【My medical skills can add experience points】【】
"Teacher, I..."
She enjoyed this feeling of being under the spotlight very much. Since entering Tuya Hospital, she had never been so honored like this moment.
It is only in school that I have enjoyed this feeling of being admired and admired by everyone.
It's just the integrity in her heart and her strong self-esteem spurring her, making her involuntarily muster up the courage to clarify all this.
Because the person who really diagnosed the possibility of diabetic ketoacidosis in pregnant women was Zhou Can.
"You are easy to be shy! You did a great job today, you should be praised, and you don't have to feel embarrassed." Director Zhang looked at his lover with kind eyes.
Parents always think that their children are the best and best, and masters also think that their apprentices are the best.
Zhang Bihua never expected that this patient was not diagnosed by his apprentice.
"Teacher, actually Zhou Can was the one who diagnosed this patient with abnormal blood sugar, not me!" Yang Chan gritted her teeth and finally mustered up the courage to tell the truth.
Not only does she look clean, but her heart is also extremely pure.
She resolutely doesn't want what doesn't belong to her.
Although she knew that even if she did not tell the truth, Zhou Can would not say anything.
However, her backbone and arrogance did not allow her to do so.
To test a person's character, just look at his attitude towards money. But to test whether a person's soul is clean, it must be seen whether he can withstand the test and not waver in the face of temptation.
"Zhou Can again?"
Zhang Bihua was only slightly surprised by this result.
"You can be as good as you are not."
After complimenting Yang Chan, Director Zhang looked at Zhou Can who was standing at the door.
This kid always likes to sit in a corner and make a high profile silently.
"Xiao Zhou, come here and share your diagnosis ideas with everyone! The diagnosis of this patient has a very high learning value, and let these young doctors learn your diagnosis methods."
[To be honest, I have recently followed up, changed sources, and have many voices for reading aloud, .yeguoyuedu Android and Apple are both available. 】
Zhang Bihua wasn't unhappy because he was upstaged by a junior.
The inch is shorter and the ruler is longer.
Everyone has their own strengths and weaknesses. Medicine is so vast that it is too extensive to learn in a lifetime. In addition, each doctor's diagnostic thinking, knowledge, experience, and understanding of diseases are different, and the ability displayed when diagnosing different diseases is naturally very different.
No matter how powerful an expert is, even in his field of expertise, there are still shortcomings and blind spots.
Just like the diagnosis of this pregnant woman, even Director Zhang Bihua did not expect that the patient had diabetic ketoacidosis.
She was particularly shocked when she heard the results from the lab.
Facing the excellence of her juniors, she was very calm.
"Doctor Zhou is too strong!"
Gao Jian watched Zhou Can once again shine in all directions and made great achievements. It would be a lie to say that his heart is not sour.
It's just that ability is not something you can have if you want it.
For now, Gao Jian has to admit that his diagnostic ability and diagnostic thinking are not as good as Zhou Can's. It seems that the diagnosis experience is far from that of Zhou Can.
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【My medical skills can add experience points】【】
"Pretend to be a good letter!"
Du Leng snorted, his face was rather ugly.
Unexpectedly, Zhou Can made great contributions under his nose again.
When Zhou Can asked Yang Chan to help check whether the patient's armpit and groin skin had changed color, he had been trying to figure out Zhou Can's diagnostic thinking. It's a pity that I couldn't figure it out after digging my brain.
It wasn't until Yang Chan suggested that Director Zhang check the patient's blood sugar that Du Leng belatedly understood Zhou Can's diagnostic thinking.
Unfortunately, it was too late to say anything at that time.
Under the watchful eyes of everyone, Zhou Can could only bite the bullet and walk to Zhang Bihua's side. He glanced at Yang Chan with some embarrassment, "Why did you drag me out!"
"Hurry up and share your diagnosis ideas with everyone! How could I take over your credit?" She had a clear conscience, and she was naturally confident when she responded to Zhou Can.
She is still the proud monitor.
"Tuya Hospital is really well-deserved of its reputation. Not only are there many famous doctors from the older generation, but also the doctors from the younger generation. Is this Dr. Zhou really just a regular doctor?"
