My medical skills add experience

Chapter 595 The doctor can only give advice, he is just a father at the moment

"That little boy was clearly found to have a brain tumor, and the manifestations were also brain diseases. How could it be related to cardiovascular?" Director Qu's wrinkled face was already full of Jianghong.

Embarrassed, ashamed, and unwilling, she couldn't bear her old face.

This kind of old expert values ​​face more than anything else.

Lin Jinzhi just listened silently without speaking.However, it can be seen from his expression that he obviously trusts Zhou Can more.

"The brain tumor was just a benign meningioma, and it was not large in size. It did not cause substantial damage to the patient's brain. After investigation, it was found that it was the blood transfusion from the aorta to the head and neck. The congenital stenosis of the arteries caused insufficient blood supply to the brain of the little boy. Especially when the little boy turned his head, the narrow section of the blood vessel was compressed and stretched, which aggravated the blood supply tension of the blood vessel, so syncope often occurred. Dr. Zhou said: After a stent was placed in the blood vessel to expand the narrowed blood vessel segment, the little boy was cured and discharged from the hospital."

Director Zhuang was also very curious about the little boy's illness at that time.

So I made a special inquiry.

In the end, I didn't expect the harvest to be quite big.

After listening to his detailed explanation, Director Qu stopped talking with a sad expression.

"Okay, let's continue to study the etiology of Wuxi! Doctor Zhou, tell me the reason why you think the evil group disease."

Director Tang Fei saw that Director Qu's face had turned from red to white, and was worried that something might be wrong with her health.

Also for the unity of the department, I hurriedly changed the subject.

Discussing that little boy's meningioma will only embarrass Director Qu even more.

She also secretly wondered, many doctors in the department got along well with Zhou Can, why some experts were so diametrically opposed to Zhou Can?

People, not only the older they get, the weirder they become.

Moreover, many veteran experts have an instinctive sense of protection for their own authority and achievements.Doctors who are too young to surpass them in their field of medicine create a sense of crisis and envy.

In the end, they became hostile and opposed to Zhou Can.

This is just normal.

As Zhou Can's strength becomes stronger and stronger, they will finally lower their proud heads and accept Zhou Can's rise and excellence.

To be honest, at Zhou Can's age, many doctoral and medical students who have just graduated may not even be able to do simple skin sewing.Tying a knot, dawdling for a long time, cutting the thread and being scolded by the superior doctor.

There are many regular trainees and interns who can't cut the thread clinically.

Needless to say, the rotation of interns is almost entirely a preliminary contact with clinical practice.What they do is basically chores, with very low technical content.What many interns do the most is to learn to write medical records and run errands.

As for entering the operating room, let alone an intern, even Gui Peisheng has to depend on his fate.

If you meet a good teacher, you may take it into the operating room and give you a chance to observe it.

The treatment enjoyed by most regular trainees requires you to work, but does not give you the opportunity to grow and learn skills.Because the department is not stupid, knowing that you will leave after two or three months of rotation, instead of spending effort and resources training you, it is better to focus on training doctors in the department.

Having said that, let's talk about the importance of regular trainees choosing undergraduate departments.

For example, Zhou Can entered the emergency department at the beginning, and this is his undergraduate department.

Under normal circumstances, the undergraduate department will put a lot of effort on training its own regular trainees.All kinds of growth opportunities will basically be given ample.

As for the rotation to other departments, it depends on fate.

If it's an evildoer like Zhou Can, or a special talent like Du Leng with a top-level education, they can get preferential treatment in any department they enter.Ordinary Pearson is rotated to other departments, especially the surgery room, and may not even have many opportunities to enter the surgery room.

You don't need the hook.

Seeing that Director Qu was being honest, Zhou Can didn't care about her anymore.

Instead, Lang said, "The symptoms of intestinal malignant histiocytosis are changeable. I have been in contact with such cases in both digestive surgery and gastroenterology. Progressive exhaustion, jaundice, and bleeding. If you want to confirm whether Lin Aixi has a malignant disease, there is another way to check whether her liver, spleen, and lymph nodes are enlarged."

"Also, the reduction in her blood count is also consistent with the disease. Judging from the current symptoms, many symptoms are highly consistent with the disease. In addition, the Provincial Children's Hospital used antibiotics and glucocorticoids to treat her to no avail. It can also indirectly prove that it is a malignant group disease."

Zhou Can continuously stated several reasons for highly suspecting the disease.

These are rich clinical experience and profound medical knowledge, and they need to be used flexibly in clinical practice to be able to be so freely and directly point to the source of the disease.

