Xiaoze looked at the patients with progressive myocardial gravis in front of him and heard the words "Kawanuma". WWw!QuAnBen-XIaoShuo!com came to mind a virtual one that he had treated in the virtual space. The patient, that patient had very similar symptoms to what Qian Xuebin said, and now I couldn't help but become curious.
"After I received this patient, I first considered it to be peripheral paralysis, but through various blood tests, potassium ion and other tests, no abnormalities were found. Later, I did related neurological tests... and found that the limbs were mainly involved, and there was no There were other neurological abnormalities...and they were getting progressively worse. At that time, I considered it to be a neurogenic problem."
Qian Xuebin said with some satisfaction: "This is probably a muscle weakness caused by neuromuscular origin. I was treated at Taoyuan City Hospital for half a month without any effect. When I was transferred to us, I had already started to accumulate abdominal muscles, but I have passed He has been cured by anticholinesterase drugs and weight-loss inhibitors, and now he has improved slightly. "It has not spread further. If treatment continues, it should still be under control, and he may even recover slowly." ! "
At this time, the patient and the family members next to him heard Qian Xuebin's words and said gratefully: "Thanks to Dr. Qian, not only did I not get better after treatment at our place, but it also became more and more serious. I can only control it now. I'm still here." Asking Doctor Qian will cost you a lot of trouble in the future!"
"Don't worry. Since you have arrived at our hospital, of course we will try our best to treat you!" Qian Xuebin nodded proudly, and then said: "However, this disease is extremely troublesome, and the results are relatively slow. And many times it requires long-term treatment. For treatment, you must have a certain degree of psychological preparation.”
"That matter, of course, as long as it can be cured, we will listen to you, Dr. Qian!" The family member hurriedly thanked him at the side.
"Yeah." Seeing the respectful look of the family members, Qian Xuebin nodded with satisfaction.
Then he smiled complacently at Xu Ze and said, "Doctor Xu, do you want to check with him?"
Xu Ze smiled. He had some doubts about this patient at this time, so of course he would not postpone it. He nodded immediately and then began to examine the patient.
This patient was not very enthusiastic about Xu Ze. He looked at the doctor and he seemed to be in his mid-twenties. Although Dr. Qian was very polite to the young doctor, he seemed to be bringing an intern with him to learn. He was an average student, so although he cooperated with Xu Ze's inspection, he was not very proactive.
However, Xu Ze didn't take it seriously. When he visited Huimin Clinic before, weren't the patients also like this? When they ask you for help, their attitude will completely change. It doesn't matter if you are used to it.
After a detailed examination of the patient. Xu Ze's eyes narrowed slightly. This patient had a slight decrease in superficial sensation in his lower limbs. It is not just the weakening and disappearance of muscle strength. Simple neuromuscular myasthenia gravis should rarely cause such shallow sensory loss.
At the moment, he smiled lightly and asked the patient: "Did you have any other bad conditions before you got sick, such as a cold or anything else?"
The patient listened to Xu Ze's words, although he was not very enthusiastic. But he still thought about it and said: "It seems that I had a cough two weeks before I got sick, but I got better after taking some injections."
"Oh?" Hearing that he had a history of infectious diseases before getting sick, Xu Ze raised his eyebrows slightly, and then asked with a smile: "So before you got sick this time, you didn't have any pain all over your body like a cold?"
"Well, I think I have. At that time, I just felt some pain in my arms, neck and thighs." But it will be fine in two days! "The patient thought about it and said nonchalantly. In his opinion, he just has weak legs. It has nothing to do with the pain in his arms and neck."
However, Xu Ze was now certain that this patient was probably not suffering from simple neuromuscular weakness, but rather Guillain-Barré syndrome.
This disease refers to a syndrome characterized by acute onset, mainly damage to nerve roots and peripheral nerves, and accompanied by protein-cell separation in cerebrospinal fluid. Also known as Guillain-Barré syndrome. People of any age and both sexes can get the disease, but it is more common in young men.
Its clinical characteristics include sudden onset of severe nerve root pain, mostly in the neck, shoulders, waist and lower limbs, and acute progressive symmetric limb softness, accompanied by superficial sensory impairment, and weakened or disappeared tendon reflexes in the aftermath of infectious diseases. disease.
Although this kind of Guillain-Barre syndrome has long existed in the internal medicine taught by Xiaoban, in modern medicine, it has only been discovered recently. Xu Ze also collected information on the Internet through Xiaodao. Know this.
Information about this disease has just been published in a national medical journal, and many people have not yet been exposed to this disease, and may not even have heard of it.