Hu Wanjun somewhat couldn't believe it.
Not to mention regular training doctors, it is difficult for resident doctors to have such a high level of diagnosis.
Ordinary people watch the fun, but as a senior expert, Hu Wanjun, who is nearly 60 years old, is watching the doorway.
She knew how difficult it would be to diagnose diabetic ketoacidosis in this pregnant woman. A seemingly simple diagnosis results, in the absence of obvious symptoms, lack of testing basis, and the blood sugar was checked before the patient was admitted to the hospital, showing that the blood sugar level was normal. In this case, to diagnose a patient's blood sugar problem requires not only extraordinary courage, but also profound medical knowledge, rich clinical experience, and extraordinary thinking ability.
All four are indispensable.
Professor Hu Wanjun seldom praises others, but at this moment he highly appreciates Zhou Can.
"It's true! In fact, I'm not as good as you think. I'm just an ordinary doctor. In Tuya Hospital, there are countless young doctors who are better than me."
When Zhou Can faced this top expert from Xinxiang Maternity and Children's Hospital, he was neither humble nor overbearing, modest but would not destroy the prestige of Tuya Hospital.
"The patient just had a check-up two days ago, why did you assume that there was something wrong with her blood sugar?"
Hu Wanjun was not ashamed to ask.
She really wanted to know Zhou Can's thinking about diagnosis.
Other doctors are also waiting for Zhou Can to share.
"It's actually not complicated. I have treated many diabetic patients, so I have a deep impression on some of the physical symptoms of the disease. For example, the skin is dark and brown, and even obvious skin diseases appear. In clinical diagnosis, If the skin on the neck, armpits, etc. is only dark, even if it is scary dark, it cannot be diagnosed as diabetes."
"Only when the condition was present in a pregnant woman did it increase the chances of being diagnosed with diabetes. And the older the month of pregnancy, the more likely the patient was to develop diabetes."
The diagnosis of the etiology is far more complicated than imagined.
A single disease, it is difficult to determine what disease.
For example, stomach pain may be enteritis, uterine fibroids, or femoral hernia.
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【My medical skills can add experience points】【】
Dull and brown skin in multiple places, coupled with 37 weeks of pregnancy, the combination of the two may be related to diabetic ketoacidosis.
"Later, the patient picked up the water glass to drink water and emptied it. I immediately realized that she might also have vision problems. After observing her words and deeds, I was even more sure of this. By now, it was basically confirmed that she Diabetic ketoacidosis occurred."
Zhou Can's diagnostic method is obviously much more efficient than the exclusion method.
The combination of the two symptoms and the special condition of the third trimester allowed him to directly identify the cause.
"It's clear that the blood sugar was checked two days ago, so why did it suddenly go wrong?" Du Leng finally couldn't hold back the strong curiosity in his heart, and blurted out.
As soon as he asked, Du Leng immediately realized that he had exposed his shortcomings.
However, many people wanted to know the answer to the question he asked, so instead of staring at him, everyone focused on Zhou Can.
"The patient developed a severe upper respiratory tract infection on the fifth day before admission. This acute infection is a stressful state for the patient. When the patient is stressed, the insulin in the body will become insufficient. And Insulin in turn regulates the increase of hormones and the release of glycogen, which eventually leads to severe hyperglycemia in patients. If the patient is hospitalized for two days in order to cooperate with the examination, eating and drinking are restricted, which will further aggravate the condition."
"The above is the entire pathological mechanism of my dialectics. There may be omissions, please correct me."
After Zhou Can finished speaking, the audience fell silent.
Many doctors were immersed in his analysis.
"Dr. Zhou's analysis is incisive and wonderful, which is completely in line with the pathological mechanism of human endocrinology."
A doctor from Xinxiang Women's and Children's Hospital couldn't help but praise.
"This case is very meaningful for learning. Let us take their stress status into consideration when diagnosing pregnant patients in the future." Hu Wanjun, a 60-year-old veteran expert and professor, is well-informed.
But this rare case is the first time we have encountered it.
Of course, it also has something to do with her specialty being gynecology, not obstetrics.
