medical road high rise

Chapter 246 Ureteral Calculus

2Chapter 16 Ureteral stones

After Qin Feng's consultation, he can understand the rules of big hospitals, unlike Taoshi's open door, its outpatient clinic can be closed.

When every patient comes in for consultation, other patients need to wait outside without any overstepping.

Once there is a situation such as jumping in the queue, the doctor is completely free to not see the patient. This is a right.

This is why many people feel that doctors in large hospitals have a bad attitude when they see a doctor.

If the attitude of other doctors is not good, you should first consider your own attitude. The income of doctors in other big hospitals is not low, so there is no need to give anyone a good look.

If you love Zhizhi, you will go away if you don’t.

It's such a simple truth.

After starting to accept patients, Qin Feng can judge the first few patients at a glance, and then issue a checklist and prescribe medicine, just wait for a while and come back for a review.

Since these patients who come to see a doctor come under the name of Qin Feng, they don't have any doubts about Qin Feng's diagnosis. In their eyes, as long as they can be publicized by the news, they are all fake doctors.

However, Qin Feng did not take it lightly because of the trust of these patients. The group of patients cannot be completely trusted by doctors. What they have done is enough to make a doctor lose his medical qualification certificate.

"Oh, I really convinced her." The patient's family members complained.

Qin Feng couldn't help but also raised his head, looking at the patient and his family.

"Is there anything uncomfortable?" Qin Feng asked.

"My mother had a stomachache, and then took medicine indiscriminately, which caused her heartbeat to be so fast that she couldn't sleep at night." The patient's son looked helpless, "She doesn't believe what our children say, but she only believes outsiders. , now it’s all right, it’s done like this.”

The patient lowered his head in shame, fiddling with his hands like a child who did something wrong.

Qin Feng nodded, probably understood what the situation was.

"Does your stomach still hurt now?" Qin Feng asked.

"It doesn't hurt anymore."

Qin Feng opened the patient's medical record and saw that the patient had undergone a color ultrasound of the heart before, and the reflux area turned out to be severe reflux, and the systolic function of the heart was normal.

It's pretty good for a patient of this age.

"It should be due to age. There is no other problem. Go back and observe. If there is any problem, go to the Social Health Hospital." Qin Feng said.

The patient's health is not a major problem, mainly caused by his age, so Qin Feng asked the patient to go home for observation and observation, and at the same time adopt a hierarchical diagnosis and treatment method and send it to the Social Health Hospital.

Shekang Hospital is a basic hospital, which is also equivalent to a community hospital. There are still many in first-tier cities. The shortage of doctors in large hospitals is the lack of top-level doctors, and ordinary doctors with low talents are also a good place to work in community hospitals. choose.

"next."

The nurse immediately called out to the next patient, but when this patient walked in, Qin Feng noticed something was wrong.

The patient walked in and sat down slowly, covering his stomach, but because of the heavy makeup that covered his lips, he could not see the color of his lips, nor could he judge whether he was anemic from his face. Even his nails were covered with nail polish, which made him Qin Feng's diagnosis and treatment fell into difficulties.

"Is there anything uncomfortable?" Qin Feng still asked according to the procedure.

"stomachache."

Abdominal pain in women over the age of 16 must first rule out gynecological problems, such as ectopic pregnancy. After all, rupture and bleeding of ectopic pregnancy may also cause severe abdominal pain or even hemorrhagic shock.

For example, pale lips, pale nail beds, fast heart rate, etc.

But for the female patient in front of him, the heavy makeup covered everything up. Qin Feng could only listen to his heart and lungs. Fortunately, his heart rate was not fast and his blood pressure was fine.

Temporarily excluding the case of gynecological diseases, Qin Feng also breathed a sigh of relief.

"When did it start to hurt, and where is the pain?" Qin Feng continued to ask.

"It started to hurt in the early hours of this morning, but I didn't pay much attention to it. I fell asleep after taking some painkillers, but after waking up, the pain got worse and worse." The patient smiled wryly.

Qin Feng glanced at the place covered by the patient's palm, which was in the lower right abdomen. What needs to be considered is whether it may be acute appendicitis. Typical acute appendicitis is pain around the navel. When the appendicitis becomes severe enough, The pain will gradually be fixed in the right lower quadrant, which is called metastatic right lower quadrant pain.

"Did it hurt around the belly button at first?" Qin Feng asked.

The patient shook his head, "No, it's always been the lower right pain."

"Is there any nausea, vomiting, abdominal distension?"

"No."

Qin Feng looked through her medical records, from the previous medical records, Qin Feng discovered that she had undergone left ovary and salpingectomy many years ago.

There is no way to confirm it just by asking a doctor. Qin Feng asked Zhang Yao to prepare an examination room. Zhang Yao is the intern nurse, and the other nurse is Yue Meng. Qin Feng learned about it during the chat before.

Zhang Yao hurriedly prepared, and when the call came, Qin Feng took the patient there, and Yue Meng stayed at the outpatient clinic to prevent Qin Feng from being found in any emergency.

When he came to the examination room, Qin Feng asked the patient to lie flat on the examination bed and did some simple examinations.

When pressing the abdomen first, there is no pain in the other parts of the abdomen except for the tenderness in the lower right abdomen.

Qin Feng had no choice but to continue with the physical examination. When diagnosing appendicitis, it must be differentiated from diseases such as kidney stones, gallstones, pancreatitis, etc. .

The patient was also given percussion pain in the liver and gallbladder area, and felt nothing, but when it was changed to the kidney area, that is, the waist, the patient experienced obvious pain.

Qin Feng probably had a judgment in his mind, the patient may have abdominal pain caused by kidney stones or ureteral stones, but this is only one of the judgments.

Qin Feng gave the patient a checklist, returned to the outpatient clinic to diagnose other patients, and waited for her news.

After 15 minutes, she came back with the test results. Qin Feng took a look. There was no abnormality in the blood routine, and the urine HCG was also negative.

However, the urine HCG is negative, which proves that there is no pregnancy, so there is no need to ask a gynecologist for consultation.

Urinary HCG is a laboratory method to detect the level of human chorionic gonadotropin in women's urine. If there is pregnancy, this hormone will exceed the normal value, and early pregnancy can be judged in advance.

The B-ultrasound results of the abdomen also came out, with obvious right hydronephrosis and dilation of the upper segment of the right ureter. The gynecological B-ultrasound also showed no obvious abnormalities, and the appendix area did not show any abnormality of the appendix.

It can almost be determined that it is a urinary tract problem, but there are no obvious red blood cells and white blood cells, and the high probability is ureteral stones.

"Your condition should be ureteral calculus. You can see that there is obvious water accumulation in your right kidney and ureter, which is usually caused by calculus, but there is no obvious calculus in the B-ultrasound. It should be that the calculus is small, or it may be something else. The reason, I suggest to go for another CT examination." Qin Feng said.

The patients did not refuse. In the hospitals in big cities, there are very few patients who have trouble checking. When they come to the hospital, they are ready to spend money.

(End of this chapter)