Qian Xuebin next to him heard Xu Ze asking about such a situation, but he frowned. He didn't know what Xu Ze meant, because he thought about it for a while based on Xu Ze's questions, but he didn't expect to read this symptom and cry. What is the relationship between this disease※
He is very confident in himself, and the name of the representative figure of the attached generation is not fake. He has already conducted relevant study and in-depth research on most of the diseases in basic science. He also understands most of the new developments, and his knowledge is even more comprehensive than that of many highly qualified older doctors.
The questions Xu Ze is asking now are at least within the scope of his current knowledge. There should be no impression of this. So Qian Xuebin also chuckled. Xu Ze was probably looking for something to ask. Is it possible that you, a rotation doctor who graduated from the Internet, can still see something
Xu Ze also chuckled lightly at this time. He did not speak out his judgment easily. After all, overturning other people's diagnoses was extremely taboo unless he was a senior doctor. Moreover, although he had a rotation doctor now, brand, but its status is still much inferior to that of a doctor like Qian Xuebin who formally manages patients alone.
Such a situation. If the relationship between the two is good, they can remind each other in private, but Xu Ze is confident that he has no relationship with Qian Xuebin. If he reminds her rashly, he may think that he is sincerely trying to cause trouble, and Qian Xuebin should not know the existence of this disease. , I’m afraid it’s all in vain. So Xu Ze hid this idea in his heart and did not reveal it rashly.
After asking these questions, Xu Ze smiled, nodded and said, "Dr. Qian, let's go see the next patient."
Seeing that Xu Ze didn't raise any questions, Qian Xuebin didn't take it seriously at this time, secretly laughing that Xu Ze also liked to act mysteriously. Then he smiled and said: "Okay, let's go see the next patient!" After that, he led Xu Ze out of the ward and headed towards the next ward.
However, when the two came out, they heard Director Zhai shouting: "Xu Ze," a patient is here, come and take a look..."
"Okay!" Xu Ze responded quickly, then smiled apologetically at Qian Xuebin and headed in the direction of Director Zhai.
Qian Xuebin looked at Xu Ze's whereabouts, but the enthusiasm on his face faded, revealing a faint sneer, and then followed Xu Ze and walked over.
Xu Ze walked to the ward where Director Zhai was and saw a new patient. At this time, the patient was panting and lying on his side in the ward. The nurse was busy giving oxygen to the patient.
When Director Zhai saw Xu Ze coming in, he deliberately wanted to know what Xu Ze's real level was. Although the old man recommended it, he at least had to have a good idea. He smiled at Xu Ze and asked tentatively: "Xu Ze Ze. How about you take care of this patient?"
Hearing Director Zhai's words, Xu Ze understood what Director Zhai meant. If he was not confident, he could tell him directly. If he was confident, he could take over the treatment of this patient.
Naturally, he chuckled and nodded. Xu Ze has seen a lot of such patients. He has seen them in the virtual space and at Huimin Clinic, but the patients he has seen in the virtual space are much more serious than this.
Seeing Xu Ze nodding in agreement with confidence. Director Zhai was a little relieved. Since Xu Ze dared to take over, it meant that he still had some foundation, so he shouldn't be too hard in the next two months.
Xu Ze walked forward with a stethoscope, and then asked the family members nearby about their medical history. After a brief inquiry. Xu Ze had a rough understanding of the condition, and then looked at the patient lying half in the hospital bed, breathing with difficulty with his mouth open, and his lips were cyanotic. Xu Ze already felt confident.
After a systematic examination of the patient's heart and lungs, without the need for cooperation with other examinations such as photos, electrocardiograms, etc., Xu Ze could basically determine what kind of disease this was based on experience alone.
I have a history of coronary heart disease, and I am prone to shortness of breath after a little activity. This time I caught a cold a few days ago, and then my shortness of breath gradually worsened. Now I can't even sleep, and I can only sit* every day. *pant.
No obvious changes in the jugular veins were seen in the physical examination, but small crackles could be clearly heard at the base of both lungs, and oral examination revealed that the heart was enlarged and the heart rate was extremely fast, reaching nearly 120 times. Per minute.
"Coronary heart disease, cardiomegaly, and cardiac function level three, Xu Bei made the following judgment. However, in order to clarify his diagnosis and reassure Director Zhai, Xu Ze took the electrocardiogram on the side, put the electrodes on the patient, and started doing the electrocardiogram.
Director Zhai on the side saw Xu Ze's skillful physical examination movements and skillful operations when doing electrocardiograms. He couldn't help but nodded secretly and said to himself: "This guy is pretty good. At least he shouldn't be the kind of guy who is worried about me. As long as he Wait and see what the result of his diagnosis is, if it’s good, then I’ll feel more relieved!”
Defense: The first update is here, I will continue to ask for monthly support on a new day.