Since 1981 Health School

  Chapter 297 Abdominal pain and bleeding after menopause

  Chen Qi didn't speak, but quietly observed the patient's condition.

  Traditional Chinese medicine pays attention to "seeing, hearing and asking"

  Western medicine also has its own set of physical examinations, that is, "visual touch, touch, listening and smelling".

"Vision" is the first, the reason is very simple, the first sensory organ that the patient comes into contact with you for the first time is through the eyes, through vision you can see the patient's overall state, face, gait, etc. There will be a general judgment first.

  It's a pity that doctors rarely use this set of basic skills proficiently after working.

  And there is a strange phenomenon, the more experienced the doctor is, the more he likes to do the physical examination carefully by himself, so that he knows what he knows.

  On the contrary, young doctors prefer to use instruments instead of physical examinations, and they are too lazy to move. The diagnosis and treatment bed is already covered with dust, which often leads to many missed diagnoses and misdiagnoses.

   There is another place where clinicians are criticized. Can doctors not see a doctor without the machine?

  Western medicine pays attention to "evidence", so auxiliary examination is essential, whether it is required by law, diagnosis and treatment norms, or the condition of the disease, auxiliary examination is necessary.

  What if there are no these auxiliary inspections?

   What if you were in a field hospital? Or there is no testing equipment like Huangtan Health Center, so you still can't cure the disease?

  Take the acute abdomen in front of me as an example. There is no emergency department in the fourth hospital at night, so there is no corresponding auxiliary department on duty, no blood test, no X-ray film, no B-ultrasound, so what should I do?

  Chen Qi felt a little tired when he saw the messy appearance of the surgeons in the Fourth Hospital.

   This is not only because the physical examination is not standardized, but also there are problems with the way of diagnosis.

  So he could bear it no longer, and stepped forward,

   "Come on, come on, you are all optimistic. Now I will do a complete physical examination according to the requirements of the textbook. Look carefully, what is the problem?"

  When the surgeons heard that the vice president wanted to do it in person, they quickly stood aside obediently and were very obedient.

  Zhao Qiaoer's parents stood beside her at this moment, but their brows were tightly frowned.

  My daughter is a big girl. Although the doctor will inevitably have physical contact, but a large group of old men touch her body after you touch it, and you press it after I press it. What does this sound like?

  Originally, it’s okay for a veteran doctor to come for an examination, but now suddenly a young man wants to come for an abdominal examination. He just graduated, right?

   What the **** is this inspection? Still want to eat sick tofu?

  The old couple wanted to speak a few times, but they held back a few times, and their eyes were already a bit unfriendly.

  Chen Qi foolishly did not observe the murderous eyes of the family members, and was still doing the physical examination seriously while thinking about what went wrong.

   After he finished the examination, he became thoughtful, and then asked the surrounding surgeons without thinking.

   "Do you think the patient looks good?"

   Not to mention that the doctors were confused, even Zhao Qiaoer's parents were full of questions, wondering if this doctor wanted to play hooligans?

  This is 1984, only one year has passed, and the stinky hooligans have resurfaced so quickly? Also mixed into the team of doctors?

  The patient’s family members can ignore it, but this is a question from the vice president, and the surgeons have to answer whether they want to or not, so they all scratch their heads in embarrassment:

   "Ugh, nice..."

   "Yes, it's pretty..."

  Zhao Qiaoer is 18 years old this year. She is at the age of a flower like a jade. She should be convex and concave. Although the abdominal pain makes her pale, it makes me feel more pitiful. To be honest, she is definitely a beauty.

  Chen Qi changed the subject again and asked, "Yang Tihao, what did you find in your physical examination just now? Why do you think it's appendicitis?"

  Yang Tihao talked eloquently: "Vice Chen, it's because the patient has tenderness all over the abdomen, and a mass can be touched in the lower right abdomen, so I diagnosed it as appendicitis."

  Zhao Qiaoer's parents were relieved when they heard it, and said again and again: "It's just appendicitis, it's just appendicitis."

  Chen Qi asked: "Then there is shifting dullness on percussion, how can this be explained?"

  Moving dullness, this generally means that there is fluid in the abdomen, either ascites or blood. Appendicitis is obviously unlikely to have dullness.

  Yang Tihao thought for a long time, but couldn't figure out why, so he could only retreat angrily.

  At this time, surgeon Zhang Xingshun asked:

   "Moving dullness may also be caused by fluid accumulation in pelvic inflammatory disease, and it can also explain symptoms such as abdominal pain."

  Chen Qi asked rhetorically: "During the consultation just now, the patient himself said that there was a small amount of bleeding in the tract. Could this be the case with pelvic inflammatory disease?"

  Will pelvic inflammatory disease cause internal bleeding? How did this group of rough surgeons know? It's useless to ask.

   Sure enough, Zhang Xingshun's eyes were a little confused, and he was trying to recall the knowledge in the book, and he probably wanted to turn the book right away.

