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The next thing is easier to handle. Find a way to arrange 24-hour brain wave monitoring and bowel sound monitoring for patients.
For this test, the patient needs to live in the hospital, but it does not belong to hospitalization.
It's just an inspection item.
After a day of monitoring, the patient's 24-hour brain wave data and bowel sound monitoring and positioning have been completed.
Of course, Zhou Can didn't need to do it himself.
Director Jia temporarily arranged for two interns to monitor the patient's bowel sounds and locate them.
The monitoring of bowel sounds does not need 24 hours, it mainly focuses on about half an hour before and after meals. However, the doctor who needs to monitor draws an accurate positioning map.
This job requires strong professional knowledge.
At least it is necessary to clearly know which intestinal segment the bowel sound is located in.
Using two interns to do this at the same time is also to ensure that no mistakes are made and the accuracy is maximized.
In the digestive surgery consultation room, more than a dozen doctors sat together for consultation.
Several chief physicians including digestive surgery were present.
There are a total of five difficult cases and the formulation of complex surgical plans requires everyone to discuss together and gather the wisdom of many people for consultation.
The first case to participate in the discussion and consultation was this case of pseudoenteritis.
"This patient is 17 years old and has had diarrhea for more than two years, and his symptoms are highly similar to enteritis in all aspects."
Director Jia first introduced the patient's condition, and then put the patient's examination report and other information on the public screen.
"That's right, this is typical enteritis!"
A young deputy chief physician in his forties came to a conclusion after seeing it.
"I know this disease. I was invited by the Gastroenterology Department for consultation more than half a month ago. We discussed it together for a long time, but the real cause was not found. It is basically certain that it is definitely not common enteritis. He was diagnosed and treated in the hospital, but to no avail.”
The speaker this time was Director Xiao of the Department of Digestive Surgery. He was fifty-six years old and also served as the director of the Department of Digestive Surgery.
In terms of diagnosis and treatment level and surgical ability, it is second only to Director Jia.
The deputy chief physician who spoke first was immediately slapped in the face.
If you are young, if you express your opinion too impulsively, you will always be easily slapped in the face.
"It's not common enteritis, what could it be? Is it refractory chronic enteritis similar to Crohn's disease?" the deputy chief physician asked with a blushing face.
In his early forties, he could be called a "young man" among doctors.
The deputy chief physician is quite aggressive and aggressive.
During the consultation, everyone spoke freely without any scruples.
Not to mention anything else, the enthusiasm of the deputy chief physician is definitely worth encouraging.
"Crohn's disease can be ruled out, but the possibility of chronic enteritis cannot be ruled out."
Director Xiao replied.
"Dr. Zhou Can in this group thinks that the patient has pseudoenteritis. Yesterday, he arranged for the patient to undergo 24-hour brain wave monitoring and bowel sound monitoring. Next, Dr. Zhou will introduce the diagnosis idea to you!"
Director Jia is not condescending at all.
Zhou Can was pushed out directly.
There was an uproar in the audience, and the focus of attention was on Zhou Can.
Zhou Can stood up and introduced the diagnosis ideas to many superior doctors.
After the introduction, without waiting for him to sit down, Director Jia then signaled to him, "Zhou Can, now that the monitoring data you want have come out, let me introduce your diagnostic conclusion to everyone."
After listening to Zhou Can's diagnosis ideas, the consulting doctors couldn't help thinking deeply.
For this Gui Peisheng who has made great achievements repeatedly, several chief physicians have long stopped treating him as a Gui Peisheng. Rather, it is raised to an equal height.
"Through the observation and comparison of brain wave data, I found that the patient's brain wave signal is basically the same as I predicted. Only when he fell asleep, the brain wave tended to be normal. At this time, bowel sounds no longer occur. It means that when the patient is awake during the day, The spirit should always be in a state of high tension. This further shows that the patient's long-term diarrhea has a correlation with mental tension."
"Also, the patient's bowel sounds after eating can roughly infer the initial digestion of food passing through the stomach.
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After entering the duodenum, the speed of intestinal peristalsis far exceeds the normal value. I have reason to suspect that after food enters the intestinal tract, it quickly passes through the peristalsis of the intestinal tract, is discharged to the rectum, and then is excreted from the body. The abnormal activity of the intestinal tract is likely to be interfered and manipulated by abnormal nerve signals. "
Zhou Can spoke eloquently, based on the first-hand monitoring results.
The disease that refers directly to the patient is neurological digestive dysfunction.
"As we all know, gastrointestinal neurosis is actually gastrointestinal dysfunction and functional dyspepsia. It is a general term for gastrointestinal syndrome. It is the dysfunction of the autonomic nervous system caused by high-level nerve activity disorders."
