My Medical Skills Give Me Experiences
Chapter 191: Brother Zhou, incurable Crohn's disease
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From the description, chronic ulcerative colitis can be compared.
The risk of intestinal polyps and intestinal cancer also exists.
Considering that she is still very young, in her twenties, at the same age as Hua'er, the risk of colon cancer is relatively low.
In addition, local hospital diagnosis and treatment, the diagnosis was enteritis.
But after taking the medicine, the effect is good.
Coupled with the vomiting symptoms, even if it is really enteritis, it is an extremely dangerous type.
"Qiu Hong, give me a physical examination first."
Director Jia was able to consider the female patient of the other party, so he asked the female doctor Qiu Hong to do a physical examination.
In fact, in the eyes of doctors, there is really a distinction between men and women.
If a female patient takes an electrocardiogram, it is very likely to meet a male doctor. Also breast disease, also young male doctor consultation. For physical examination, the female patient will be asked to lift up her clothes, and then the doctor will perform palpation and visual inspection.
According to the requirements of the hospital, there will be female nurses or female doctors.
If it is only the case of male doctors and female patients, if the disease says that male doctors are indecent, then they will be washed away by jumping into the Yellow River.
Also, female patients should ask their husbands or their relatives to accompany them when they go to see a doctor.
In the outpatient room, family members enter.
Only the operating room, examination room, and intensive care unit allow family members to enter.
The emergency room depends on the situation. In principle, the family members are allowed to enter, but after the rescue is completed, or the doctor feels that the family members must be encouraged by the patient to stimulate the patient's desire to survive.
Will take the initiative to invite family members in.
Physical examination is actually much more complicated than imagined. Including armpit body temperature measurement, calculation of respiratory rate, blood pressure measurement of the right extremity three times, observation of the patient's complexion, development, nutrition, auscultation of bowel sounds and many other items.
Absolutely simple pressing on the painful part of the TV can do nothing.
While Qiuhong was giving the patient a physical examination, Zhou Can picked up the patient's examination report to check.
The first thing to look at is the results of routine blood tests.
After the body has a disease, at least 70% of the disease will be more or less mapped to the blood.
The white blood cell count of the female patient was significantly increased, while the red blood cell and hemoglobin were lower than normal. The hematocrit also decreased significantly, and the erythrocyte sedimentation rate increased rapidly. Mucin increased, and albumin decreased.
Only blood test results are enough to confirm the disease.
There are so many blood abnormalities, from a doctor's professional point of view, illness will occur.
Enteritis can only be considered a disease.
So, what could be a more serious disease than enteritis?
Intestinal perforation should be ruled out because intestinal perforation is often accompanied by intra-abdominal infection, which is much more severe.
Patients also experience severe pain, high fever, and even chills.
Zhou Can then checked the stool examination, saw red and white blood cells, and the occult blood test was positive.
Most of the diseases are intestinal.
On CT examination, no obvious abdominal abscess was found.
According to these inspections, the patient was diagnosed with common enteritis. The treatment plan and diagnosis results prescribed by the local hospital are all correct.
"Zhou Can, did you find anything?"
Director Jia's perception of Zhou Can's address has changed.
From Zhou to Zhou Can.
I also know that considering the meaning of Zhou Dian's respect for the sick face, and because Zhou Can discovered the hidden disease of the third bed sickness, I think Zhou Can should be given a certain amount of respect.
All in all, a good sign.
At least Director Jia called the beautiful doctor Qiu Hong, not Qiu, but directly by his name.
"It's okay to say now, the inspection data is less. It can only be inferred that the disease should occur in the intestines, can enteritis, not ordinary enteritis."
Zhou Can gave his diagnosis opinion.
It must be difficult to let the diagnosis result be given directly.
It is already very wrong to be able to narrow the scope of the disease again and again.
"It's wrong. His diagnostic thinking is not as impetuous as many young people, but very down-to-earth. It is better than imagined."
Director Jia also praised for the first time.
And in front of the sick.
It shows that he is very satisfied with Zhou Can's performance.
"The specific cause of the disease can only be further confirmed by a colonoscopy." Director Jia also told the patient.
