Signing in at the hospital, the first operation shocked the whole country!

"We need to do further examinations. There are many reasons for the bleeding. We need to confirm the results of the examinations before we can make a final diagnosis."

Qin Feng explained,

"Doctor Zhang, contact the doctors from the Department of Pediatrics and Endocrinology."

"it is good."

Upon hearing this, Zhang Qingquan immediately contacted the doctors in the two departments.

The woman also walked out of the examination room with the baby in her arms. She was also a little dumbfounded when she heard the result, but she was still very happy, but at the same time worried.

After all, the cause of her daughter's bleeding has not been found. If not, what could it be?

As for the two policemen, they also went back.

After the transcript is completed, they still need to arrange the case.

Because the results of the hospital's examination are different from what the couple guessed, they still need to wait for further information.

If not, they might as well close the case.

......

Soon, the attending doctors from both the Department of Pediatrics and the Department of Endocrinology arrived.

Priority is given to physical examination of young girls to assess the developmental level and determine bone age and organ development.

"Dr. Zhang, call the laboratory department and ask them to give us the results of the six hormone tests first without affecting the normal test results."

Qin Feng said to Zhang Qingquan who was on the side.

Six items of hormones: Six items of sex hormones, mainly including estradiol, progesterone, testosterone, prolactin, follicle-stimulating hormone and luteinizing hormone, which are specially used to detect the levels of various developmental hormones in the human body.

In addition, there are serum sex hormone determination, gonadotropin determination, luteinizing hormone-releasing hormone (LHRH) stimulation test, vaginal exfoliated cell smear examination, B-ultrasound, X-ray examination, magnetic resonance (MRI) and so on.

Although it is true that the little girl develops early after bone age and physical examination, to fully determine whether it is precocious puberty requires more complicated examinations to demonstrate.

The diagnosis of precocious puberty generally involves 3 steps.

First of all, it is necessary to determine whether it is precocious puberty;

Secondly, judging whether precocious puberty is central or peripheral;

The third is to find the cause. The diagnosis process of idiopathic precocious puberty is mainly to exclude other causes of precocious puberty, especially to differentiate from tumors of the central nervous system, adrenal gland, gonad, and liver.

Now it is necessary to figure out what causes the little girl's precocious puberty.

"Director Qin, why does my daughter need so many tests?"

The woman looked at the inspection reports that kept being sent back, her heart raised her throat again, her face flushed nervously,

"Is there something wrong with her body?"

"Ma'am, don't worry, our preliminary opinion is that your daughter may have precocious puberty."

Qin Feng looked at part of the report sent, and the cause of the disease has been determined in his mind.

But he still needs to wait for the last report to confirm the diagnosis!

Because even if I know what caused the little girl, I don't need to rush for a while, and the operation can only be performed after everything is confirmed.

"What did you say? Sex...precocious puberty?!"

The woman was also dumbfounded when she heard this, without any concept at all.

"Well, to put it simply, your daughter developed early at an age that shouldn't be. As for what caused the development, we are still not sure, and we need to wait for the test results."

Qin Feng nodded.

"But...but isn't it a good thing for children to develop?"

The woman doesn't seem to understand, and even has some doubts.

"She was fully developed early, which means that the puberty period ended early, and the consequence was that the epiphysis would close prematurely, so she would be shorter than children of the same age.

And children can't understand it, and they can't manage it by themselves, which can easily cause psychological harm, understand? "

Although Qin Feng feels funny about women's thoughts, he can understand them.

After all, I am a doctor, but others are not!

The patients themselves and their family members usually lack common sense and understanding of the disease, which is the disadvantage that doctors and patients sometimes cannot communicate smoothly and understand each other.

Some patients and their family members even broke out conflicts and disputes between doctors and patients because of serious misunderstandings.

In the end, the doctor is unwilling to cause trouble, and it doesn't matter if he doesn't cooperate. The patient feels that the doctor is deliberately defrauding money and only wants to treat the disease according to his own ideas.

In the end, as long as the consent form is signed, it is not the responsibility of the hospital to make trouble.

Indifference belongs to both sides!

The root cause of this indifference is human nature, which cannot be solved by simply changing the rules.

......

check the interior,

"Director Qin, it can be confirmed that the child is indeed a precocious puberty."

The doctor in the endocrinology department gave all the reports to Qin Feng, and then said.

"Well, I know this, why?"

"Whole body CT is coming soon."

"There's no need to wait, let the clinical department release the brain and send it over directly."

Qin Feng was really anxious to wait, so there was no need to keep procrastinating.

He had just done a palpation of the meridians of the little girl's whole body, and he had already determined the location of the lesion.

And the culprit that caused the little girl's precocious puberty was in her mind.

Chapter 344 Hypothalamic hamartoma, surgery

"Okay, I'll go right away."

