【My medical skills can add experience points】【】
Zhou Can was a little puzzled. The diagnosis of this case is not difficult. Why did you invite experts from the two hospitals together to discuss this case?
Even at his half-level level, he could easily diagnose that the patient's disease was likely to be venous thrombosis. He didn't believe that the experts at Xinxiang Women's and Children's Hospital would be so good at it.
"Director Zhang, what do you think is the cause of this patient?" Professor Hu Wanjun asked.
"Uh... this patient's illness seems to be related to blood vessels, and I specialize in surgery. I'm not very good at this field." Zhang Bihua said unclearly, and then turned to look at a male doctor in the expert team. "Director Shen Tu, you are an expert in cardiovascular medicine, and you should be good at diseases in this area. Do you have any good suggestions?"
Zhou Can clearly felt that the atmosphere at the scene was a bit weird.
Whether it is Professor Hu Wanjun or Director Zhang Bihua, they must be able to diagnose the cause of this patient at a glance.
But both of them are doing Tai Chi here.
Zhou Can is a rich second generation after all, and his knowledge and mind are much more mature than ordinary people.
After noticing that the atmosphere was abnormal, he just watched his nose and nose and his heart, and never spoke indiscriminately.
Xinxiang Maternity and Children's Hospital has always had a lot of drama.
That day, Section Chief Tang was sent directly to dig him up in the emergency room, so you can see what kind of style this hospital is.
If a doctor only knows how to see a doctor, no matter how skilled he is, it will be difficult for him to accomplish much.
It's even possible that you won't be able to get along in this industry.
In addition to facing complex interpersonal relationships, the ability to deal with various situations is equally important.
For example, during the treatment of a patient, the doctor did not pierce the middle vein with a single needle. At this time, a second injection is definitely needed. How to explain to the patient or family tactfully is a test of the doctor's resilience.
After explaining it, the patient smiled generously, and even thought that he had a special constitution.
For example, some patients are too fat and the fat layer is too thick, so it is really difficult to find veins.
Some patients are born with small blood vessels, which are not easy to find.
If the doctor misses the middle vein with one injection, then just gives another injection without explaining to the patient, the patient will definitely scold in his heart without scolding his mother.
If the doctor has low EQ and poor adaptability, he blindly emphasizes "I have had injections for so many years, and I have never seen a patient like you, who can't even grow a blood vessel."
It is estimated that after the patient heard this, he would immediately jump up and use old fists to preach to the doctor.
Right now, Xinxiang Maternity and Children's Hospital has invited these experts to participate in the consultation, and the cases are not difficult. The atmosphere is still so weird, whoever talks nonsense is afraid that he will be unlucky.
Director Shentu is here on behalf of the Department of Cardiovascular Medicine of Tuya Hospital.
He is in his fifties, wears black-rimmed glasses, and looks serious. He is also very serious when he sees patients. Zhou Can secretly observed that Director Shentu never smiled when he diagnosed patients.
No matter what kind of patient he is, he frowns tightly and speaks in a rigid manner.
"Then I'll throw bricks to attract jade and talk about my personal opinion!"
Director Shentu did not refuse.
Shentu is actually a compound surname, his full name is Shentu Bao. People who didn't know thought he was the younger brother of the ancient **** Shen Gongbao.
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【My medical skills can add experience points】【】
"The initial symptom of this patient was pain in the left lower extremity, which later developed into pain in both lower extremities. Pain in the extremities can be caused by lesions in the skin, muscles, nerves, blood vessels, joints, and bones. I have even seen kidneys enter the decompensation period. Patients with severe pain in the posterior limbs. There are also malignant tumors that are particularly prone to cause unknown pain in various parts of the body."
Director Shentu's commentary is as meticulous as his personality.
"Nerve pain should conform to the distribution area of the nerve. It is often spontaneous and characterized by sharp pain, needle pricking pain, burning pain or pulling pain. Nerve tenderness may even appear during physical examination. At the same time, it will also be accompanied by numbness and weakness of the limbs, etc. Symptoms appear. Some of the pain symptoms in this patient are consistent with neuropathic pain."
