Sun Chao felt a little bored. It was indeed ridiculous that Boss Zheng left him as the director aside early in the morning to ask the patient's family about the details of the patient's birth thirty years ago.
But before Sun Chao could get distracted, he saw Boss Zheng standing up and shouting, "Professor Zhao, please come here."
"Hey!" A voice came from the other side of the corridor, followed by a series of hurried footsteps.
Zhao Wenhua rushed over and saw Sun Chao in the room. He was startled for a moment. He didn't even say hello because he didn't know him, so he stood next to Boss Zheng.
"The patient initially thought it might be Sheehan's syndrome. He had a massive hemorrhage when giving birth 32 years ago, and has had this problem since then. You can check the three thyroid function tests, and then do a head MRI. If the diagnosis is clear, you can stay for treatment. , it’s okay to transfer to the endocrinology department.”
"Boss Zheng, please speak more slowly, what syndrome is it?" Zhao Wenhua asked immediately.
"Sheehan's Syndrome, Old Zhao, your basic skills are not up to par." Su Yun said with a smile.
"Hey, I have forgotten all the things I learned in school." Zhao Wenhua was not angry at all when facing Su Yun's ridicule, but lay down and let it go, saying with a smile.
Sun Chao watched all this in silence. No matter how mean Professor Su was, Zhao Wenhua would always smile and take it for granted.
Is he cheap? Definitely not. It should be that no matter what happened, Boss Zheng would solve it. Over time, if he usually said some harsh words, he would treat it as a joke between friends.
But what the hell is Sheehan's syndrome? Sun Chao vaguely remembered that it should be secondary to placenta previa, placental abruption, retained placenta, uterine weakness, etc. during the perinatal period, which caused massive bleeding, shock, and thrombosis, resulting in ischemia, necrosis, and fibrosis of most of the adenohypophysis, causing glandular adenopathy. Clinical syndrome of hypopituitarism.
But no matter how much he said, he didn't understand. As for what it had to do with hypoglycemia after splenic embolism, he was even more clueless.
"Okay, I'll check it right now and report the results to you, Boss Zheng." Zhao Wenhua followed the order and left without any doubts.
Sun Chao was also speechless. He suffered from hypoglycemia all year round, but Boss Zheng actually asked him to have his head MRI and thyroid function checked.
Forget it, it has nothing to do with me. What if it really is Sheehan's syndrome
But it seems that Boss Zheng is very interested in this. Why don't you ask for advice yourself? Sun Chao suddenly came up with such an idea.
Seeing that Zhao Wenhua was busy, Sun Chao walked to Boss Zheng and asked, "Boss Zheng, why do you think it is Sheehan's syndrome?"
"For women who have frequent episodes of hypoglycemia throughout the year, if their pancreas and glycated hemoglobin are fine, the first thing to consider is Sheehan's syndrome. Although the incidence is not high, the condition is quite serious, so early diagnosis and early treatment are better."
Zheng Ren said with a smile. It was obvious that he was more interested in explaining the condition, at least more than chatting.
"You are a little unfamiliar with Sheehan's syndrome, right?" Zheng Ren saw Sun Chao's confused face and immediately realized that this was the director of the vascular department, who does not treat Sheehan's syndrome.
“The case in front of us has a history of hepatitis C cirrhosis, and the glycogen synthesis and reserve capacity of the cirrhotic liver are reduced, and the liver’s ability to inactivate insulin is reduced, resulting in hypoglycemia. Therefore, the patient has been misdiagnosed as cirrhosis by other hospitals many times. and hypoglycemia.”
"The patient has a history of postpartum hemorrhage, clinical manifestations of hypogonadism, thyroid, and adrenal cortical insufficiency, and reduced levels of thyroid function and aldosterone. If the head MRI is examined, it is estimated that the volume of the pituitary gland has been reduced, and the sella turcica is partially vacuolated..."
"Boss Zheng, wait a minute." Sun Chao didn't understand. He immediately interrupted Boss Zheng and asked, "Is there something wrong with the MRI of the head? Is this your estimate?"
"Oh, no, it's a statistical probability issue. The research is very thorough." Zheng Ren said with a smile, "Due to postpartum hemorrhage, especially accompanied by long-term hemorrhagic shock, the anterior pituitary tissue is hypoxic and Degeneration and necrosis, followed by fibrosis, eventually leads to the syndrome of anterior hypopituitarism, which accounts for about 25% of patients with postpartum hemorrhage and hemorrhagic shock."
"Simply speaking, Sheehan's syndrome means massive bleeding during childbirth, causing hemorrhagic shock, or even DIC, when sympathetic nerve reflex excitation causes arterial spasm or even occlusion."
"The blood supply of the pituitary artery is reduced or cut off, the tissue cells of the anterior pituitary gland become degenerated and necrotic, and the various hormones secreted by the anterior pituitary gland and the target organs it controls are drastically reduced, leading to premature decline in the functions of the target organs acted upon by various hormones. change and cause a series of syndromes.”
Listening to Boss Zheng talk endlessly about the ins and outs of Sheehan's syndrome, Director Sun Chao recalled that this was how he explained the characteristics of echocardiography to himself in the neurosurgery department at that time.
One, two, three, four, five, it is clearly the iconic characteristic of a scientific dog.
Cirrhosis of the liver and hypoglycemia can bring out so many things. It's really... Sun Chao sighed softly.
"Professor Zhao." Zheng Ren suddenly shouted.
"Hey, Boss Zheng, I've finished giving the doctor's orders." Zhao Wenhua responded immediately.
"Be more detailed when asking about the medical history next time. If you ask about this patient's massive intrapartum hemorrhage, it probably won't be that dangerous." Zheng Ren said softly.
Zhao Wenhua scratched his head, a little embarrassed, but did not refute.
Sun Chao didn't think it would disappear, and he only had a vague impression of the so-called Sheehan's syndrome.
The probability of intrapartum hemorrhage itself is not high, and there are also probabilities within probabilities. They are all gathered together. It seems that I have not encountered many similar patients in so many years.
Boss Zheng is really a good teacher. He seems to be the chief director of the department, leading a group of professors to teach him whatever he wants.
But given his ability, Sun Chao had no doubt that the test results could not confirm Boss Zheng's diagnosis.
I saw a patient and it was already time to go to work. Sun Chao knew that the morning was the busiest time, so he thanked Boss Zheng a few more times before leaving. I didn't sleep last night, it was like riding a roller coaster and I almost broke my heart.
Dahuang Ya looked at Zheng Ren helplessly. Zheng Ren had no choice but to leave Liu Xiaomei's contact information and make an appointment to go to the community hospital in the afternoon. Only then did Da Huang Ya leave with satisfaction. Looking at his leaving figure, Su Yun frowned and asked, "Boss, do you think Da Huang Ya would be so kind?"
"Definitely not." Zheng Ren said, "I think he just wants to place someone in the community hospital. Whatever he does in the future, he will have to adapt accordingly. But this time, he owed Dahuangya a favor and gained some knowledge. The girl stayed in the community hospital. it does not matter."
"Hey, don't be careless." Su Yun said with a smile, "If the boat capsizes in the gutter of Dahuangya, where can we reason?"
"It's not that dark. With Lao Fan here, she can't make any waves."