It is mainly gastrointestinal motility and secretion dysfunction, without histological organic pathological changes, and does not include gastrointestinal dysfunction caused by other systemic diseases.
"If the patient's condition is uncovered, it will be found to be highly similar to neurodigestive disorders."
After Zhou Can published his diagnosis, the other doctors fell into deep thought again.
"Although your analysis is very reasonable and supported by certain evidence, it is still impossible to diagnose the disease!" It was the "aggressive" deputy chief physician who was the first to question it.
"It's actually not difficult to diagnose. You can give the patient psychotropic drugs to relieve mental anxiety, and let the patient eat when the brain wave is stable. Then observe whether the patient's intestinal peristalsis speed returns to the normal level."
Zhou Can had long thought of further testing methods.
If this small problem can still trouble him, the three months in the intensive care medicine department will be in vain.
Learning the operation of the three major systems of the human body and practicing them will allow him to have a deep understanding of each system.
"I think it's worth a try."
Director Xiao's eyes were extremely bright.
Zhou Can's diagnostic ideas and even experimental methods are unique.
"Prescribe it to the patient immediately and see how the treatment works."
Director Jia directly wrote a prescription by hand, and then handed it over to Qiuhong to execute.
…
When the consultation was about to end, Qiu Hong ran back excitedly.
The face is full of smiles.
"Director Jia, after administering the medicine to the patient, wait for the patient's brain waves to stabilize, and then let him eat. Forty minutes later, the patient's intestinal peristalsis is still in a normal state, and for the first time there is no more diarrhea. The family members are very happy, and they said that we The hospital is worthy of being the most famous hospital in the province, and I also praise you and Dr. Zhou for their superb medical skills, and they are living miracle doctors!"
When Qiu Hong talked about this, her face was full of pride.
After preliminary experiments, it has been basically proved that the patient's enteritis is really related to high mental stress.
Now no one questioned Zhou Can's diagnosis.
When they looked at Zhou Can, their eyes were full of admiration or admiration.
It's not shocking, because it's not the first time Zhou Can has made such a great achievement.
There have been many cases of intractable diseases "diagnosed and solved" by Zhou Can.
"My contribution to this disease is very small, mainly due to Zhou Can's contribution." Director Jia is very honest and never competes with his doctors for credit. "Zhou Can, it has been basically confirmed that the patient's illness is really a mental illness. Tell me about your treatment plan! What I want to hear is to cure as much as possible, rather than relying on psychotropic drugs to control the disease for a long time."
Director Jia can be regarded as half of his teacher.
When making a request to him, it was exactly the tone of an elder to a junior.
Based on Director Jia's teaching and cultivation of Zhou Can, he really has this qualification.
"If you want to be cured, you must find the cause of the patient's high mental stress. From the description of the family members, I suspect that the patient's high mental stress has something to do with the high school entrance examination. Because when the patient became ill, it happened to be the second half of the third year of junior high school, which was close to the time stage of the high school entrance examination. Children in this period of time, the cause of high mental stress is easier to investigate. I want to talk to the family members and patients, and then formulate a corresponding treatment plan, do you think it is okay?"
During this period of time, Zhou Can has been supplementing the basic knowledge of psychological medicine.
At this moment, it came in handy.
He suspects that the cause of the patient's high mental stress may be related to the senior high school entrance examination.
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Even if this is not the reason, it should be relatively easy to troubleshoot.
For example, the emotional state of the parents, or the stimulation of the child's puppy love, or the teacher's severe criticism of the child because of something, may cause the patient's high mental tension.
As long as the patient's heart knot is untied, the disease will heal itself.
"Hurry up, I'm looking forward to the final result!"
Director Jia asked Zhou Can to quickly communicate with the patient and his family.
…
Zhou Can easily found the smiling family member outside the brain wave monitoring room.
The cause of the child was found, and the condition was preliminarily controlled after taking the medicine, which made the family members happy. Most of the sadness on his face has been swept away, replaced by a smile from the bottom of his heart.
"Doctor Zhou, thank you for saving our son, you are the benefactor of our family!"
When the family members saw Zhou Can approaching, they excitedly stepped forward to express their thanks to Zhou Can.
"I am only assisting in the diagnosis and treatment of your son's disease, and it is mainly due to my teacher, Director Jia. I am here now, just to talk to you about the specific causes of your child's disease. I will strive to completely cure your child's disease, not always Control the condition with medication."
Zhou Can didn't choose a place, so he sat down on a bench outside and chatted with his family members.
"Before the child got sick, did you put any pressure on him about the high school entrance examination? For example, you want him to be admitted to a good high school."