"I have checked Yanxi, and her liver area is indeed enlarged, and the right upper abdomen can even be seen directly with the naked eye. There is also enlarged lymph nodes, especially in the axillary lymph nodes. .”

Director Tang Fei said.

As soon as this remark came out, the cause of the child's disease had already pointed to the malignant group disease.

"I have also been in contact with two cases of malignant group disease, which are relatively rare in clinical practice. In the two cases I have been in contact with, no abdominal mass was found. The malignant group of cells has a characteristic, and most of them are scattered and unevenly distributed after they appear."

An old expert demurred.

"Its symptoms are variable, and I don't think it should be the only gold standard for sporadic and uneven distribution."

Zhou Can argued.

"Okay, even if we can't use this as the gold standard, the Provincial Children's Hospital has already done a bone marrow puncture on the sick child, and the test result was negative. No abnormal cells were found. This can always overturn the conclusion of malignant group disease, right?"

The level of this old expert is quite high.

Grasp some of the important doubtful points to demonstrate and overthrow Zhou Can's diagnostic conclusion.

This is also the biggest difference between Zhou Can's diagnosis and that of the old experts.

Zhou Can's thinking is very young, bold and careful, and he often dares to think and act.For some intractable diseases, the symptoms themselves are complicated, and the results of various examinations are confusing. It is difficult to draw effective conclusions according to conventional diagnostic thinking.

Old experts tend to be conservative and overly cautious, and the probability of making mistakes is of course much smaller.

But it can also be difficult to diagnose the real cause.

"I don't agree with ruling out malignant group disease only based on a negative bone marrow puncture result. Intestinal malignant histiocytosis, bone marrow involvement is relatively rare, and a negative bone marrow puncture result is normal. If you really want to clarify the cause, I suggest laparotomy or laparotomy. However, abdominal puncture is extremely difficult, and laparoscopic exploration should be a more patient-friendly method that can ascertain the cause of the disease to the greatest extent."

Zhou Can also knew that the little girl was young, only five years old.

And he is currently seriously ill, and the situation is extremely dangerous.

In this case, it is difficult for the family members to accept the laparotomy.

There is also great harm to sick children.

"Thank you to all the experts, Director Tang, and Dr. Zhou for in-depth discussions on the cause of my daughter. It's just that my daughter's current situation is not ideal. Will she be able to bear the laparoscopy? Will it be dangerous?"

Lin Jinzhi objected.

Doctors can only give a diagnosis and treatment plan, and family members are the real decision makers.

No matter how good the treatment plan given by the doctor is, it is useless if the family members disagree with the treatment.

"Any operation has risks. The risk of laparoscopic exploration is less than that of laparotomy, but there are still relatively high risks. The risk of paracentesis is relatively low, but the operation is extremely difficult, and the puncture results are not necessarily accurate. In clinical practice In fact, the detection of malignant group diseases is mostly autopsy. If the Forestry Bureau has concerns, based on the location of your daughter's abdominal mass, I suggest a fiberoptic colonoscopy and biopsy, which should also be able to clearly diagnose the cause."

Zhou Can proposed a new inspection plan.

Under normal circumstances, the malignant group disease is located in the colon, and it is easier to detect it with colonoscopy and biopsy.

But the little girl's mass is in the ileocecal area, so the conclusion is unknown.

Taking into account the concerns of the family members, Zhou Can could only propose such a compromise solution.

"Choosing fiber colonoscopy is indeed more suitable for Wuxi."

Director Tang Fei spoke.

"I listen to the experts. Since you think it is necessary to check a colonoscopy, then check one."

Lin Jinzhi no longer hesitated.

Especially when I heard Zhou Can say that the cause of the evil group is often found in corpses.

This made him very scared.

"Okay, since the Bureau of Forestry agrees, I will arrange it immediately. The evil group disease is very dangerous. It has been delayed for such a long time. I will go to see the situation of Wuxi first. If it meets the requirements of colonoscopy, tonight Just make one for her."

Director Tang Fei's words were obviously opening a green channel for the daughter of the Forestry Bureau.

Well, there are many ways.

Her show of favor is much more clever than Director Qu's show of grabbing credit.

"Director Tang, Bureau Lin, fiber colonoscopy is certainly a good way, but considering that Lin Yuxi currently has blood in the stool, colonoscopy may not be possible. If it doesn't work, I still recommend laparoscopy."

Zhou Can said to the two very sincerely.

"Okay, thank you Doctor Zhou, I will think about it carefully."