"However, the patient's main complaint is muscle pain. In clinical medicine, muscle pain is often located in the sarcolemma, non-localized and spontaneous, and the nature of the pain is mostly dull pain, which is aggravated during exercise. At the same time, muscle pain, muscle weakness, Even muscle atrophy. This patient’s pain is not dull pain, and the relationship between pain and movement is not clear. She has been sitting for a long time or squatting for too long, and she suddenly has severe pain when she stands.”
"In addition, after the patient was admitted to the hospital for observation, the latest ck, electromyography, and muscle biopsy results showed no typical muscle damage. Therefore, the common causes of muscle pain include cramps, myolysis, myositis, hook Leptospirosis, dermatomyositis, polymyalgia rheumatica, and fibromyalgia syndrome all ruled out."
Every doctor's approach to diagnosis is different.
Director Shentu's diagnosis was as rigorous and meticulous as his personality. The method of exclusion is used for various etiologies.
In clinical practice, his diagnostic method is time-consuming and laborious, but the probability of error is small.
It was Zhou Canlai's diagnosis, but it was another way of diagnosis. Based on the patient's symptoms, B-ultrasound results, and his own clinical experience, he could directly diagnose the patient's vascular disease. And it can be locked as a venous thrombosis.
In terms of efficiency, Zhou Can's diagnosis method must be more efficient.
Moreover, Zhou Can's diagnosis does not mean that if he is fast, he will definitely make mistakes. So far, he has not been misdiagnosed.
As for missed diagnosis, due to the lack of personal medical knowledge and limited clinical experience, missed diagnosis is inevitable.
With Director Shen Tu's diagnosis method, the probability of missed diagnosis is lower, but there is still the possibility of missed diagnosis.
As long as he encounters a patient with multiple lesions, it is guaranteed that he will have to pick and choose for a long time, one head and two big ones.
Therefore, there is no one who has a good method and who has a poor diagnostic method.
Whether it is a black cat or a white cat, it is a good cat if it catches mice.
"According to the patient's auxiliary examination, especially the results of b-ultrasound examination, the possibility of deep vein thrombosis is extremely high. Therefore, pain caused by vascular disease is considered. This type of disease includes acute arterial blockage, arterial stenosis caused by atherosclerosis, Thrombophlebitis, deep vein thrombosis, thromboangiitis obliterans, Raynaud syndrome, etc.”
"If it is the patient's arterial disease, intermittent claudication of the affected limb will occur, and then develop into rest pain. If the artery is acutely and completely occluded, the patient's affected limb will experience severe pain, white skin, low skin temperature, and continuous pain , there is no possibility of remission. And there will be gangrene of limbs..."
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【My medical skills can add experience points】【】
Director Shentu could really say that a venous embolism would be the end of the matter, so he talked a lot.
And they are all symptoms and diseases related to the disease.
Some people like the elimination method, but Zhou Can finds it very tiring.
However, it also showed Director Shentu's profound medical knowledge and extremely rich experience in clinical diagnosis.
People who don't have anything in their stomachs really can't analyze the disease like him.
At least Zhou Can asked themselves, absolutely impossible.
Maybe in another ten or twenty years, he will be able to use extensive references like Director Shentu to investigate the causes one by one. But he definitely won't do it, he's too tired. There is really no need for this.
"Deep vein thrombosis of the lower extremities can cause pain and edema in the limbs, sometimes without any symptoms. It can be intermittent pain. The symptoms of this patient are more consistent with deep vein thrombosis, but the diagnosis cannot be confirmed. I think further inspections are needed, first of all. A vascular color ultrasound can clearly diagnose whether there is disease in the arteries and veins."
After Director Shen Tu ruled out a bunch of cases, even though he found the possibility of deep vein thrombosis was very high, he still couldn't draw a conclusion easily.
Instead, ask for further inspection.
Zhou Can is also very supportive of asking the patient to have a color Doppler ultrasound.
B-ultrasound and color Doppler ultrasound both belong to ultrasonic examination, but their functions are not the same.
Many patients do not understand the principle of the examination, and think that the doctor is making black-hearted money, first prescribing a B-ultrasound and then a color Doppler ultrasound. Isn't it obvious to see how much money the patient has?
Really not.
B-ultrasound is a two-dimensional sonographic examination method, which has very good examination results for the investigation of tumors, organ tissue displacement, atrophy, etc. It can accurately display the size, shape and location of tissues and organs.
