【My medical skills can add experience points】【】
Du Leng's theory is not weak, but his diagnostic ability may be at the bottom among many attending physicians. It does not match his super high theoretical level at all.
The reason for this is that Du Leng did not realize that true medical skills are not learned from books, but need to be learned from patients in clinical practice.
You need to comprehend it yourself in clinical diagnosis.
The real ability is never taught by others, but needs to be comprehended by oneself and transformed into one's own ability.
He has an enviable doctorate degree, and graduated from a famous overseas university, and his knowledge is also extremely profound. It's a pity that after he entered Tuya Hospital, he has always been complacent and has a high self-esteem. He never thought of being down-to-earth and learning from the most basic clinical practice.
Instead, he has always been keen to participate in various director-level difficult case consultations and various difficult major surgeries.
In the end, Du Leng made a fool of himself in this expert consultation.
Only when the sea recedes will it be known who is swimming naked.
This time, Du Leng was dragged to the Xinxiang Women's and Children's Hospital for real combat, which immediately made him show his original shape.
At this moment, his face was ashen, and his expression was dark.
I guess I must feel bad in my heart.
Thinking about it, he used to jump so high, but now he fell from a high place, which is naturally extremely miserable.
But for him, it may not be a bad thing.
As long as you find out your own problems, learn lessons, and calm down and start exercising from the most basic clinical practice after returning to Tuya Hospital. With his foundation, I believe he can become a doctor with real skills in a few years.
Gao Jian followed Director Jiang back to their consultation table.
Before leaving, Gao Jian gave Du Leng a sympathetic look. Compared with Du Leng, Gao Jian is very lucky.
At least Gao Jian has been diligent and down-to-earth during the nearly two years of training. He is not as ambitious as Du Leng, and all he does is for vanity.
"Xiao Zhou, I am optimistic about you! In the future, you should take care of Yang Chan more. Aren't you classmates? You should help each other."
Director Zhang Bihua also brought Yang Chan back to his consultation table.
There are not a few patients who seek her medical treatment. Although she participates in the consultation here, there is a long queue in front of her consultation table. Under the organization of nurses, those patients and their families patiently waited in line.
This is the face of a top famous doctor.
Patients and families are willing to buy her account.
When Yang Chan followed Director Zhang to leave, she glanced at Zhou Can faintly, and quickly shrank back. For the first time, Zhou Can saw the astringency on her face.
This is not like the heroic, domineering and uninhibited squad leader of 512.
Defeated her three times in a row and conquered her?
Zhou Can never dared to think so.
In his impression, Yang Chan was very proud in her heart, and had never conceded defeat. She will definitely try to win it back next time.
After Director Jiang and Director Zhang left, their clinic table became deserted again.
No way, the reality is so cruel. Patients and their families will never entrust their lives to an unknown 'expert'.
Deputy Director Shi's reputation is still too small.
The time passed bit by bit in boredom.
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【My medical skills can add experience points】【】
This kind of idle consultation is what Zhou Can hates the most, not one of them.
In his opinion, it is simply a waste of life.
It's just that on the current occasion, if he reads with his mobile phone in his hand, the impact will be very bad.
Fortunately, not long after, the super obese female patient came back from the examination.
Although the family members had a good impression of Zhou Can and had a certain foundation of trust, they did not bring the test results to Zhou Can, but went to Director Zhang Bihua for further diagnosis.
Compared with the young Zhou Can, the family still trusts Director Zhang Bihua more.
"Doctor Zhou, Doctor Zhou, come and have a look. Your diagnosis is really accurate. The patient's thyroid function is indeed problematic. The bone examination results show osteoporosis."
After seeing the patient's examination results, Zhang Bihua waved to Zhou Can excitedly.
Both inspection results were similar to what Zhou Can predicted.
This made Director Zhang Bihua trust Zhou Can's diagnostic ability even more.
"Her sleep apnea syndrome should be diagnosed as caused by endocrine and metabolic diseases. The focus is thyroid disease."
Zhou Can was very happy when he saw the result.
"No wonder the patient's symptoms are very similar to mixed sas, but the real cause has not been found out! Who would have thought that it would be caused by thyroid disease! Now it is all right, symptomatic treatment should be able to cure the disease."
Director Zhang Bihua was also very happy.
When a difficult case is successfully diagnosed, every doctor and nurse involved will feel a special sense of accomplishment.
"Dr. Zhou's surgical ability is very strong, and he has rich experience in breast cancer diagnosis and treatment. Do you think she needs surgery?" Zhang Bihua was somewhat unconfident about the treatment plan he prescribed.
Because this patient has seen many doctors, including many famous doctors in related fields in the province, but none of them could cure this patient.
Now it can be cured with just a prescription, and she feels somewhat unreal.