Hearing this, Zhang Qingquan trot out excitedly.

"Director Qin, do you suspect that the patient's precocious puberty is rooted in the brain?"

The endocrine doctor heard this and looked at Qin Feng in surprise.

You know, there are several causes of precocious puberty, and they are all in different locations.

Even now, the root cause of many young children's precocious puberty is actually caused by excessive intake at home.

This includes animal and plant residual hormones, environmental hormones, excessive intake of health products, blind tonic and so on.

Nowadays, children's living standards are improving rapidly, but children's learning pressure is also increasing.

In order to ensure their children's health and nutritional supply, parents will buy so-called children's health products and stew various nourishing soups, including animal offal.

And there may be a lot of hormones here, and it will take time to balance after entering the child's body.

If it is ingested at a high frequency for a long time, it will easily cause the hormone level to rise, resulting in signs of precocious puberty and changes in physical appearance.

There is also a relatively special cause of precocious puberty.

Premature psychological stimulation!

Nowadays, children spend a lot of time in contact with electronic products. Children may have high-frequency psychological stimulation through some video clips, e-books, special websites, etc., thereby increasing hormone levels, which can easily lead to precocious puberty.

Therefore, parents must pay attention when watching TV and playing with mobile phones for their children, so as to avoid letting their children watch some movies that they should not watch.

As for the third cause.

Most girls with precocious puberty belong to idiopathic precocious puberty, also known as constitutional precocious puberty.

This is due to the decreased sensitivity of the hypothalamus to the negative feedback of sex hormones and the premature increase in the secretion of gonadotropin-releasing hormone.

And this kind of treatment only needs drug assistance, as well as daily control, lowering the hormone level in the body, and delaying the growth rate close to the normal level.

Under normal circumstances, if a girl has the appearance of secondary sexual characteristics before the age of 8, it can basically be judged as precocious puberty.

But this is also divided into the performance of sexual characteristics in different parts.

Simple premature mammary gland development, the onset is usually less than 2 years old, without growth acceleration and advanced bone age, the serum E and FSH basal values ​​are often slightly increased, and the FSH bee value in the GnRH stimulation test is increased.

However, a small number of patients with this disease can gradually develop into true precocious puberty.

The second is premature hair growth.

It is a special type of incomplete precocious puberty, which can occur in both sexes.

It tends to occur around the age of 6, and may be accompanied by axillary hair development in addition to private parts. Agonadal development may be related to early adrenal function and premature secretion of a large amount of androgen.

The third is the case of a little girl, but it can be ruled out now, so don't worry about it.

The last one is also what people don't want to see.

It is precocious puberty caused by organic disease!

"Director Qin means, tumor?"

Zhu Yijun, the attending doctor of pediatrics, heard it and said immediately.

"Well, I can basically judge that the child should be precocious puberty caused by hypothalamic hamartoma."

Qin Feng nodded and said his diagnosis.

"This is indeed possible!"

Hearing this result, the two also looked at each other and nodded slightly.

There is indeed such a possibility!

"If it's really a hypothalamic hamartoma, then this is a little troublesome."

Zhu Yijun frowned slightly. The size and location of the hamartoma is still unknown, so we still have to wait for the results.

After about ten minutes,

Finally, the brain CT arrived!

When the image appeared in the light box, both Zhu Yijun were stunned.

It really is!

"Director Qin, you are right, it really is a hypothalamic hamartoma."

He Yue, the attending doctor of endocrinology, couldn't help being surprised.

I didn't expect Qin Feng's judgment to be so accurate. Although they also doubted this, they never dared to get the correct result only through some basic inspections like Qin Feng.

This requires not only medical skills, but also sufficient experience!

But how old is this young deputy director of the emergency department?

Less than 30, the Ph.D. has not yet graduated!

In just one and a half years, I became the deputy director of the emergency department from intensive care medicine, which is really not covered!

Even this rare disease of precocious puberty in children can be diagnosed!

"The location of this tumor is not very good~"

At this time, Qin Feng was looking at CT carefully, and couldn't help frowning slightly.

Because hypothalamic hamartomas are difficult to detect under ordinary X-ray films and CT scans, only three-dimensional imaging of MRI (magnetic resonance) can detect the size and shape of the space-occupying lesions.

The most important thing is that the surrounding nerve structure can be fully realized, providing conditions for surgical tumor resection.

Now, according to the three-dimensional CT imaging, the boundary between this hamartoma and the surrounding normal brain tissue is not very clear.

The longest position of the entire tumor exceeds 2.5CM, and surgery must be performed.

Otherwise, the impact will be great!

"Doctor Zhang, this little girl is looking for a quiet ward first, and is going to be hospitalized."

Qin Feng thought for a while, then turned his head and said,

"Take the parents of the children to the small conference room, and we will go there right away."

"okay, I get it."