Chapter 365: : Encounter the big guy!

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There is a key point to diagnose a disease!
This key point can be found in order to make a clear diagnosis in the true sense.
This is what modern medicine says: the gold standard for diagnosis!
For example, tuberculosis can be diagnosed by tuberculosis in sputum culture. For example, cancer diagnosis can find cancer cells in tissues, etc ...
but!
Many diseases have no gold standard.
This requires finding a major clue that can help diagnose the disease!
Once you find this, you can help diagnose the disease.
Chen Cang took a deep breath and looked again at the old man's eyes full of awe.
Chen Cang nodded slightly and expressed his thanks!
The old man just smiled slightly, nodded, and said nothing.
...
...
The old man is terrific, he is terrible here.
But the most amazing thing is not only here.
The best part is the philosophy of dealing with people.
He knew that Wu Yushu had a problem, and the problem might not be small, but he wouldn't say it directly.
He knew it was a hospital, and he had to listen to a doctor.
Even if the old man is a famous doctor and a powerful doctor, he will not surpass his authority, nor will he teach Chen Cang what to do.
However, as a doctor, seeing the patient's diagnosis encountered something, his heart did not allow him to stand by.
At this time, Chen Cang's "blood pressure" operation seemed to have a high emotional quotient.
If the old man asked Chen Cang to make a chest radiograph, an electrocardiogram, and even a cardiac color ultrasound, would the patient be willing?
What do patients think?
Does your doctor give a diagnosis to help others?
Will the patient feel that the doctor is a quack!
He doesn't even follow the advice to check.
The measurement of blood pressure is from the perspective of the patient, do you think? Taking a blood pressure, how easy it is, anyway, it doesn't cost any money, just a simple check.
One is that the patient did not reject his heart and heeded the advice.
Second, the doctor can also get a lot of useful clues from it.
It can be said that the situation is solved with the help of light clouds and light wind, which seems very powerful.
Don't underestimate the sphygmomanometer, this thing seems simple.
However, this blood pressure test can find many things.
This is the place of depth.
Strange pulse refers to the phenomenon that the pulse significantly weakens or even disappears when inhaled, and then appears or returns to its original state when exhaled. Observing the odd pulse with a sphygmomanometer is more intuitive and obvious than palpation with a finger.
Experienced doctors can feel a lot of things with a slight touch.
The principle of odd pulses is due to the increased pressure in the pericardial cavity, which limits the diastolic filling of the ventricle, the restriction of systemic venous return during inhalation, the reduction of right ventricular blood flow into the pulmonary circulation, and the pulmonary circulation is affected by negative respiratory pressure and pulmonary vasodilation As a result, the amount of blood returning from the pulmonary veins to the left heart decreases, and the output of the left heart decreases, so that the pulse weakens or even disappears.
The occurrence of odd pulses is common in diseases such as right heart failure, pericardial effusion and constrictive pericarditis, and severe asthma.
With this diagnosis, Chen Cang's next need to do is simple and clear.
The sound of the auscultation of the heart just now coincided with the strange pulse at this time, and now Chen Cang already knew about the situation of Wu Yushu.
Nine times out of ten is constrictive pericarditis!
However, in order to confirm the diagnosis, there must be a basis. Thinking of this, Chen Cang observed carefully. With Wu Yushu's breathing, the neck and jugular veins were faintly visible, but because of the obesity, it was not very obvious.
Chen Cang thought of Wu Yushu's swollen stomach, indigestion, and poor appetite.
Said: "I touch your belly."
Wu Yushu raised his legs very cooperatively.
After Chen Cang's abdominal examination, he was slightly silent. There might be effusion in the abdominal cavity and hepatomegaly.
At this time, Chen Cang was already able to judge it.
Thinking of this, Chen Cang asked about the history of the disease and its predisposing factors in detail.
After that, Chen Cang looked at Wu Yushu: "What you are doing now, and my examination of you just now, I feel that you are more like a constrictive pericarditis."
When Wu Yushu heard it, his eyelids jumped, startled by this professional term.
He's heard of pneumonia, rhinitis, but for the first time about what kind of pericarditis!
Thinking of this, Wu Yushu's face changed: "What is this pericarditis? What does it mean?"
Chen Cang explained: "Constrictive pericarditis is due to chronic inflammation of the pericardium, which has a long-term effect on the human body, leading to thickening, adhesion and even calcification of the pericardium, which restricts the relaxation and contraction of the heart, reduces cardiac function, and causes systemic blood circulation disorders A disease. "
"Your breathing pain, chest pain, and bloating are directly related to this!"
Wu Yushu was frightened when he heard the truth.
He can't get sick ...
This is the key.
He bears a heavy burden. Where can he dare get sick?
Do not dare to rest, let alone get sick?
Thinking of this, Wu Yushu quickly asked, "Doctor, am I serious?"
Serious or not, this is really hard to say, but when Chen Cang saw Wu Yushu, he had to tell the truth:
"To be honest, it is not a simple disease, because long-term development will not only affect the cardiovascular system, but may also accumulate diseases of the liver, lungs, etc., and the entire system."
Wu Yushu said a little inwardly: "Does this ... need to be hospitalized? Or can I take anti-inflammatory drugs?"
In Wu Yushu's heart, inflammation, you should take some anti-inflammatory drugs, right?
But ... the inflammation on the heart left him at the bottom.
Wu Yushu heard Chen Cang's explanation, it seemed very serious, and suddenly he was afraid.
Chen Cang could not help but shook his head: "In the case of constrictive pericarditis, it is mainly surgical treatment, supplemented with medication, and the sooner the better, and the fluid in your abdominal cavity needs to be drawn. My suggestion It is to arrange hospitalization as soon as possible. "
"After hospitalization, improve the relevant examinations, and then make specific diagnosis and treatment."
Chen Cang said everything that should be said.
He could see that Wu Yushu seemed to resist the inspection for two reasons, one was economic pressure and the other was delay.
But when the disease comes, the treatment still needs to be treated.
However, the test can be done after being hospitalized.
In this way, you can take out medical insurance and reimburse a large part of the cost of the examination.
This is already Chen Cang's best effort.
Therefore, Chen Cang did not let Wu Yushu check up in the clinic as soon as possible, but hoped that he could be hospitalized as soon as possible.
Wu Yushu heard Chen Cang's words, and was a little silent, sitting there silently.
At this time, Chen Cang accepted the elderly.
Seeing the old man, Chen Cang didn't know what to say, thought about it ~ EbookFREE.me ~ instead said: "Old man, what can I do for you?"
The old man handed over the emergency department registration: "Give me an electrocardiogram.
When Chen Cang saw the old man's name, his eyes narrowed!
This name, perhaps most people do not understand.
However, in the field of medical treatment in Dongyang Province, or in the field of Chinese medicine, the significance of this represents something quite different.
Chen Cang also learned the name by accident, and never expected that he could see this big guy!
Master of Chinese Medicine: Zheng Sanshui!
ps: Hey, for the time being, I will write a lot of interesting stories about integration of Chinese and Western medicine in the future. Medical treatment is not just surgery, but also includes diagnosis, treatment, and so on.
Qimai is actually a very interesting thing, and I have actually met it.
Finally ... cheekily for tickets, cough!