Chapter 264: Surprised assessment results

As a doctor, he treats people. The most important thing is to learn to see the essence through the phenomenon...
A patient with a stomachache, do you know which part of the pain he is in? Then determine the cause by location;
For example, when Xu Ze found that the patient had obvious gallstones through color Doppler ultrasound, and the gallbladder was also swollen, it was basically determined that the patient's abdominal pain was mainly caused by the gallstones.
But doctors are not such an easy occupation, and seeing a doctor is not so simple. Xu Zefang was only to cope with this assessment, but he forgot what was very important for a doctor.
That is, in addition to the main diseases, it is necessary to carry out discrimination analysis of other diseases, because like this abdominal pain, in addition to gallstones, gastritis and even pancreatitis can be caused.
At present, Xu Ze can confirm that it is mainly gallstones, but it must also rule out other corresponding diseases...Although the possibility of combining other diseases is small, as a doctor, you should not go because of the small possibility. Ignore; because in many cases, there are only a few minor problems and no attention, which leads to serious consequences...
Now Xu Ze suddenly remembered this problem. Although there should be no major problems, he was always cautious and responsible for the patient. This is an issue that cannot be ignored.
So he settled down again, started the color ultrasound and scanned the stomach and pancreas of the patient.
Color ultrasound can effectively determine the overall changes of the pancreas and stomach. Through this examination, you can roughly determine whether there are abnormalities.
The result of the color ultrasound scan gave him a little peace of mind. The patient's stomach did not show any major problems, and the appearance of the pancreas was very smooth, and there seemed to be no abnormalities.
Xu Ze was almost relieved at this time, but remembering the new blood amylase function in the function of the tripolar system recently, he did it for the patient.
This blood amylase measurement is the most standard test to exclude the presence of pancreatitis. As long as you do this measurement, you can confirm whether there is a problem, which is much more accurate than a simple color B-scan.
Following his order, he was holding the ring on the right index finger of the patient's vein door, and quickly ejected a bovine capillary needle, gently pierced the patient's wrist, and extracted it without the patient's consciousness. A little blood was tested.
"1200UL" Xu Ze looked at the red value displayed on his glasses and frowned. The blood amylase obviously exceeded the standard. This patient actually had pancreatitis!
However, the main diagnosis is still gallstones, the second diagnosis is pancreatitis; in the diagnosis of traditional Chinese medicine, there should be no problem with the diagnosis of cholelithiasis.
Then he stood up slowly and nodded to the senior players who were already impatient. Then he said: "President Guo, I have finished the examination..."
Hearing Xu Ze's words, all the senior national players nodded slowly, and Wang Laoguo's hands saw Xu Ze's face, although serious, but still confident, but relieved.
Originally, Wang Laoguo could see where Xu Ze hesitated, and he saw that Xu Ze was indeed weaker than other rookies in traditional Chinese medicine. This is worrying that Xu Ze can pass through smoothly; but now Xu Ze is more expensive It took some time, but it seemed that the confidence was still extremely full, and naturally I was slightly relieved.
Wang Laoguo is not able to pass Xu Ze now, and he doesn't care much about his reputation. What he cares about is that the young man in front of him is indeed very good. If he can't get the practice certificate through this assessment, it will be true. It's a pity.
Dean Guo looked at the young man opposite him, and then nodded gently, saying: "Okay...Since the diagnosis has been completed, Xu Ze, please answer the diagnosis basis and treatment plan of this patient. …"
"The main manifestations of the patient are upper abdominal pain, oily and bitter mouth, signs of thin yellow fur on the tongue, pulse string... Western medical examination shows mild tenderness in the right upper abdomen, and Murphy's sign is positive... Therefore, TCM diagnosis considerations: cholelithiasis. , The principle of treatment is to relieve the liver and qi, the prescription is: Chaihu Shugan powder... Acupuncture: Take the sun, moon, period gate, gallbladder points, match Zusanli, Zhongwan..."
Speaking of which, Xu Ze couldn't help squinting his eyes, and looked at the expressions of several senior national players... It seems that Wang Laoguo nodded his head with a smile, his heart was relieved. As long as there is nothing wrong, then he will not Worried...
