Vol 3 Chapter 2376: Like a 134-year-old patient

After explaining the surgical images, Zheng Ren landed on a stone.
This heart x syndrome is not uncommon, but it is particularly easy to ignore. After all, non-invasive examinations are difficult to find out. It is normal for patients to go to countless hospitals without a definitive diagnosis.
"Ah ah!" Su Yun suddenly hesitated, and then said, "I forgot one thing!"
"Ah? What's wrong?" Zheng Ren asked in amazement.
"General Manager Wang came to you just now." Su Yundao, "He asked me if you have time, and you saw a patient with heart x syndrome ..."
"Oh, what is Wang looking for?" Zheng Ren asked.
"There is a patient who has difficulty breathing and is dizzy on walking. There is nothing good to diagnose. I want you to take a look." Su Yun said, "Haidong is preparing for a consultation in the hospital. Know if the consultation is over? "
哦 "Oh?" Zheng Ren asked, "They judge emphysema or vertigo?"
"Boss, do you want to pay for the consultation in the future? Why are we all experts in the Imperial City? Just look for our consultation, just like the big girl who called Huotongfang." Su Yun didn't answer Zheng Ren's words, but he was holding other things.
别 "Don't say it so badly." Zheng Ren smiled, "Is the data coming over?"
"No, he just asked to see if you are interested." Su Yundao.
"Look at 呗, if you don't understand, let the patient come over." Zheng Ren said casually.
"Come here?"
"..." Zheng Ren froze for a moment, then said: "Seeing, hearing, hearing, asking, and looking at the patient inside. Do you think remote consultation can solve all incurable diseases?"
"Boss, why do you feel like you have been tailed?" Su Yun asked with a smile. He just asked casually, but did not expect his boss to be so serious.
However, Su Yun didn't care, he just habitually gave a word to his boss and stopped.
"Don't talk nonsense, always ask Wang for information." Zheng Ren said.
Su Suyun took out her mobile phone and flashed back and forth on the screen of the mobile phone with almost a ghost image in her hands.
The whole hospital consultation is not over yet, it looks really troublesome, Zheng Ren judged. No matter the illness or the patient's family, there will be trouble.
Soon, President Wang sent the patient's information.
The patient complained of general weakness, fatigue and dyspnea for three months.
He does not smoke, does not drink alcohol, does not have pets at home, and usually eats normally. There have been no special changes recently. There is no history of previous illnesses, no family history, etc. The job is a bank clerk, without exposure to dust and other metallic materials.
Suddenly, this situation suddenly occurred, and it would last forever, neither the patient nor the doctor could do anything about it.
I had a chest radiograph at the first visit a few months ago, diagnosed with a lower respiratory tract infection, and underwent targeted treatment.
After the anti-inflammatory and symptomatic treatment, his symptoms improved at the beginning, but he relapsed after one month. It is even more strange that after the second time, his x-rays did not look any problem.
All examinations have been done, and there is still no problem detected in the patient.
If you look at the results of the inspection, this is a very healthy person. However, according to President Wang's description, the patient's condition is extremely serious. Now he can't go up the stairs and walks trembling on flat ground. He takes a few steps to rest.
Looking at the patient's profile, Zheng Ren sat on a chair in Zhou Litao's duty room and began to wonder.
"Seeing the brief introduction of the condition, like severe pulmonary heart disease, but the chest radiograph and lung CT display are not set up." Su Yundao.
Zheng Ren clicked the mouse to enlarge the chest radiograph.
"Want the original data?" Su Yun asked.
"No need, you can see clearly." Zheng Ren said: "No wheeze was written in the medical record. Su Yun, do you think asthma can be ruled out?"
"Early during the asthma attack, you can see that the transmittance of the two lungs increased, and it was over-inflated. It was not on the film, but there were also reasons why it was not during the asthma attack period." Su Yun continued, "But I don't think about it either. No wheeze is mentioned, I don't think this obvious symptom should be overlooked. "
After Yun finished speaking, Su Yun smiled. "No matter how tertiary hospitals are, the wheezing sounds can't be heard, so Dean Xiao can resign."
"Well, when the asthma does not occur, it does not consider the symptoms of limb weakness." Zheng Ren added, ruling out the possibility of asthma.
"It's okay to look at the heart, and the 24-hour ambulatory ECG is also checked, and the patient is very healthy."
"Epilepsy?" Su Yun asked.
"It is possible, it may be the patient's self-reported symptoms, and convulsions ... not right, if the limbs are weak ... This diagnosis is retained first, although it is unlikely, but it is possible." Zheng Renshen said.
Wu Suyun recorded the diagnosis of epilepsy on a4 paper. If you want to make a clear diagnosis, you can do an EEG examination when the patient has an attack.
After all, it is a remote consultation. If you want to check whether the patient has other reactions during the activity, it is unlikely that the diagnosis will be made.