"Young people are awesome! In the future, this world will belong to you young people!" Director Zhang Bihua expressed his feelings.
Her field of specialization involves obstetrics, and she did not expect that in this case, she was not as good as a regular doctor.
As she said, there are talents from generation to generation, and the world is dominated by young people.
After all, the older generation has an end.
All the elders present, none of them were simple.
…
After the infusion, the blood sugar of the pregnant woman dropped to about 14mmol\\/l, and the fetal heart rate became stronger obviously.
Everyone breathed a sigh of relief.
Director Zhang Bihua asked the nurse to replace the normal saline with 5% glucose sodium chloride.
The purpose of doing this is to increase the patient's calorie, which is conducive to faster correction of ketone bodies.
At this point in the treatment, it has basically turned the corner. A big stone that weighed on the hearts of Professor Hu Wanjun and others was removed.
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【My medical skills can add experience points】【】
Their expressions relaxed a little.
The group returned to the conference room to discuss the backlog of several difficult and critical cases again.
This time, Zhou Can's status has been significantly improved, and no doctor at Xinxiang Maternity and Children's Hospital dares to underestimate him.
As for Tuya Hospital, everyone has seen Zhou Can's ability for a long time, and now they just admire him even more.
At this time, the patient with sore lower limbs and venous thrombosis also finished the examination.
It can be basically confirmed that her cause is deep vein thrombosis of the lower extremities. Moreover, multiple embolisms occurred, accompanied by varicose veins of the lower extremities. Considering that the patient's family is relatively poor, and the patient's own poor surgical conditions, the experts formulated a treatment plan for her on the spot with drug thrombolysis.
If the effect is not good, it can only be hospitalized for elective surgery.
The diagnosis of this patient was just an episode, and it wasn't particularly difficult in the first place.
At least for the experts present, this kind of deep vein thrombosis of the lower extremities is nothing.
A total of seven difficult or critical cases were backlogged, and everyone discussed them one by one. The atmosphere in the conference room gradually became active, and everyone spoke enthusiastically.
The doctors of the two hospitals have gradually become more harmonious from the initial separation.
"This hospital admitted a patient, a 63-year-old female patient. The results of the CT scan showed that the upper lobe of the left lung occupied space. Considering the possibility of lung cancer, please ask the experts present to see if it can be operated on?"
Professor Hu Wanjun signaled the assistant to play the ppt film on the screen, so that the patient's CT examination image could be clearly seen.
"This should still belong to the early stage of lung cancer, which is completely in line with the indications for surgery."
"I think the patients are too old, and traditional thoracotomy should be avoided as much as possible."
"Thoracoscopic surgery is a good choice!"
You say a word, I say a word.
Many of the doctors present were actually physicians, not good at surgery.
That is to say, in recent years, with the rapid development of endoscopic surgery, coupled with the market pressure, internal medicine has to develop interventional surgery and endoscopic surgery in order to survive.
This allows physicians to have a little say in surgery.
In terms of professionalism, doctors in cardiothoracic surgery must be more professional.
"The difficulty of this operation should be quite high. There are a lot of lymph nodes to be removed, and a left upper lobectomy is required. Director He Miao of the Department of Cardiothoracic Surgery at Xinxiang Women's and Children's Hospital happened to go abroad for further training. Zhang Director, do you think it is possible to ask Tuya Hospital to send a powerful surgeon over to support me?"
The lung cancer patient was left for the last discussion. The Xinxiang Maternity and Children's Hospital must have made up their minds to ask for reinforcements.
It's just that the two hospitals are cooperating for the first time, and both are for mutual benefit needs. It is not an easy task to ask someone else's surgical team to come and help.
Although surgeons are always despised by internal medicine in hospitals, many diseases cannot be treated without surgery.
And there is a big difference between surgery and internal medicine.
Internal medicine can often be fought alone, and individual heroes abound.
Surgery requires a team with a high degree of tacit cooperation and excellent professional quality.
Ask a physician for consultation, and just go alone.
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【My medical skills can add experience points】【】
To ask a surgeon to perform the operation, especially for such a major operation, requires a team.