Color Doppler ultrasound is based on the two-dimensional sonogram, using color to display the direction of blood flow and the relative speed of blood flow in real time. It has very good diagnostic support for doctors to observe the blood flow of human diseased tissues and the speed and direction of tissue movement.
Check the blood circulation, and even many doctors believe that the effect of color Doppler ultrasound is more efficient than expensive MRI and CT imaging.
However, the inspection of some deep arteries still relies on angiography, which is a shortcoming of color Doppler ultrasound.
In short, in clinical diagnosis, doctors prescribe B-ultrasound and color Doppler-ultrasound at the same time, which has a certain meaning.
As long as the doctor has a little medical ethics, he is not making black-hearted money, but really wants to diagnose the patient's lesions in a cheaper way.
It is actually quite difficult for doctors sometimes, not only to ensure the accuracy of diagnosis results, without misdiagnosis and missed diagnosis, but also to find ways to reduce the examination costs of patients as much as possible.
But sometimes patients and family members do not understand, all kinds of abuse and even beat doctors.
In Zhou Can's view, those who choose to work as doctors and nurses have great love in their hearts.
Whose life is not precious if you can?
Who doesn't want to stay at home with his wife and children and enjoy the warmth of the family?
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【My medical skills can add experience points】【】
When the motherland is in need and the people are in need, many of them sign up spontaneously. This kind of great love is really not something ordinary people can have.
"Please ask the medical technology department to work overtime and give that patient a color ultrasound examination immediately."
Professor Hu Wanjun gave the order.
Regarding Director Shentu's diagnosis, she seemed very calm, as if she had known it for a long time.
Zhou Can had a panoramic view of everything, and he was even more sure that Xinxiang Maternity and Children's Hospital was fully capable of diagnosing this patient's disease.
Since he has the ability to diagnose the cause of this patient, why did he invite Tuya's experts over for consultation? It is not a glorious thing to ask a doctor from another hospital for help.
What is their purpose in doing this?
Zhou Can quietly waited for the other party to show his fox tail.
He remained calm, and Director Zhang Bihua sitting next to him was even more so.
Even Du Leng, who is usually high-profile and shows off, felt a little strange at this moment, lowered his head, and fiddled with his slender fingers like a woman, and his long nails.
Du Leng's IQ and EQ are actually not low.
It is because of the smooth sailing from childhood, the smooth sailing on the road to study, and the academic achievements that ordinary people can hardly achieve in their lifetimes at a young age. So his heart is extremely proud.
Pride makes people regress, and sometimes makes people do some stupid things.
In addition, he has been hanged and beaten by Zhou Can, and he feels aggrieved in his heart, and wants to feel proud. So confronting Zhou Can **** for tat became a perfectly normal thing.
In addition, Yang Chan maintained a very close relationship with Zhou Can, but always maintained a polite manner towards Du Leng, which made Du Leng very uncomfortable.
How could a genius like him be suppressed like this?
What's more, the opponent who suppressed him was an undergraduate with a much lower education than him.
In addition, those who can study abroad for a few years are generally not too poor.
Because tuition fees and living expenses abroad are not small expenses.
Hundreds of thousands of annual tuition fees are really beyond the reach of ordinary families.
A kid from a rich family, whose academic achievements have reached the pinnacle of his life, his inner arrogance is even greater than that of ordinary geniuses.
The duel between him and Zhou Can will definitely happen again.
After many setbacks, he should sum up his experience and lessons, and find ways to maximize his strengths and avoid his weaknesses, instead of continuing to fight with Zhou Can in some fields that he is not very good at.
"Director Zhang, with the help of Director Shen Tu of your hospital, this patient with sore lower limbs was basically diagnosed. The experts in Tuya Hospital really deserve their reputation!"
Professor Hu Wanjun smiled and praised Tuya's experts.
"You're too proud! The doctors at Xinxiang Women's and Children's Hospital are not bad either, they just have their own strengths."
Director Zhang Bihua handled it carefully.
"I guess it will take a while for the patient's color Doppler ultrasound results to come out. We happen to have a few difficult cases here. Can we also take this opportunity to invite experts from your hospital to help us make a diagnosis?"
Professor Hu Wanjun finally showed her fox tail.
The previous case should be just a bait to invite the experts from Tuya Hospital. The latter cases are the ones who really need help.
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【My medical skills can add experience points】【】
I can understand their half-concealed way of coquettish operation.