"What about pneumonia?" Su Yundao, "You can see a vague image of inflammation on the first x-ray film. Although it is not in the later stage, it cannot be simply ruled out."
"Anatomy is classified as lobar pneumonia, lobular pneumonia, and interstitial pneumonia. The state of the patient, I think the possibility of interstitial pneumonia is higher."
"The cause is divided into bacterial pneumonia, viral pneumonia, mycoplasma pneumonia, pneumonia caused by other pathogens, fungal pneumonia, and other non-infectious factors, such as radiation pneumonia, aspiration pneumonia, allergic pneumonia ..."
Zheng Ren and Su Yun investigated all the way and began to make various differential diagnoses.
Zhou Litao watched silently. The patient was only 34 years old. He had weak limbs and dyspnea. He didn't make a clear diagnosis after doing many tests. It looked strange.
The first thing he thought was that the patient's age was wrong.
34 years old! This patient looks like 134 years old.
Uh ...
Uh ...
Erhai City, the city's first courtyard.
Although it is already off work, the doctors are still working like worker ants.
President Wang is attending a consultation in the hospital.
As a support expert of the Imperial Capital, now the City First Hospital will ask him for a look during the whole hospital consultation.
Only this time, President Wang didn't have any ideas, and he had no choice but to use the ultimate skill-summoning Zheng.
"The family members of the patients are very dissatisfied. They have not done a diagnosis after doing so many tests." Chief Zhou of the medical department tapped his finger on the table and Shen said, "If there is no clear diagnosis, the patient will be referred to a superior hospital. . "
的 The director of respiratory medicine nodded.
She had long wanted to remove the patient, but she was still a little worried because the first time she was given symptomatic treatment for pneumonia diagnosed in respiratory medicine.
No one expected that an ordinary patient with pneumonia would last forever, and eventually turned into a huge trouble.
I just can't help it, I really don't understand. Don't go to the higher hospital anymore, I'm afraid the patient's condition will get worse.
Judging by the difficulty of breathing, even if you want to go on the ventilator in a few days, it is not impossible.
If that's the case, once you enter icu ...
主任 He Director of Respiratory Medicine has begun to think about the referral of patients. It is not important not to understand the disease. Who can guarantee that all diseases can be understood?
As long as the patient does not "smash" in his own hands.
Director He He started to think about how to communicate with the patients' family members for a while. Is it better to go to the provincial capital or the emperor? It seems that in the provincial capital, the families of patients are more acceptable, after all, the journey is closer.
But she doesn't think the provincial capital can solve this case. Such a weird situation ... Think about it, she's a little bit lost.
The next few directors who came to the consultation also expressed their views, and they were very simple, and they didn't have anything too special to say.
Check what, what is normal, what to say.
He said it was all car talk, and it was totally meaningless.
Master Wang repeatedly recalled the patient's condition, but still had no clue. Autonomic dysfunction? Or hysteria? It doesn't look like it.
For a 34-year-old man, it is quite difficult to get snoring to the point where he can breathe while walking.
I was thinking, the phone vibrated.
Mr. Wang always glanced at Su Yun's phone. He embarrassedly smiled at Chief Zhou, and lowered his head to answer the phone.
Fortunately, this is not 912. I want Director Wei to sit here, or it is Director Lin who presides over the whole hospital consultation. I am afraid that I will not be scolded. As for Director Ye, President Wang did not dare to think.
普通 For ordinary doctors, the director of the medical office, Ye Qingqiuye, is the governor of Jin Yiwei. If he comes forward, he will have to peel off the skin if he doesn't die.
Director Zhou Zhou shook his head ~ EbookFREE.me ~ Looking around the directors of the relevant departments of the First Academies of the City, they have already guessed the expressions on their faces.
Everyone is right.
While going through the referral procedure, they were sent to the provincial capital by a 120 ambulance. As for who to contact in the provincial capital, Director Zhou felt that it was better to let the patient's family members contact themselves first.
If you do too much of this kind of thing, the patient's family will definitely think that there is something wrong with the diagnosis and treatment in the hospital.
Among them, the main reason lies in one degree. How to grasp Director Zhou has gradually become more and more eye-catching. The clinical work is really troublesome. Thinking about it, Chief Zhou is annoyed. When can I go to logistic work?
"It's so determined, Director He will talk to the patient's family." Director Zhou said, "This disease ..."
"Director Zhou." President Wang came back with a mobile phone and interrupted Director Zhou's words.
"General Manager Wang, what do you think?" Director Zhou asked.
"I just consulted with Boss Zheng, he said that it is recommended to check an EEG when the patient has difficulty breathing. In addition, check a lung enhancement CT." President Wang said seriously.
He didn't change his expression because he was Boss Zheng's consultation opinion, but just stated a fact calmly.
Director Zhou stunned for a moment, Zheng Zheng? He suggested checking what the lungs do to enhance CT.