Chapter 135: Guillain-Barre syndrome

Xiaoze looked at all the patients with severe myocardial muscles in front of him, and heard Qian learning spider "Kanuma." A virtual patient who had been diagnosed and treated in a virtual space emerged in his mind. The patient and Qian Xuebin The symptoms mentioned are very similar, and I can't help but wonder.
"This patient first considered a Zhou Ming palsy after receiving a consultation, but through various blood tests, potassium ions and other tests, there were no abnormalities. Later, related neurological tests were performed... Now mainly the limbs are involved, and there is no Other neurological abnormalities... and it is a progressive aggravation, I was thinking of a neurogenic problem at that time"
Qian Xuebin was somewhat complacent and said: "This should be a muscle weakness caused by neuromuscular origin. The treatment in Taoyuan City Hospital for half a month has no effect. When I transferred to us, I began to accumulate abdominal muscles, but I have passed He was cured with anti-cholinesterase drugs and free of lean inhibitors. Now he has improved a little bit. "It has not spread further. If the treatment is continued, it should still be controlled and may even recover slowly. ! "
At that time, the patient and the family members nearby heard Qian Xuebin's words, but they were grateful: "Thanks to Dr. Qian, my treatment in us is not only not good, but it is getting worse. It is only under control here. Please pay attention to Dr. Qian in the future!"
"Relax. Since arriving at our hospital, of course I will try my best to treat you!" Qian Xuebin nodded proudly, but then said again: "But this disease is extremely troublesome, and the effect is relatively slow. And many times require long-term Treatment, you must have certain psychological standards"
"That thing, then naturally, as long as it can be cured, we will listen to Dr. Qian!" The family thanked quickly.
"Um" to see the family's respectful appearance, Qian Xuebin nodded in satisfaction.
Then he smiled at Xu Ze complacently: "Doctor Xu, do you want to check with him?"
Xu Ze smiled, but he had some doubts about this patient at this time, of course, he would not postpone. Then he nodded, and then checked up for the patient.
This patient was not very enthusiastic about Xu Ze. He looked at the doctor as if he were only twenty-one or two. Although Dr. Qian was very polite to this little doctor, it was like an internship with him. Health is normal, so although the inspection of Xu Ze cooperates, it is not very active.
But Xu Ze didn't take it seriously. When I used to be at the Huimin clinic, didn't those patients do the same? When they are begging you, the attitude will be completely changed. It doesn't matter if you get used to it.
After passing a detailed examination of the patient. Xu Ze's eyes narrowed slightly, and the patient had a slight decrease in the shallow feeling of the lower extremities. It is not just the weakening and disappearance of muscle strength. Simple neuromuscular myasthenia gravis should rarely have such a shallow sensation.
At the moment, he smiled and asked the patient: "Before you got sick, did you have any other bad conditions, such as a cold or other behavior?"
The patient heard Xu Ze's words, although not very enthusiastic. But I still thought about it: "It seems that two weeks before the onset of illness, I had a cough, but after a few injections it was fine."
"Oh?" Xu Ze raised his eyebrows before hearing a history of infectious disease, and then asked with a smile: "Then you didn't have a cold that felt the same pain before this illness?"
"Well, it seems to have happened. At that time, I felt this arm, my neck and thighs were a little sore." But just two days later! "The patient thought for a while and thoughtfully. It seemed to him that his feet were weak. It has nothing to do with this arm and neck pain."
However, Xu Ze was sure this time. The patient was afraid that it was not a simple neuromuscular muscle weakness, but it should be Guillain-Barre syndrome.
This disease refers to an acute onset, which is mainly characterized by nerve root and peripheral nerve damage, and is accompanied by a syndrome characterized by protein-cell separation in cerebrospinal fluid. Also known as Guillain-Barre syndrome. Any age and men and women can get sick, but it is more common in young and middle-aged men.
The clinical features of the disease are sudden and severe after a week of infectious disease, mainly nerve root pain, mainly neck, shoulder, waist and lower extremity, acute progressive symmetrical limb soft recurrence, accompanied by superficial sensory disturbance, weakened or disappeared tendon reflex disease.
Although this kind of Guillain-Barre syndrome has already existed in the internal medicine teaching, it has only recently appeared in modern medicine. Xu Ze also collected data on the Internet through a knife. Knowing this.
The information about this disease has just been published in the National Medical Journal. Many people have not been exposed to this disease and may not even have heard of it.
