"This patient should go to the hematology department, not the circulatory department." Zheng Ren compared dozens of case reports and guessed that it might be some kind of rare disease, so he told Director Chu.
"Boss Zheng, what disease do you suspect it is?" Director Chu was not surprised, but looked at the film and asked calmly.
He was also thinking about the possibilities of various diseases in his mind, and did not take Zheng Ren's words too seriously.
"The information is incomplete and we can't diagnose it yet," Zheng Ren said.
Director Chu was a little dissatisfied. He glanced at Zheng Ren and said, "Boss Zheng, you are too cautious. We read the films internally and speak freely. We will not blindly believe your words and cause the patient to be misdiagnosed." .”
Zheng Rendao: "Can the patient's ECG be found?"
"Let me ask." Director Chu took out his mobile phone and made a call. Less than a minute later, the WeChat prompt sounded.
The doctor over there sent the electrocardiogram picture.
With the rapid development of instant messaging, the models of in-hospital and out-of-hospital consultation have also undergone fundamental changes.
In the past, this type of information required sending emails and conducting remote consultations. Even Haicheng City No. 1 Hospital established a remote consultation center for this purpose, preparing to work with large tertiary hospitals in Imperial Capital and Shanghai to improve medical standards.
Unfortunately, the construction of this remote consultation center has been slow. With the rapid advancement of mobile communications and the improvement of the quality of pictures transmitted by WeChat and QQ, while the consultation center was built, it also lost its original function and was directly scrapped. (Note 1)
To send videos, the clarity of WeChat QQ is enough, and there is no need for more advanced professional equipment.
"Boss Zheng, take a look." Director Chu said while holding his cell phone.
"Director Chu, let's add WeChat." Zheng Ren had an idea and added Director Chu's WeChat.
Others are looking for the WeChat messages of pretty ladies on the street, but Zheng Ren is anxious to ask for the WeChat messages of various old directors.
People, it is indeed different.
If Su Yun were here, he would definitely give Zheng Ren a serious evaluation.
After adding WeChat, Director Chu sent the ECG photos to Zheng Ren.
Download, zoom in, Zheng Ren looks at it carefully bit by bit.
The patient's electrocardiogram showed changes in the T wave and depression of the st segment, which were indeed the electrocardiographic changes of standard myocardial infarction.
However, Zheng Ren noticed that at the same time as these changes, the patient had low voltage in the limb leads and poor R-wave increment in the precordial leads, accompanied by arrhythmia.
This... is increasingly similar to the ECG changes of primary light chain amyloidosis. Of course, Zheng Ren was just guessing that this disease was rare. And according to dozens of case analyzes and reports, other inspections are needed to support it.
And the electrocardiogram in front of me,
The typical ECG changes of myocardial infarction are just a "side effect". The seemingly unimportant R-wave changes are the key point!
Zheng Ren asked: "Director Chu, I'm sorry, I need to check the results of the patient's relevant examinations."
While he was thinking about the patient's condition, Zheng Ren became less polite. But Director Chu didn't care. After asking about it, he got all the test results back.
Most of the people who come to 912 for medical treatment are patients who have had examinations done locally. The family members of the patients come with all the examination reports and films. If necessary, the 912 doctors will order an examination here. But in most cases, various checks on the place of origin are enough.
It took a full five or six minutes for all the data on that side to be transmitted.
Zheng Ren looked at them one by one and found that the protein in the urine was +++, showing early changes in nephrotic syndrome. The echocardiogram was like its own reconstruction. The left ventricular ejection fraction was slightly reduced, the whole heart myocardium was thickened, and there were standard "snowflake-like" echoes in the myocardium.
"Have you checked your liver?" Zheng Ren asked.
"Well, no." Director Chu saw Zheng Ren's serious face. Although he was surprised, he held back and answered directly.
"I want to take a look at the patient." Zheng Ren said.
Director Chu nodded, Dr. Liang packed up the film and handed it to the doctor who gave the report. Director Chu took out his mobile phone and dialed.
The bell rang for a long time before the other side picked up. It seemed that the doctor who was visiting was very busy at this time and had no time to connect on the phone.
"Where is the patient?" When the call was connected, Director Chu asked directly without being polite.
"Okay, let's go there right away."
"There is something wrong with the film. I want to take a look at the patient."
After Director Chu finished speaking, he hung up the phone and left. Zheng Ren immediately followed Director Chu out of the reading room and went all the way to the outpatient clinic.
"By the way, Boss Zheng, what do you want from me?" Director Chu asked at this time.
"That's right, Director Chu." Zheng Ren quickly walked a few steps and came to Director Chu's side, slightly behind him, and said: "Director Luo from the Department of Gastroenterology introduced me to a patient with portal hypertension and advanced liver cirrhosis. . I am thinking of having surgery tomorrow, but the patient does not have an MRI diffusion examination, so there is no way to determine the puncture point."
When Zheng Ren said this, all his thoughts were clearly expressed.
"Oh, this is about something. Is it too late to do it after get off work?" Director Chu asked.
"There's time, there's time." Zheng Ren quickly replied with a smile.
"Xiao Liangzi, you can do it for Boss Zheng." Director Chu immediately arranged.
What seemed difficult to Zheng Ren was just a matter of casual remarks to Director Chu.
"Okay." Dr. Liang responded immediately.
Zheng Ren was a little ashamed. Dr. Liang had been very helpful when he came to the imperial capital before. But I didn’t even ask for their WeChat account or phone number. It seems that things like interpersonal communication will be more difficult in the future.
Humans are social animals and always need to communicate with other people.
If you don’t want to work on a Nobel Prize project, it doesn’t matter. But in the current situation, someone, many people, must help him to complete it.
Zheng Ren followed Director Chu and thought silently. But Director Chu agreed, which is a good thing. Zheng Ren immediately contacted Mr. Liu of the Department of Gastroenterology and asked the patient to fast and drink water, replenish fluids appropriately, and undergo MRI diffusion around 7 p.m.
Although it is a bit early to fast and drink water now, it is better than not doing it at all.
When patients from other places came to see a doctor in the imperial capital, very few of them came (Note 2). As a family, everyone eats horse chews, and the daily expenses are not low.
If you can be discharged from the hospital one day earlier, you will save a lot of money.
Arriving at the outpatient corridor, patients were queuing up outside, with security guards maintaining order.
Looking at the countless red and light red background boards, Zheng Ren let out a sigh of relief.
No matter how powerful the big pig hooves of the system is, he can't solve too many problems with just one person.
Entering the clinic and arriving at Circulation Specialist Clinic 3, Zheng Ren saw a patient in his 30s standing at the door with a look of fear on his face.
His system panel showed a faint red color, and the diagnosis was clear that he had primary light chain amyloidosis.
…
…
Note 1: This is how the remote consultation center in our hospital was scrapped.
Note 2: I managed a female patient last year. It was said that she had an ovarian cancer removal surgery in Beijing by herself. A very strong and optimistic person.