"You can use drug treatment to see the effect first, and then consider surgical treatment if it is ineffective. However, any operation will cause irreversible physical damage to the patient, so try not to do it if you can."
Zhou Can does not recommend surgery for patients.
Take it for a while to see the effect.
…
Director Zhang prescribed medicine to the patient and told the patient to pay attention to weight control. It is best to keep exercising every day to lose weight.
Excessive obesity can easily cause many diseases, and her thyroid degeneration is likely to be related to obesity.
From a medical point of view, there are four causes of hypothyroidism. The first is inflammatory infections, including bacterial infections and autoimmune diseases. The second type is tumor. The third type, trauma, thyroidectomy and isotope radiotherapy, and even radiotherapy for nasopharyngeal carcinoma can cause thyroid damage and lead to hypothyroidism. The last is the well-known iodine deficiency.
Adding iodine to salt is to solve the problem of insufficient sulfur intake and prevent the occurrence of big neck disease.
This female patient's living and eating habits are not good, coupled with excessive obesity, it is also easy to cause insufficient iodine intake and absorption.
If she does not control her weight at a reasonable and normal level, she will increase the load on the heart, lung, liver, kidney and other organs for a long time, which will easily cause a series of serious diseases.
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【My medical skills can add experience points】【】
The treatment plan given by Director Zhang is to gradually supplement thyroxine to correct the problem of hypothyroidism. The patient is then asked to lose weight.
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All are effective treatments.
Zhou Can watched the obese patient leave, hoping that after she took the medicine, her sleep apnea syndrome would be cured.
Not long after, the patient who had a minor cold that had not been cured for two years came back from the examination.
Under normal circumstances, the pathological examination takes three to seven days to get the results.
For example, tumor tissue needs to be tested by immunohistochemistry or molecular pathology, which will take a week.
If it is just intraoperative pathology, this can be quickly checked, and the result can be obtained within 30 minutes.
This young female patient was very unfortunate, and it was found that there was a mass in the left pharynx.
Doctors from Xinxiang Women's and Children's Hospital took her tumor tissue from the upper part of the lateral pharynx and the upper back for pathological examination, and initially suspected non-Hodgkin's lymphoma.
Seeing this result, Director Zhang's face became very serious.
Although Zhou Can had expected it, he couldn't help but look dark, and lamented for the young female patient in his heart.
"Doctor Zhou, now that the examination results are out, it's really a tumor in the throat. And it's lymphoma, what can I do?" Director Zhang Bihua didn't know how to deal with it, but felt sorry for the female patient.
Based on her diagnosis and treatment experience, she was very worried that the female patient's tumor had metastasized.
In fact, the spread of tumors is usually divided into three ways.
The first is to infiltrate into adjacent tissues, which is the easiest way to control. As long as it is discovered in time, all the affected tissues are excised, and then supplemented with chemotherapy to consolidate the curative effect, a satisfactory therapeutic effect can basically be achieved.
The second is the transfer of tumor cells through the blood. This is more tricky, but a tumor cell has to take root in other places and proliferate wildly, growing into a tumor. This requires the body's multiple immune defenses.
It's like a bandit who ran to a strange place and wanted to develop into a force, but the success rate was actually not high.
If you are not familiar with the place, you may be wiped out by the local government or local organizations.
It takes time for tumor cells to migrate to a new location through the bloodstream, successfully take root, and then develop into a second tumor.
It is relatively easy to find out with modern medical examination methods and the diagnosis of experienced clinicians.
It is also possible to achieve a better therapeutic effect by resecting all the primary lesions and metastatic lesions, followed by radiotherapy.
The third type of metastatic spread of tumors is through lymph. The lymphatic tissue of the human body is an important immune organ of the body. After it is captured by tumor cells, it is equivalent to the government being infiltrated by bandits and controlled.
It is conceivable how serious the consequences are.
If I had to describe it, it was lawless.
Therefore, as long as lymphoma is found to be malignant, the prognosis is often poor.
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【My medical skills can add experience points】【】
The girl's mother learned that her daughter had lymphoma, and seeing the dignified expressions of the doctors, she almost collapsed, holding the edge of the table tightly with both hands, trembling slightly. Tears welled up in his eyes, his breathing became short, and his face was pale.
"Doctor... I beg you to save my daughter. Her father is working hard outside in order to provide the child with a superior living environment. Now if I know such a result, how can I explain to her father... "
The family members' voices were choked with tears.
That is to pretend to be strong in front of her daughter, otherwise she would have collapsed and cried.
"Don't worry, it's just the results of the initial diagnosis. First, lymphoma is not necessarily malignant. Second, even if it is malignant, it can be surgically removed. The key now is to further clarify the pathological nature, and then check whether it has spread."
Director Zhang Bihua comforted the family members.