The following diagnosis and treatment of Western medicine is naturally simpler for Xu Ze. Xu Ze, who is in a relaxed mood, then continued with a light smile: "Consideration of Western medicine diagnosis: acute cholecystitis, gallstones; does not rule out acute Pancreatitis may be...It is recommended to perform liver and gallbladder color Doppler ultrasound, blood routine, blood amylase and other tests. For treatment, temporarily give cefradine and ofloxacin anti-infection treatment, and give cimetidine acid suppression, 6542 antispasmodic analgesia..."
"If there are relevant examinations confirming gallstones, according to the patient's physical condition is acceptable, it is recommended to perform surgical treatment in the case of effective anti-infection and gastric acid suppression to protect the pancreas..."
Hearing Xu Ze say nothing, Dean Guo frowned lightly. Dean Guo always obeyed Chinese medicine. Although he gradually accepted Western medicine in recent years, he still resisted the surgery that Western medicine was good at.
Because in his view, if conservative treatment can be used, assisting the row of stones with Chinese medicine is naturally the last thing. After all, Western medicine performs surgery. Although it is simple, it is a matter of killing three thousand enemies and self-destructing. Not in line with Chinese medicine.
However, at this time, although he was not very satisfied with the treatment method proposed by Xu Ze, this operation belonged to the category of Western medicine after all. In this regard, he was naturally inconvenient to easily deny it and turned his head to look at the two capital medical universities. Professor, wait for their judgment.
Dean Guo Lao looked at Professor Tang Wuyou and Professor Jiang Lingyun, but found that they looked at Xu Ze at this time, and there was a trace of surprise in their eyes.
Dean Guo was stunned and couldn't help but questioned the two professors: "Two professors, please also comment..."
Tang Wuyou and Jiang Lingyun glanced at each other, but Jiang Lingyun nodded and smiled and said: "Guo Lao... The diagnosis and dialect are extremely close... The diagnosis of acute cholecystitis and gallstones is very clear, and the treatment is very clear. The plan is clear..."
Hearing Professor Jiang's words, Dean Guo was stunned. In front of this young man, Xu Ze, has the attainment of Western medicine really reached such a superb level?
The Wang Laoguo hand next to him also smiled gently at the jaw, Xu Ze did not let him down finally...
However, the rookies next to them, especially Guo Yujian, looked at Xu Ze, but they also showed a hint of admiration in their eyes, all of whom were studying Chinese medicine, but they could achieve this degree in Western medicine. That is naturally unmatched by them...
Especially Guo Yujian, but at this time, his pride is also converged,
In surprise, he heard Professor Jiang and suddenly said, "It's just..."
"But what?" Dean Guo Guo was surprised for a while, but he was not surprised. Although Xu Ze seemed very superb in Western medicine, he was still too young after all. It will be worse.
But I was also a little bit happy at the moment, if Xu Ze had no problem at all in this round of assessment. Well, if it is so good to participate in the assessment of Chinese medicine rookies in the capacity of learning Western medicine, then the faces of everyone here are not good-looking.
Moreover, his grandson Guo Yujian had already won the first place today, and he also competed with him for a big face, but if Xu Ze can achieve such good results this round, then he can carefully cultivate ten with his own. The grandchildren of several years went hand in hand... He was naturally not very comfortable...
It seems that there are still some omissions in Xu Ze’s answer at the moment, and he was slightly relieved at the moment, laughing: "Professor Jiang is in charge of the judgment today, he has his own words, but it’s okay... If Xu Ze has an inappropriate diagnosis, he It’s when Professor Jiang mentions something..."
Jiang Lingyun nodded with a smile, but then curiously smiled at Xu Ze and asked, "Do you think Dr. Xu..."
"Professor Jiang...I am Xu Ze!" Xu Ze looked at Jiang Lingyun like this, but he also followed for a moment, and he was suspicious in his heart. Was he wrong?
"Dr. Xu... Just now, your diagnosis of acute cholecystitis and gallstones is very clear and the diagnosis is very good; but how can you be sure that he may have acute pancreatitis?" Professor Jiang looked at Xu Ze, very Asked with some curiosity.