Not to mention the Xinxiang Maternity and Children's Hospital, even the No. 2 and No. 3 sub-hospitals attached to Tuya are facing many difficulties if they want to second the surgical team from the General Hospital. The hospital has never been a monopoly of anyone, but an interest group composed of multiple departments.
It's more like a country.
Each department is like each province of the country, and a slightly larger decision-making needs to be discussed by everyone.
Cardiothoracic surgery is a very busy department, and there are only a few surgeons who can preside over major surgeries above grade 3.
Xinxiang Maternity and Children's Hospital wants to invite a team to help it cure this lung cancer patient, but Tuya will definitely not agree.
"Director Hu, I really can't decide on this matter. If your hospital really needs this, you can directly contact the senior management of Tuya Hospital or the Department of Cardiothoracic Surgery. Or refer patients to Tuya Hospital for this operation. Nice plan."
Zhang Bihua reminded the other party tactfully.
Without that ability, but still thinking about eating meat, how can there be such a good thing in the world.
The best way to do things is to do what you can.
"Okay then! I will report this matter to Dean Tian before making a decision. Thank you for your hard work today, experts, doctors, and nurses for taking time out of their busy schedules to help us solve these difficult cases. On behalf of Xinxiang Maternity and Children's Hospital Say thank you to you guys."
Professor Hu Wanjun stood up and bowed to the doctors and nurses at Tuya Hospital to thank them.
One by one difficult cases were solved, and their expressions were obviously much more relaxed.
Back at the hotel, the Xinxiang Maternity and Children's Hospital is very sensible. They have specially ordered fruits and midnight snacks for each doctor and nurse, and delivered them to the room. The service is quite attentive.
The next day, Zhou Can and the experts went to the outpatient hall of the hospital for consultation.
Seeing a long queue formed in front of his consultation desk, there were more than 20 patients. He thought he was dazzled.
Rubbing his eyes, yes, it was indeed Dr. Zhou Can's desk.
With such a big sign, it is impossible for these patients to recognize the wrong table.
Du Leng's consultation desk was still the same as the previous two days, with a small queue of eleven or two people lined up.
"Doctor Zhou, what did you do last night? It seems that your consultation table is going to be overwhelmed!" Deputy Director Shi asked in surprise.
"I'm a little worried, did they line up the wrong table?"
What Zhou Can said made his colleagues laugh out loud.
"It may have something to do with the two news reports yesterday. After all, it is a news program on satellite TV. Although it is of an advertising nature, it is enough to attract many patients. Our seven-day expert outpatient activity, Doctor Zhou is the biggest winner! Doctor Zhou, after the event, you have to treat me."
Director Jiang also laughed and teased him.
"It's okay to treat guests. You have the final say on what to eat." Zhou Can has always been super generous when it comes to money.
But he never takes advantage of it.
All the money is spent on what he thinks is worth it~www.mtlnovel.com~ I'll be good, two pieces of news directly made an ordinary doctor's reputation soar, and he became a famous doctor, which is too exaggerated. Could it be that you bribed the reporter of the TV station in private to give you a little trouble? "
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【My medical skills can add experience points】【】
A middle-aged doctor in his forties asked sourly.
"Haha, I really have this idea. Everyone, please don't wake me up, let me keep this dream going. The day before yesterday, I saw two patients in a whole day, which is really sad."
Zhou Can was very happy to see so many patients queuing up for treatment.
He took Ji You and strode over.
Sit down at the desk.
"Doctor Zhou is here!"
The family members and patients who lined up were excited and showed happy expressions.
It seems that they didn't recognize the wrong diagnosis table, they came here for themselves.
Zhou Can suddenly seemed to have taken a reassurance, and the smile on his face was more calm and confident.
It was the first time that so many patients lined up to see him for treatment.
At this moment, he looks like a lucky guy who suddenly became rich overnight.
The effect of being on TV news is really scary.
Now that he has a little fame, he also cherishes this hard-won situation. He subconsciously looked up at the opposite corner of the wall, but he didn't see the TV reporter and cameraman.
If there is a chance, I have to provide a piece of big news to Mu Jie, and return the favor.
She really helped Zhou Can a lot.