She looked at Zhou Can again, "Dr. Zhou, I know that you have done many surgeries in multiple surgical departments, and you must have rich experience. Which parts do you think are the key targets for investigation?"
Director Zhang is not ashamed to ask, because he has a specialty in surgery.
She has done a lot of obstetrics and gynecology surgery, but she has done little tumor surgery.
When encountering cancer patients, they are usually handed over to the corresponding specialist for treatment.
For example, breast tumors are usually handed over to doctors of nail and breast surgery. Cervical tumors, ovarian tumors, etc., the obstetrics and gynecology departments handle a little more by themselves.
Most obstetrics and gynecology operations are cesarean section, curettage, ligation and other operations.
Lymphoma in the throat, this kind of disease is really rare for her.
Relevant processing experience is also less.
"The patient is now suffering from liver disease and hearing loss. Lymphoma in the throat has now been detected. For further examination, I suggest a binaural CT and a chest CT. Ear drums and lungs are the key areas for investigation. In addition, it is best to do it again A lumbar puncture, check for hydrocephalus routine."
Zhou Can did not refuse this time, but seriously gave further inspection suggestions.
Director Zhang nodded slightly and looked at the family members.
Before Director Zhang could speak, the family members bit their lips and nodded vigorously, "Yes, we will do all these tests."
It can be seen that Zhou Can successfully diagnosed a tumor in her daughter's throat last time, and now the examination has confirmed that her trust in Zhou Can has risen to an extremely high level.
She accepted all the inspection suggestions given by Zhou Can.
After Director Zhang issued an examination application for the patient, she took her daughter for the examination without mentioning it.
After she left, Director Zhang sighed, "It would be great if the girl's cause of disease could be found out sooner. It has been two years now, the liver has been damaged, and many lesions have been caused in the whole body. very bad."
"Her illness has indeed been delayed."
Zhou Can was cursing in his heart, quack doctors are hurting people!
Some quack doctors are killing people when they treat people.
This girl has just turned nineteen, exactly the same age as Hua. It would be great if lymphoma in the throat was detected two years ago!
Now it has affected multiple body tissues and organs, and in all likelihood, it has spread and metastasized.
The only thing that can be done is radiotherapy and chemotherapy.
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【My medical skills can add experience points】【】
Prognosis will be very poor.
Like her, she might not be able to survive the five-year survival period.
"Doctor Zhou, please tell me, have the three examination applications you prescribed for her confirmed where the tumor has metastasized?" Yang Chan watched as Zhou Can diagnosed these difficult cases one after another, and all of them were verified.
His diagnoses were all correct.
While secretly admiring her, she was also curious about the condition of this female patient.
With her current level, it is natural that she cannot accurately judge whether the tumor has metastasized and where it has metastasized like Zhou Can.
Driven by strong curiosity, she asked Zhou Can for advice.
Zhou Can looked at her, his heart was still a little heavy, so his expression was relatively serious.
"Basically, it has been confirmed. The hearing loss must be due to the attack of tumor cells in the eardrums, and there are lesions. There is also her liver disease, including fatty liver, which should be a superficial symptom. When lymphoma metastasizes, it is easier to attack the lungs , so I asked her to have a chest ct scan. The liver is known as the most silent organ and has no pain sensation. Its resistance is naturally stronger than other organs~www.mtlnovel.com~ To put it bluntly, it has a thick defense.
According to Zhou Can's understanding, the liver is a warrior in heavy armor, with a high attack and a thick defense.
For example, no organ can match the detoxification ability of the liver.
This can be regarded as a high attack power.
"Then why a lumbar puncture?"
"This is simple, mainly to check the routine of hydrocephalus. Although the head is at the top of the body, it is called the head of the six yang, but the patient's primary lesion is located in the throat of the head and neck, so it is very easy to attack. The patient's head. And some of her symptoms also suggest that the brain, cerebellum, and nerves in the head may have been involved."
Zhou Can patiently explained the doubts to Squad Leader Yang.
She used to teach others when she was studying. Because she is a proper female schoolmaster.
Zhou Can did not go to graduate school because he failed the exam.
But she is fully capable of taking the postgraduate entrance examination, and even directly guaranteeing the postgraduate entrance examination. She voluntarily gave up and insisted on entering social work after finishing her undergraduate degree, probably because her family conditions did not allow it.
Many girls are very sensible.
Knowing that their family conditions are not good, they are not only frugal at school, but also try their best to earn tuition fees and get various scholarships. Then obviously you can continue your studies, but you will choose to enter social work in advance.
Yang Chan is a girl with strong self-esteem. She never said that her family is poor in front of her classmates or teachers.
Also, as far as Zhou Can knows, she has never applied for a poverty bursary.
But seeing that she usually dresses very plainly, and the class holds some expensive activities, she, the class leader, never participates. There are also many small details, which let Zhou Can understand that her family must belong to a particularly poor one.