Hearing Professor Jiang's words, Xu Ze's heart also released a strange color, secretly said: "Don't these two professors don't know that the patient may have acute pancreatitis?" Looking at Professor Jiang's appearance, Xu Ze's heart There is a certain amount of knowledge. The two professors must have seen this patient in advance, but did not conduct detailed inspections and examinations in various aspects, so they did not confirm this conclusion.
However, Xu Ze naturally did not say that he was determined by making blood amylase for his patients...Of course, he had his own preparations, and he had already thought about his defense.
Then he laughed and said: "Professor Jiang, the patient reported that he had eaten a lot of greasy fried rice and beer before the abdominal pain, and abdominal pain appeared in the rear; this overeating and abdominal pain after drinking alcohol, although it can cause cholecystitis One of the factors of the attack; but there is also a disease of acute pancreatitis that must be considered, because the first article in the medical sciences about this situation has mentioned that this type of overeating and drinking alcohol can lead to this comparison. critical illness…"
"So, I think although the positive Murphy's sign can be used to conclude that there is a high possibility of cholecystitis and gallstones, this situation is naturally unavoidable, and the possibility is not small...so. I proposed this merger disease…"
Hearing Xu Ze’s analysis, Professor Jiang and Professor Tang Wuyou glanced at each other in surprise, but they did not expect that Xu Ze even remembered such a small record in the book, he could remember It's so clear, and it can be analyzed so clearly...
Even the two of them did not notice the situation in a hurry, and they could analyze it in a short time. This young man is really extraordinary...
Thinking of this, Jiang Lingyun smiled and nodded at Xu Ze with a sigh, then turned to look at the senior Guo Dean aside and sighed: "Guo Lao... These young people are terrific... Actually this simple With this method, such a complicated situation can be diagnosed...it is not easy...not easy..."
Hearing Professor Jiang's words, Dean Guo's face was stagnant. He naturally didn't expect that Professor Jiang was just... actually, Xu Ze had even more disputes for several points, even the two Western medical circles. Old experts are so reputed...
At the moment, he can only smile at Fu Xu Qian: "Looking at the present generation of talented people, I am so gratified to wait for the old... to be gratified..."
After all, he had to laugh and commented: "Xu Ze performed well today, and the evaluation was excellent... All rookies passed smoothly... Please ask Director Lin to announce the overall situation of this assessment..."
Lin Zhikui, the deputy director of the National Medical Examination Center next to him, nodded with a smile and was waiting to speak, but suddenly an old man next to him suddenly laughed and said: "Guo Lao, Fang Cai Wang said that Xu Ze’s acupuncture is very difficult. In order to get it, we don’t know if we can take a look today...I don’t know what everyone thinks?"
Hearing the old man's words, Xu Ze frowned secretly. It seemed that he was a major in Western medicine to participate in the evaluation of the rookie of traditional Chinese medicine, but he had achieved such good results, and grabbed the limelight of these rookies.
However, the old folks next to me, after hearing this proposal, naturally nodded one after another. After all, Wang Yibo first praised Xu Ze's acupuncture technique. If you don't look at it today, it is naturally a pity. ;
Moreover, this kid just got better today, and the results are better than most Chinese medicine rookies. If this kid doesn’t have that skill~EbookFREE.me~ can be considered as a slight pressure on him, and let these old people The guy is not too dull...
Seeing everyone agree, Wang Laoguo's hands also looked helpless and smiled bitterly, it was hard to object that everyone would take Xu Ze into the exam again...
Dean Guo also looked at Xu Ze with a smile and said, "Xu Ze... Brother Wang is very appreciative of your acupuncture technique, and I am also very curious. How about showing this patient now? "
Looking at the old men all looking at each other with a smile, but they couldn't object to it, Xu Ze had to smile bitterly. But his certificate was still in your hands, could you not agree?
Now I have to nod my head and say: "Since all the senior teachers want to be tested underneath, they will naturally obey..."
The old men heard that although Xu Ze's words were somewhat disgruntled, they did not dare to object. Everyone laughed at each other and then said: "Naturally it's good... then let's start..."
Xu Ze took a light breath, knowing that if he doesn't show his hands today, I'm afraid it's not easy to explain. These are all seniors in the country, and it's not good not to give them a little face...I just figured out that I always carry it with me. Silver Post, ready to start... (!)