  Director Bian stood beside him, and obviously heard something was wrong. If there is bleeding from the **** and abdominal pain, then the obstetrics and gynecology diseases must be considered first, but he did not say a word. This is the teaching time of Vice President Chen.

  Chen Qi looked at Zhao Qiaoer, and asked again without thinking: "Are you married?"

  In an instant, Zhao Qiaoer's face turned even paler, and she shook her head desperately, "No, I, I don't!"

  The dissatisfaction of Zhao Qiaoer's parents is about to reach its peak, thinking that the doctor doesn't care about her faults, and asks her daughter if she is pretty, and asks if she is married. What is this for?

   Have you taken a fancy to her?

   You really want to fall in love with it. It is not impossible to find a doctor to be your son-in-law. The question is that my daughter is in pain now, should I see a doctor first? Have a priority?

  Chen Qi didn't know what the family next door thought, so he asked another question:

   "When was your last period?"

   "Doctor~~~"

  Zhao Qiaoer's mother couldn't help it anymore. Things like menstruation are the extreme privacy of girls. What kind of doctor is asking such weird and shameless questions?

   "Doctor, just now several other doctors also said that my daughter may have appendicitis or pelvic inflammatory disease. What do I think about my daughter's menstruation, whether my daughter looks good or not, it seems that it has nothing to do with seeing a doctor, right?

   I see you are also young, you are new here, just started working? You have to learn skills, and I can bear to touch my daughter, but now you molested my daughter again and again, my wife wants to ask, what is your reasoning? "

   Director Bian burst out laughing when he heard this, and quickly covered his mouth.

  The other young surgeons also turned their heads away, but the twitching of their shoulders showed that they were holding back their laughter.

  Chen Qi was also embarrassed, "Auntie, I'm a doctor, and the doctor still needs to ask clearly, whether it's appendicitis or pelvic inflammatory disease is not certain."

  The old lady was about to say something just now, but was stopped by the old man: "Don't talk, let the doctor check it first."

  The old lady shook the old man's hand, looked at Chen Qi dissatisfied, and finally rolled her eyes.

  Chen Qi was also speechless, he could only blame himself for being too tender, the 22-year-old vice president had to be believed.

  Zhao Qiaoer replied in a murmured voice: "It was the 5th of last month..."

   Oh~~~~~

   Now the surgeons realized that something was wrong. It is now September 25th, and this menstruation has been delayed for more than 20 days, so something can be explained.

  The problem is that this girl clearly said that she is not married, what is going on?

  At this time, some smarter surgeons suddenly understood why Vice President Chen asked them whether the patient was good-looking or not.

  How could the leader flirt with other girls for no reason? Every word the leader said has connotations. Who said that girls can only get pregnant if they get married? Pretty girls are more likely to be seduced.

   But if it is related to pregnancy, it will be a shocking scandal! !

  In the 1980s, it was still conservative, especially in small cities and places like Vietnam, where a woman’s reputation was very important, and everyone around her would make fun of her when she was unmarried and pregnant, not to mention that Zhao Qiaoer didn’t even have a fiancé in name.

  The doctors of the Fourth Hospital already faintly felt that the outcome of this matter might be worse.

  Zhao Qiaoer's parents didn't realize the seriousness of the matter, but felt uncomfortable being looked at by the strange eyes of several doctors.

  Director Bian asked softly: "Deputy Chen, what do you say? Did you really win the bid?"

  Chen Qi nodded lightly: "Morses, cervical pain is obvious, and the lump can only be touched behind the right uterus. I'm afraid it's not as simple as a precursor, it's probably the most serious situation."

  Director Bian gasped: "You mean heterotopic?"

   Not to mention that Director Bian was gasping for air, the doctors in the first surgery department next to him also had scalp numbness and ectopic pregnancy, which is also the legendary "ectopic pregnancy".

  In Vietnam, the mortality rate is almost 80% of the disease, and it is the number one cause of death among pregnant women, far exceeding dystocia.

  Moreover, only the People’s Hospital and the Second Hospital in the Vietnam-Central region have successful rescue records. So far, the Fourth Hospital’s success rate in rescuing ectopic pregnancy is still 0.

   All of a sudden, the doctors became nervous, and many of them broke out in cold sweat.

  When the patient's mother heard that the two doctors began to play charades about what aura and abnormal position, she felt strongly dissatisfied again.

  The old lady felt that the doctors around her had strange eyes and speech, and there was a feeling that they were going to murder me. This feeling made her very insecure.

   "Doctor, what is my daughter's disease? Can your fourth hospital treat it?"

  Chen Qi hesitated for a while, and decided to tell the truth:

   "The patient's condition is very dangerous. We suspect an ectopic pregnancy, and there is already a small amount of bleeding, so we want to do a posterior fornix puncture immediately. If we can extract non-coagulated blood, it will be almost impossible."

   "Don't tell me what I don't understand, I'll just ask you, what is one, and what is one?"

   There was a little doctor next to him, seeing the poor attitude of the patient's family members, he felt unhappy and went straight back:

   "It's an ectopic pregnancy, and I have it in my stomach!"

"what???"

  (end of this chapter)