Chapter 137: lumbar puncture

"Green's only benefit syndrome. Hearing Xu Ze's words, Zhai rate Ren Leng Xu Xing's two eyes under the tent mirror flashed a glimmer of light, fixedly glanced at Xu Ze, but some unexpectedly said: "You Also know this disease? "
Seeing Director Huo asking this back, Xu Ze was very pleased. Secretly, Director Zhai knew that he didn't need to spend much time talking about it.
Nodded lightly, and then handed this medical record to Ranwen Fiction Net, said to Director Huo: "Director, look at this patient,"
Seeing the medical record handed over by Xu Ze, it was the patient who had seen the cause of fatigue. Director Zhai couldn't help but stunned. After taking a deep look at Xu Ze, he finally took over the medical record and looked at it.
Director Zhai read it very carefully. He turned to the literary novel network page by page and thought for a long time. He also visited this patient today, but there were too many patients at that time, he did some examinations, and then heard of Qian Xuebin. After reporting, he agreed with his diagnosis. At the time, this disease was not considered.
However, according to the information I saw last time, this time, some symptoms are very similar, and it seems to be more appropriate than the diagnosis of neurogenic myasthenia gravis.
After thinking for a long time, Director Cheng looked up at Xu Ze and said slowly: "Have you read the latest information?"
Xu Ze nodded, then looked at Director Zhai and said: "Director, I have already conducted a detailed examination and physical examination of the patient, which is slightly more detailed than the medical history recorded by Dr. Qian. The patient had two weeks before the disease. History of infection, and history of limb, neck and back pain before illness!"
Hearing Xu Ze's commentary, Director Zhai's eyes gradually brightened, and he begged Xu Ze to continue.
"Physical examination, in addition to the decrease and disappearance of the muscle strength of the limb, and the disappearance of the tendon reflex, I also feel that the patient has a shallow sensory disturbance of the lower limb. Although it is only mild, it does exist..."
Xu Ze paused for a moment, so that Director Zhai looked at him and listened carefully, then continued: "But with some medications given by Dr. Qian, the patient's effect is not certain, it only temporarily prevented the condition. Further aggravation did not achieve a tangible effect, indicating that the diagnosis of neurogenic muscle weakness is still questionable."
"So according to the current medical history and physical examination analysis, Guillain-Barre syndrome is extremely likely," he said. Xu Zeding looked at Director Zhai calmly, waiting for his reaction.
After listening to Xu Ze’s analysis, Director Cheng nodded slowly and looked at Xu Zedao with approval:
Yes, you are now this year, but you can have such a wide range of knowledge, and you can be so careful and very good,

"Yes, but we must be careful about the diagnosis of this disease. After all, it is a new disease. There are not many reports on this in China." Director Zhai stood up, picked up the stethoscope and the percussion hammer, and looked at Xu Ze carefully. : "Let's" Let's go to check together "
Seeing that Director Qiao did not object to his opinion, nor did he agree with it lightly, but insisted on checking and confirming together again, Xu Ze couldn't help but nodded secretly. This is the prudence that a medical expert with advanced professional qualities deserves. Without hesitation, the two went straight to the ward.
After watching Director Sparrow talk with his new disciple for a while, they went out together. The next Zhang Yan looked up in surprise, and then continued to write his own medical record.
The two pushed the door of the ward and walked to the bed of the tired patient. The family members and patients next to him had met Director Zhai this morning, knowing that he was the professor of the First Division and the director here. When he came to the room today , Dr. Qian accompanied the examination respectfully.
At this time, Director Zhai came in. The family was feeding the patient to eat rice porridge. Then he stood up happily and said, "Director Zhai, hello!"
Director Cheng smiled and nodded, then said to the patient: "This morning there are too many patients and things are too busy to do a detailed examination for you. Now, Dr. Xu and I will give you a closer examination together!"
"Ah, well, it's really trouble you and Dr. Xu!" The patient looked at Director Zhai and Xu Ze beside him, and was now excited and politely thanked.
Director Zhai smiled and re-examined the patient's medical history. He heard Director Que's inquiry, but the patient was curious. How could Director Bird like the doctor Xiaoxu like to ask some inexplicable things.
I heard what I asked, as Xu Ze said, Director Zhai nodded, and then conducted a detailed physical examination. The final result was indeed the same as Xu Ze said. The patient except the lower limb muscle strength and tendon reflex disappeared , And slight superficial sensory disturbance of the lower extremities
After the inspection, Director Zhai nodded at Xu Ze, and the two left the ward.
Director Zhai looked at Qian Xuebin's medical record and couldn't help but frown and shook his head. He secretly said that Qian Xuebin didn't ask the condition carefully. If you ask carefully, you won't have missed the disease today.
I can't help but look at Xu Zedao happily now: "According to this situation, it is indeed very much like Guillain-Barre syndrome, but there is no official information in China, and our diagnosis is still not sure."