People, the poorer they are, the more inferior they become.
The Xinxiang Maternity and Children's Hospital suffered accidents one after another, and its reputation was notorious, and the reputation built up over decades also plummeted.
At this time, Xinxiang Maternity and Children's Hospital, from top to bottom, has a deep inferiority complex.
Doctors are the core of a hospital. To put it bluntly, doctors are equivalent to technicians in a large factory.
Those who engage in technology must be full of pride in their research field.
Let an old man like Hu Wanjun come straight to the point and come up with a lot of difficult cases and ask the doctors of Xinxiang Women's and Children's Hospital for help, she can't get rid of this face. But Dean Tian and the hospital management put pressure on them to take this opportunity to solve the backlog of difficult cases.
In order to improve the quality of diagnosis and treatment, enhance the reputation.
They had no choice, and finally thought of a way that they thought was less embarrassing.
There was a smile in Zhang Bihua's eyes, "It's ok, anyway, we're just sitting here and waiting, and we can consult other cases along the way, that's good."
As expected of the helm of the Department of Obstetrics and Gynecology of Tuya Hospital, Zhou Can admires Director Zhang's demeanor and demeanor.
Knowing the opponent's little tricks, but not revealing them, instead trying to protect the opponent's face as much as possible.
This is true maturity.
Some people don't know how to understand the world, and they help others, but they don't show mercy to them, or even expose their faults in person. This is a big taboo.
Also, when the other party wants something, it is also very unwise to take advantage of the danger to raise conditions.
Either don't do this favor, or help more generously.
Just look at Han Xin in ancient times, and you will know how miserable his end was.
When Liu Bang and Xiang Yu faced each other, Liu Bang couldn't beat Xiang Yu, and he was in danger of being wiped out. He asked Han Xin for help, but Han Xin took the opportunity to raise conditions, to divide the land and rule, and to be king.
At that time, Liu Bang was so angry that he almost lifted the table and slapped the table hard, intending to greet the eighteenth generation of Han Xin's ancestors. The counselor Xiao He next to him kicked Liu Bang in an emergency and winked wildly at Liu Bang.
In the end, Liu Bang couldn't bear it, so he had an idea, and the table had already been taken away, and he couldn't take it back.
How to do it?
He laughed a few times and told Han Xin that the conditions you raised are too shabby. You have helped me so much, and you only want such a little benefit. Isn't that looking down on me, Liu?
Liu Bang promised Han Xin a larger fief and reward on the spot.
Later, with the help of Han Xin, he defeated Xiang Yu, and Liu Bang also gradually removed obstacles and hostile forces, and secured his throne. At this time, it was his turn to settle accounts with Han Xin.
People in the world only know that Han Xin was killed by Liu Bang's wife, Empress Lv~www.mtlnovel.com~ but they don't know that the real reason is that at the critical moment when Liu Bang and Xiang Yu entered the final duel, Han Xin claimed that he was ill and would not go to court and not send troops, so he was invited by Liu Bang After coming here, he took the opportunity to raise conditions, which violated the taboo of the monarch and ministers, and only then did he plant the disaster of killing himself.
Compared with ancient times, modern competition is actually more intense.
People who can sit in a certain high position will not be far behind in their breadth of mind, EQ and IQ.
Director Zhang Bihua showed affection to the doctors of Xinxiang Maternity and Children's Hospital, which is the truest portrayal.
"Director Zhang, and Tuya experts and doctors, please look, this pregnant woman has a particularly serious respiratory infection. After being admitted to the hospital, she was given anti-inflammatory drugs. weaken."
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【My medical skills can add experience points】【】
When Professor Hu Wanjun introduced the patient's situation, he had a serious expression and a dignified tone.
It is quite different from the case of the previous patient discussed.
As soon as Zhou Can heard it, he knew that the situation of this pregnant woman must be very serious and especially difficult.
"She has been pregnant for 37 weeks! With such a big fetus, the mother has a serious respiratory infection, which is very dangerous!" Zhang Bihua took the information and looked at it, but her brows became more and more wrinkled.
"Isn't it? It's only been two days since she was admitted to the hospital, and her fetal heart rate has been weakening. We are very afraid of the occurrence of stillbirth. Do you think there is any good way?"
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Professor Hu Wanjun humbly asked for advice.