"Yes! At that time, the senior high school entrance examination was approaching, and the child's father emphasized more than once that he hoped that the child could be admitted to the No. 1 Middle School in the county. Because the child is the only child in the family, and his academic performance is not bad, so our husband and wife have high expectations for the child. Could this also cause my son to get sick and have diarrhea?"
The family members did not question Zhou Can.
Rather, it felt a little unbelievable.
No wonder they don't understand.
Without professional medical knowledge, who would have thought that giving a child some pressure in the senior high school entrance examination would actually cause diarrhea in the child? In their view, diarrhea may occur only after eating unclean things or when the body is sick.
"I'm not 100% sure yet. Can your son communicate with you normally now?"
Zhou Can had asked patients questions before when he was in the outpatient clinic, but he couldn't communicate normally at all.
The patient has autistic tendencies.
At that time, it was thought that the patient's body had a serious illness, which led to autism.
It is only now that I understand that he may be autistic due to mental illness.
"Yes! When I talk to my son when there are no outsiders, he can respond to me more normally. It's just that our son has been introverted since he was a child and doesn't like to talk much."
The patient's mother said.
"As long as someone can communicate with the child normally, this is a good thing. You can try to chat with the child and tell the child that getting into a good high school is not that important. Untie his knot as much as possible and let him Get out of the mental prison you set for yourself."
Next, Zhou Can specifically taught the patient's mother some directions for persuasion.
It is not difficult to provide patients with a private space that causes as little tension as possible. Pull the curtain above the monitor bed to cover the whole bed.
According to Zhou Can's instructions, the child's mother went in and tried to do ideological work for the child and enlighten the child.
If it doesn't work, they can only take their children to do special psychological counseling.
Less than half an hour later, I heard crying from inside.
The child's father had been anxiously waiting outside, but when he heard his son crying inside, he immediately wanted to rush in to find out.
He was held back by Zhou Can.
"It's a good thing for a child to cry. I'm afraid that he will hide all the pressure in his heart and bear everything in silence. Also, after you see your child, you hope you can take the initiative to tell him that you don't need him to go to a good high school. Stop putting pressure on him. Give him as much care as you can."
For a seventeen-year-old child, crying is the initial manifestation of the psychological defense line being torn apart and the complete release of emotions and pressure.
This cry means that the child's heart knot is collapsing.
is a good thing.
Zhou Can is very busy, it is impossible to stay with him all the time
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here.
After a few words of advice, he went about his own business.
It was around one o'clock in the afternoon, and he was writing medical records and checking information in the office.
The boy's father came.
As soon as you enter the door, you have to kneel on the ground.
Zhou Can was so frightened that he got up quickly to support him, and the other doctors watched all this in astonishment.
"Dr. Zhou, thank you... My child ate half a bowl of rice and a lot of vegetables for lunch. It was the first time in more than two years that he called me out loud. Also, after eating, he didn't have diarrhea anymore. It's incredible. You Saving my son is equivalent to saving our family, if my son dies, my family will also be destroyed."
The man's voice choked several times.
For most families, children are their hope and their lifeblood.
"Haha, that's great! It's the most gratifying thing for us doctors to see the patient's condition improve and recover. Your child's body is very thin due to long-term malnutrition. A fat man needs to take it step by step and slowly. You must not give him all kinds of nourishment immediately, and you must increase it gradually."
"In addition to the gradual supplementation of nutrition, we also need to help him increase the amount of exercise. After he can stand up, take him to walk more and breathe more fresh air outside. When Director Jia comes, I will help you. See if you need to prescribe medicine."
When Zhou Can heard the good news, he was really happy from the bottom of his heart.
Finally, he successfully treated a patient with intractable diseases who was on the verge of death.
[Pathological diagnosis experience value +1.]
[Congratulations on successfully diagnosing a super-difficult case, and you will be rewarded with +100 experience points for pathological diagnosis. Reward first aid life wisdom experience value +100. 】
Zhou Can received two big rewards at the same time.
[Congratulations on your first-aid biomedical skills being promoted to the intermediate level~www.mtlnovel.com~The current experience value is 1/10000. When rescuing patients, you can multiply your wisdom, keep your mind highly calm, and improve your diagnostic thinking by 100%. 】
This special medical skill was successfully promoted to the intermediate level.
Zhou Can was very happy.
The usefulness of special medical skills is different from ordinary medical skills, it is more like spring rain moistening things silently.
Secretly and silently improve Zhou Can's diagnostic ability and help him maintain a calm mind. Able to see the sun through the clouds and not be confused by the manifestations of some diseases.
The diagnostic thinking has been improved by 100%, which is equivalent to doubling.
According to his understanding, it should double the diagnostic ability when diagnosing critically ill patients.
Whether this is the case or not needs to be tested with a patient next time to find out.
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