Xu Ze smiled lightly: "Director, Guillain-Barre syndrome has a characteristic thing, that is, the separation of cerebrospinal fluid protein cells, we only need to do a lumbar puncture,
"Protein cell separation?" Director Zhai frowned and recalled the information he saw. There seems to be this statement above. I remember it is not particularly clear, but it seems that what I said above is not very certain. Can't help looking at Xu Zedao: "Xu Ze, are you sure?"
"I remember that the treatment of Guillain-Barre syndrome and this neurogenic myasthenia is almost completely different, this must be careful!" Director Zhai looked at Xu Ze seriously.
Xu Ze nodded with a smile, but he was absolutely sure he was right, because the future medical technology has proved this.
"Okay, let's go wear it now, don't delay the time!" Director Guan resolutely stood up and said.
Seeing that Director Que is so anxious, Xu Ze couldn't help but stunned: "Don't we have to wait for money doctor?"
"I don't wait any longer. He should be ready to have lunch now. He will come to take over at noon. Let's do it first and make a diagnosis as soon as possible." Director Zhai said flatly.
Seeing Director Zhai affirmed, Xu Ze no longer hesitated, nodded, and then said: "Then I will prepare utensils!"
Although Xu Ze is not too familiar with the emergency department, but with the help of the nurse Hu Xia, he quickly prepared all the equipment worn by the waist.
Director Zhai personally called the patient's family to come and talk about the new situation and the necessity of performing this lumbar puncture examination.
The family heard Director Zhai's words, remembering that it was Dr. Xiao who came to check it first, and then asked about the situation, and then Director Huo came again and asked again before considering this question. But he couldn't help but be grateful for Xu Ze's secret life. If it wasn't Dr. Xiao Xu who had the problem, he told Director Zhai very responsibly, fearing that he could not find this possible reason.
At the moment, I signed the consent form on the waist and asked Director Huo to take great care. Waiting for Xu Ze to bring in the equipment worn by the waist, the family saw Xu Ze with great enthusiasm, making Xu Ze not used to it.
Seeing that Xu Ze was ready, Director Zhai took Xu Ze with them, and they went straight to the ward.
At this time, the patient already knew the situation from the family, and to do such an examination, the vision of Xu Ze was very different from that of Xian, and his eyes were full of gratitude.
Director Zhai pushed his glasses and watched Xu Ze skillfully position the patient with his knees on his side. Now he was curious again and secretly said: "Does Xu Ze even perform lumbar puncture? Is this impossible?" It is impossible for the clinic to do this lumbar puncture!"
However, out of the surprise that Xu Ze gave him today, there was an inexplicable confidence. After Xu Ze prepared for himself, he looked at Xu Ze and tentatively said, "Will you do it?"
Hearing the question from Director Que, Xu Ze responded honestly after a moment of stunned: "Yes"
"Yes?" There was a flash of strange light in Director Zhai's eyes, and a flash of surprise. He smiled and said, "Okay, then you do it!"
"Oh, good!" Hearing to let yourself do it, Xu Ze was very excited to be able to actually perform a lumbar puncture. After all, simulation operations have only been performed in the void space before, although these simulation operations are different from the real operations. Very few, but when he really started, Xu Ze was extremely excited.
Lumbar puncture is also a small operation that is not difficult. Many doctors rarely succeed the first time, but Xu Ze is still confident in himself.
At present, in order to succeed in a puncture, Xu Ze adjusted the patient's position again. The patient's back is perpendicular to the bed surface, the head is flexed forward to the chest, the knees are held tightly against the abdomen with both hands, the torso is arched, and the patient's spine is protruded as far as possible to increase the width of the intervertebral space and facilitate needle insertion.
Then he began to choose the location of the puncture. He extended his hands and determined the puncture point at the intersection of the posterior supraspinal line of the pelvis and the posterior median line of the spine~EbookFREE.me~ This is the location of the spinal process space of the lumbar spine , Is also the best place to puncture.
Then take out the complex iodine cotton swabs, routinely sterilize the skin at the puncture point, then wear a sterile waist bag, and put a disinfectant hole towel on the patient...
Director Cheng looked at Xu Ze's movements with satisfaction. These programs were extremely proficient in Xu Ze's procedures. They completely complied with the procedures of aseptic operation. They did nothing wrong in one step, just like a veteran.
This made Director Cheng secretly marvel at the city. Xu Ze really gave him too many surprises today. I really don't know where he learned this from? How can a junior student know this?
At this time, Xu Ze had put the disinfection hole towel on, and the umbrella had raised the syringe. Director Huo suppressed the surprise, took a lidocaine from the plate, opened it, and put it in front of Xu Ze, waiting for Xu Ze to take the medicine. , Do one's duty as an assistant.
And Zhang Zuo, who had been in the office at this time, also followed with curiosity. At this time, Director Zhai was actually acting as an assistant for Xu Ze. At the moment, he couldn’t help but be surprised. Director Zhai was an assistant, and this One is one. Novice, who can believe if this is said?
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