The next Qian Xuebin heard Xu Ze asking about such a situation, but he frowned, not knowing what Xu Ze meant, because he followed Xu Ze’s questions and thought about Xu, but did not expect to read this symptom and cry What are the key points of this disease ※
He is very confident in himself. The name attached to a new generation of representative figures is not a fake. Basically, most of the diseases in internal medicine have been studied and studied in depth. He also knows most of the new developments, and his knowledge is even more comprehensive than that of many senior senior doctors.
The few questions Xu Ze is asking now, at least in his current knowledge. There should be no impression in this regard. So Qian Xuebin smiled lightly. Xu Ze was afraid that it would be fine to find something to ask. Could it be that you are a doctor who graduated from the Internet, and what else can you see?
Xu Ze also smiled lightly at this time. He didn't say his judgment easily. After all, he overturned other people's diagnosis. Unless he was a senior doctor, he was extremely taboo, and although he now has a rotation doctor Brand, but it is still a lot worse than the official identity of Qian Xuebin, a doctor who manages patients alone.
Such a situation. If the two have a good relationship, you can remind them in private, but Xu Ze confident and Qian Xuebin have no feelings. If he reminds himself, I am afraid that he thought he was sincerely dismantling the platform, and Qian Xuebin should not know the existence of this disease. , I'm just afraid to say it in vain. So Xu Ze hid this idea in his heart, and did not rashly reveal it.
After asking these questions, Xu Ze smiled and nodded, "Dr. Qian, let's go to see the next patient."
Seeing that Xu Ze didn't raise any questions, Qian Xuebin didn't take it seriously at this time. He laughed secretly that Xu Ze also likes to pretend to be inscrutable. Then he smiled and said: "Okay, let's go to see the next patient!" Then he led Xu Ze out of the ward and headed towards the next ward.
However, the two came out of the network, but heard Director Zhai yell: "Xu Ze" is coming to the patient, come over and see..."
"Okay!" Xu Ze responded quickly, and then smiled toward Qian Xuebin and went in the direction of Director Zhai.
Qian Xuebin looked at Xu Ze's whereabouts, but the enthusiasm on his face faded away, revealing a faint sneer, and then walked behind Xu Ze's novel network with Xu Ze.
Xu Ze walked to the ward where Director Zhai was located and saw a new patient. At this time, the patient was lying on the hospital bed sideways, and the nurse was busy oxygenating the patient.
Director Zhai saw Xu Ze coming in, so he wanted to know how Xu Ze really was. Although it was recommended by the old man, at least he had to have a bottom in his heart. Then he smiled at Xu Ze and tried to ask: "Xu Ze. How about this patient?"
Hearing Director Zhai's words, Xu Ze understood the meaning of Director Zhai. If he didn't have confidence, he could tell him directly, and if he was confident, he could take over and treat the patient.
Naturally, he nodded with a smile. For such patients, Xu Ze sees a lot. In the virtual space, Huimin Clinic has seen it, but the patients seen in the virtual space are much more serious than this.
See Xu Ze nodded confidently. However, Director Zhai was also relieved a little. Since Xu Ze dare to take over, it means that he still has some foundation, and he should not be too hard for the next two months.
Xu Ze walked forward with a stethoscope, and then asked the family members around him about the medical history. After a brief inquiry. Xu Ze had probably got some understanding of the condition, and then looked at the patient half-lying on the bed, breathing with difficulty in opening his mouth, and lip cyanosis. Xu Ze now had a heart in mind.
Then through a system to check the patient's heart and lungs ~ EbookFREE.me ~ does not need to cooperate with other photographs such as electrocardiogram examination. Based on experience alone, Xu Ze can already be absolutely sure what this disease is.
I have a history of coronary heart disease, and I'm prone to shortness of breath after a little activity. This time I got a cold a few days ago, and then slowly became more anxious. Now I can't sleep, I can only sit on the bed every day. pant.
On physical examination, no obvious changes in jugular veins were seen, but a small wet rales on the bottom of both lungs could be clearly heard, and the heart examination showed that the heart had dilated, and the heart rate was extremely fast, reaching more than 120 times Per minute.
"Xuanbei, who has three levels of coronary heart disease, cardiac enlargement, and cardiac function, got the following judgment. However, in order to clarify his diagnosis and let Director Zhai rest assured, Xu Ze took a side of the electrocardiogram, quickly put the patient on the electrode, and began to do electrocardiogram. .
Director Zhai on the side could see Xu Ze’s skillful physical examinations and proficiency in electrocardiogram. He could not help but nodded secretly and said in secret: "This kid is still good, at least it should not be the kind of mixed-life guy he worries about, as long as Wait a minute and see how his diagnosis is. If it's good, then I'm more at ease!"
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