Bureau Lin is obviously still concerned about the risks of laparoscopy.

After all, life is no child's play.

He never wanted anything to happen to his daughter.

……

After the consultation, Zhou Can also went home.

After a day of work, he was also very tired. After that, he was busy every day, so he didn't care about the daughter of the Forestry Bureau.

Until six days ago, according to the rules, he was going to see the pediatrics again the next day.

But in the middle of the night on the sixth day, I received a call from a stranger.

At that time, Zhou Can was sleeping with Su Qianqian in his arms.Seeing that it was an unfamiliar call, I wasn't going to answer it.

Out of the doctor's sense of responsibility, he finally accepted it.

As soon as he got through, he heard the trembling voice of a middle-aged man crying from the other end of the phone.

"Doctor Zhou, help..."

"Who are you, please?"

Zhou Can's heart tightened, could it be that this person had a sudden illness like myocardial infarction?In this case, it is indeed more efficient to ask him, the doctor, for help.

"I'm Lin Jinzhi from the Bureau of Health and Family Planning! My daughter's condition continues to deteriorate and she's about to die. I regret not following your advice for a laparoscopy. Please come and save my daughter! I really can't help it." ..."

The fact that the BOSS of the Bureau of Health and Family Planning can break down in tears shows that Bureau Lin's daughter is already seriously ill.

During the consultation that night, Zhou Can repeatedly urged Bureau Lin to perform a laparoscopy for his daughter.

When performing any operation, the surgeon will fully consider the harm and benefits of the operation to the patient.

Laparoscopy is more harmful, but compared with saving lives, this risk is really nothing.

This means that the current medical technology is developed, and the level of laparoscopic surgery in Tuya Hospital is very high.Otherwise, according to the previous traditional method, only laparotomy can be performed.

"Okay, I'll rush to the hospital right away!"

Considering the special status of the other party, Zhou Can couldn't shirk this matter.

In fact, he knew in his heart that even if it passed, it would be very difficult to bring people back to life.

There are so many experts in pediatrics who don't eat dry food.

They can think of all the treatment methods that Zhou Can can think of.

When he arrived at the hospital, Director Tang Fei was already there.

Only a boss at the level of the Forest Bureau can make her rush to the hospital in the middle of the night.

The directors are actually very busy on weekdays, and their work and rest schedules are disrupted, which has a great impact on their health and work.

"Doctor Zhou, I beg you to find a way to save my daughter! I really regret that I didn't listen to your advice at the beginning, so I shouldn't be hesitant. Now my daughter has been hurt like this..."

Seeing Zhou Can, Lin Jinzhi quickly grabbed Zhou Can's hand, and asked him for help with tears in his voice.

In the face of life and death, status, fame, power, majesty... everything is just a cloud.

At this moment, Lin Jinzhi is just the most ordinary father, fearful and worried about his daughter's imminent death.Do everything possible to find a way to ask the doctor to save her.

"Bureau Lin, don't worry. Let me understand the situation first."

After Zhou Can finished speaking, he looked at Director Tang Fei.

"Director Tang, where is the sick child now?"

"In the ICU, the situation is very bad, I'm afraid... you should go and have a look first!"

Director Tang Fei should have wanted to say that he might not make it through tonight.

He finally swallowed the words.

She has to consider the feelings of the family.

Zhou Can is actually reluctant to enter the ICU, because various strict disinfection and sterilization procedures are very troublesome.

It will take a while just to clean your hands.

Had to change into protective clothing and shoes.

Moreover, the atmosphere inside was particularly dignified, which made him very dislike the depression of fighting against death all the time.

After entering, he saw that the little girl was already very thin, her upper abdomen was swollen more obviously, she was short of breath, and her face was so pale that there was no blood.There is almost no big difference from the face of the dead.

"Ugh!"

He sighed deeply.

After reading it, Director Tang and Lin Jinzhi accompanied him to the lounge outside.

"The situation is too bad, and the malignant group disease itself is very dangerous. Every hour of delay, the disease may progress a lot. My level is limited, and there is really nothing I can do."

Zhou Can is not a god. His medical skills are considered very high, but there is a limit.

If he could raise multiple medical skills to level seven, he might be able to try to save the little girl's life.Now, he didn't even think about trying.

Because it is really helpless.

"Dr. Zhou, I have heard a lot of medical staff and family members talking about you in the pediatric department these days. I know you are very capable. I beg you, save my daughter. Just let go and save others. You don't need to take the risk."

Lin Jinzhi begged again.

(End of this chapter)