the trachea was in the middle.

Rhythm.

Auscultation of both lungs was also unremarkable.

The abdomen is flat and soft, and a cord-shaped mass can be touched in the lower right abdomen, with a length of nearly 10 cm and a width of nearly 6 cm. As long as it is touched, the child will cry out for pain.

Seeing this, Zhou Can first suspected intestinal tumors.

The right lower abdomen should belong to the ileocecal part of the intestine.

Experts from the Provincial Children's Hospital did further examinations on the child, and the hemoglobin was only 36-85g/L.

Repeated blood and stool cultures were negative.

This should be to check the possibility of intestinal malignant bacteria.

The intestinal environment of the human body is extremely complex, and there are countless kinds of bacteria and toxins in it.But under normal circumstances, these bacteria are beneficial, not only harmless to the human body, but also provide some help for the human body's food digestion.

Just like earthworms help plants break down organic matter in the soil.

These tests failed to find out the problem. The experts from the Provincial Children's Hospital worked hard and checked the child for anti-nuclear antibodies and rheumatoid factor.

Rheumatoid disease has always been one of the strangest diseases in clinical practice.

It's as ghostly as it is difficult for doctors to diagnose.

And it can cause many diseases.

During the diagnosis process, it is extremely easy for doctors to misdiagnose.Nowadays, many experienced old doctors will look up this item as long as they encounter such difficult-to-diagnose symptoms that are basically close to rheumatoid.

Unfortunately, not much was gained.

Next, I checked the responses of Feida and Waifei.

As a result, typhoid bacillus type H, type O, paratyphoid bacillus type A, type B, type C, and proteus were all negative.After finding this step, it is estimated that the experts from the Provincial Children's Hospital will start to scratch their heads.

Facts have proved that the experts were a little confused, because the children were checked for hepatitis B virus antigen, serum potassium, serum sodium, serum chlorine, carbon dioxide binding capacity, blood urea nitrogen, blood creatinine, serum protein electrophoresis...

It's simply a matter of checking everything that can be checked.

This also illustrates a problem. If Western medicine diagnoses with such a wide-ranging inspection method, it will check everything. This is a manifestation of poor medical skills.

A doctor with real medical skills will prescribe the necessary examination application for the patient.

There won't be a single redundant check.

Of course, this girl is a super VIP. It is understandable that the experts from the Provincial Children's Hospital gave her various examinations in such a grand manner without finding out the cause.

The more distinguished patients are treated, the more cautious the doctors are.

This point can be referred to the ancient imperial doctors who treated the emperor, concubine, and prince.Basically, you put your head on your trouser belt, and you may offend Long Yan at any time and be decapitated.

The civilization of modern society has improved a lot, and the situation of pulling doctors out and killing them has no longer happened.

However, if a doctor makes a big mistake when diagnosing an important patient, it is perfectly normal for him to sit on the bench and ruin his future.

Therefore, Zhou Can can well understand the mentality of the experts in the Provincial Children's Hospital.

After a series of laboratory examinations, the experts checked the chest and abdominal plain films of the child, and found no abnormalities.

Bone marrow aspiration was done, the ratio of grain red decreased, intracellular iron deficiency, no abnormal cells were found.

To put it bluntly, this bone marrow puncture is tantamount to doing nothing.

It does not provide much practical significance in diagnosis.

After the child is admitted to the hospital, the cause must be found out, but now the child's condition is very serious, and it is impossible to wait.Besides, the father of the sick child is watching.

Experts must first give some symptomatic treatment to the sick child, and first save the life of the sick child.

This is also the most common operation in clinical practice.

Some tests take several days to get the results. If you have to wait for the test results before giving medicine, the patient may not wait for the results at all.

The experts from the Provincial Children's Hospital gave the child a number of symptomatic treatments such as blood transfusion, hemostasis, and anti-infection before the cause was identified.

Currently suspected diseases are intestinal hookworm disease, Crohn's disease, lymphoma, intestinal tuberculosis.

From the perspective of treatment drugs, experts seem to be more inclined to intestinal tuberculosis.

Because many symptoms of sick children are similar to intestinal tuberculosis, and intestinal tuberculosis is a common disease in our country.

After taking the film, the possibility of intestinal tumor can basically be ruled out.

Initially, there was great hope for intestinal tumors.

Because a huge cord-like mass can be felt in the ileocecal area.

Unfortunately, after many days of treatment, antibiotics and corticosteroids were used, and the sick child's condition kept recurring.When using the medicine, the body temperature can be controlled, and the bleeding seems to have improved significantly.

However, recurrence occurred soon after stopping the drug.

This shows that no real cause has been found.

Zhou Can began to carefully deduce the possible cause of the disease in his mind.First list all the diseases that match the symptoms, and then exclude them one by one. This is the most commonly used method for clinical diagnosis of difficult diseases.

At this time, a dignified middle-aged man with big ears walked into the consultation room.

It can be seen that the middle-aged man's face is quite haggard.

The daughter has been seriously ill for several days, and the treatment has not improved significantly, which must have brought great pressure to this man.

"My name is Lin Jinzhi, and my daughter's name is Lin Nuanxi. I'm very sorry to bother directors, experts, and nurses at such a late hour. But my daughter is in danger, and I really can't delay. I'm here to express my sincere thanks to everyone. Regardless of the outcome How, today's kindness, Lin must keep it in his heart."

After speaking, the man bowed to everyone.

As expected of a great leader, he speaks and does things very well, and his handling of human nature and control of people's hearts is even more wonderful.

Just a few words and a bow are enough to make the medical staff present go all out to rescue his daughter.

And the impression of him will be very good.

"My daughter was born to my ex-wife. She married me when I was the poorest and most down-and-out. Later, due to work reasons, we never had a child. It was not until my job became more stable that Lin Ai was born. Hee. However, she suffered from amniotic fluid embolism due to heavy bleeding during childbirth, and finally abandoned me and my newborn daughter. It can be said that my daughter is my lifeblood. I implore the experts here to find a way to save my daughter. Everyone If you want to know anything, you can ask me at any time, and I will fully cooperate with the doctors in their diagnosis and treatment."

Lin Jinzhi expressed his opinion to everyone again.

Zhou Can originally thought that this Lin Jinzhi was like most successful men, getting promoted and getting rich in exchange for wives.

I didn't expect it to happen for a reason.

It turned out that his wife died of amniotic fluid embolism and postpartum hemorrhage.

It is not easy to be a father and mother at the same time.

It is understandable to marry another wife out of personal physical needs and family needs.

It's just that he didn't expect that the second wife he married was not a good man, but a poisonous woman.

If the child has a problem with his body, it would be great if he could be sent to the hospital for treatment as soon as possible!

There are many diseases, especially malignant diseases, the earlier the treatment, the better.

For example, cancer, which is so distasteful in our country, is not taken seriously in many developed countries.Because people attach great importance to physical examination, cancer can often be detected in the early stage.

After surgery and drug treatment, can achieve a radical effect.

Many people look forward to the invention of drugs to treat cancer in the future. One day, treating cancer is as simple as treating a small cold.

This can be very large, but it takes time.

Before the drug is developed, regular physical examinations, early detection and early treatment are the most correct methods of prevention and treatment.

Lin Jinzhi glanced across the crowd, and slowly took out a paper-folded love peach from his bosom.

"This is a birthday present from my daughter, and she said, Dad, I know you are very busy at work, but I especially hope you can spend more time with me, because you smile very happily every time you see me. Happy birthday to you!"

A dignified boss of the Bureau of Health and Family Planning, his lips trembled when he read the content above.

Emotion is the most precious thing in human beings.

Even money and work are not as important as emotions.For the one we love, we can go bankrupt, work hard, and then when we get paid, we can spend it all on the one we love without complaining.

This is the charm of emotion.

After hearing this, the doctors and nurses present were also moved.

The nurse in charge of the tea work and several female doctors even wiped away their tears.

"Does your daughter vomit a lot of blood? When did she start to vomit blood? How many times has she vomited blood so far?"

Zhou Can was the first to ask.

It's not that he came up with the limelight, but he wholeheartedly diagnoses this sick child, and he needs to know more detailed information.

Lin Jinzhi looked up at Zhou Can, and found that the first person who asked the question was only a very young young doctor, he seemed a little disappointed.

But still answered.

"The amount of hematemesis is not very large. The symptoms of hematemesis probably started this morning, that is, the sputum spit out when coughing has blood streaks in it. I have vomited a few times, and I really haven't counted it."

It seems that the vomiting of blood is not as serious as imagined.

Zhou Can preliminarily suspected that it was the poisonous effect of the medicine, or that the disease had worsened, and it had invaded the upper gastrointestinal tract from the lower gastrointestinal tract.

Or invade the lungs.

Coughing up blood is mostly related to lung disease.

For example, lung cancer and pneumonia are prone to coughing up blood.

"Is your daughter vomiting blood now? I mean, is there blood in her phlegm now?"

Zhou Can continued to ask.

Lin Jinzhi frowned slightly.

"Sometimes the sputum is bloody. I really appreciate your enthusiasm, but I suggest trying to leave the time for questions to the old experts here. Because they have more experience and are more likely to diagnose my daughter's cause. "

Obviously, he thought Zhou Can asked too many questions, and worried that it would take up the time for other experts to ask questions.

Almost everyone has a deep-rooted subconscious, that is, the older the doctor, the better, the higher the level, and the richer the experience.

"Ok."

Zhou Can's expression was calm, and he didn't ask any more questions.

Director Tang Fei wanted to explain a few words, telling Lin Jinzhi that although Zhou Can was young, his level was not low.But at this time, someone had already started to ask questions, so she swallowed the words for a while.

"Bureau Lin, what kind of food does your daughter usually eat?"

"My daughter has been taken by the nanny and my current wife. Because I am very busy with work, I often get home very late. So I am not very clear."

"Do you usually eat more snacks? Because such a young child has serious intestinal diseases, and after excluding genetic factors, the diseases often come from the mouth."

"Well... I do eat a lot of snacks at ordinary times. I think she likes to eat them, and I will often buy some back. Because I eat too many sweets, my daughter's dental caries is more serious."

……

Zhou Can just listened quietly, still analyzing the cause of the child in his mind.

Half an hour later, the experts asked almost all the questions they should have asked.

We also launched several rounds of new discussions.

Director Tang Fei began to make a concluding speech.

"According to the results of the discussion just now, five diseases are suspected: intestinal tuberculosis, typhoid fever, Crohn's disease, myeloma, malignant group or intestinal lymphoma. First of all, intestinal tuberculosis should be ruled out. From the analysis of Wuxi's general condition, There is no symptom of tuberculosis toxemia, no significant increase in erythrocyte sedimentation rate, and no similar genetic or past medical history, and her condition is very critical, so I think intestinal tuberculosis can be basically ruled out."

Director Tang Fei can become the chief director of the Department of Pediatrics, and her medical skills and academic level are both top-notch.

It is by no means an empty vase with good looks.

She is very talented in many fields of pediatrics.

The only thing lacking, perhaps, is the ability to operate.

Surgery is highly practical, highly skilled, and requires high physical strength, so it is generally difficult for female doctors to make great achievements in this field.

Only a few cases can have good achievements.

That is also concentrated in the two major areas of obstetrics and gynecology.

(End of this chapter)