"Can I have a colonoscopy? I heard that it's scary, I'm afraid of pain, and I'm even more afraid that the colonoscopy will pierce the intestines!" The patient is very repulsed by the colonoscopy.
In the local hospital, the doctor may have already discussed with him and ordered a colonoscopy.
"Colonoscopy is a little risky. If you really want to have a colonoscopy, then do a barium enema! It is recommended to do a colonoscopy to be more intuitive."
Director Jia said to him.
"Well... do it. A sister hospital had a colonoscopy examination, and it hurt a lot. Unless it is a painless colonoscopy, then it may be considered."
It looks childish.
In fact, most of these girls are kind-hearted and very self-motivated.
At least when encountering adversity, it is more open-minded.
The ability to withstand pressure is much stronger than that of ordinary girls.
"Girl, I'm already sick now, do you still care about a little pain in the examination? Painless colonoscopy requires an appointment, at least half a year, and the first illness can be delayed. Also, the cost of painless colonoscopy is much more expensive ,Why bother."
Director Jia shook his head helplessly.
Today's youth, specialness, and thinking are much different from those of the older generation.
Finally, after the patient finished the physical examination, Director Jia prescribed a barium enema application.
I dragged my weak body to pay the fee and have a checkup.
It's very worrying to see, the illness is so serious, but there is no parents' house to accompany the doctor.
I also know what kind of family is like.
Some are young and very sensible. In order to worry their parents and increase their burden, they work hard outside, even when they are sick, and encounter serious setbacks at work, all of which are carried by themselves.
It looks both pitiful and sad.
…
Around ten thirty in the afternoon, Qiu Hong's cell phone rang.
"Doctor Tang, what's the test result for the third patient?"
Qiu Hong took the initiative to ask.
The doctor who treated the patient on the third bed made a phone call.
"Ah... really gallbladder cancer! The new Dr. Zhou in our department is amazing." His pretty face was full of shock, and he was extremely surprised that Zhou Can could discover the patient's hidden disease without knowing it.
[Pathological diagnosis experience value +1.]
[Successfully diagnosed a case of difficult recessive disease, pathological diagnosis experience +100.]
As soon as the 101 pathological diagnosis experience points were received, Zhou Canle was overwhelmed.
Finally, I got rich rewards.
Pathological diagnosis is four grades, attending and other levels. If you want to advance to the level of deputy chief physician, you need to earn 10,000 experience points. If you can only earn 1 point each time, you don't know that you can upgrade your medical skills to the deputy director level in the Year of the Monkey.
After finishing the call, the look in Zhou Can's eyes changed completely.
"Teacher, just now Doctor Tang called and said..." After finishing speaking, Director Jia waved his hand. "I heard it all. Zhou Canzi, you really are two sons."
After complimenting Zhou Can, he sighed slightly.
"Oh, gallbladder cancer is known as the king of cancers, and its prognosis is very poor. The patient's condition is fatal, and I'm afraid he has lost the chance of surgery. Wait until the outpatient clinic is over, and then look at the MRI results!"
Director Jia felt sorry for the patient.
It would be great if gallbladder cancer could be detected early, and by now, it is likely to have metastasized.
The prognosis of pancreatic cancer and gallbladder cancer is particularly poor.
The two cancers are known as the king of cancers, and they are more dangerous than the other.
Its common feature is that it is very easy to infiltrate the surrounding organs and tissues. And the surrounding full weight body tissue.
If it is discovered later, it will directly cause the patient to lose the chance of surgery.
The self-replication of cancer cells, allowing them to spread rapidly throughout the body. The operation is okay, but once the operation is done, it will grow wildly.
The time between diagnosis and death is often very short.
Gallbladder cancer is a malignant skin tumor with a high degree of malignancy. According to the same pathological mechanism, it can be divided into adenocarcinoma, squamous cell carcinoma, adenosquamous cell carcinoma, mesenchymal tumor, and neuroendocrine tumor.
No matter which type, it is a narrow escape.
The five-year survival rate for gallbladder cancer generally exceeds 10%.
The patient is old, in his 70s, and he tried to re-evaluate the surgical plan and risks. Otherwise, conscientious doctors will basically tell the family members that if they really treat it, then they should be prepared to lose both money and money.
"Junior Brother Zhou, I'm very curious, how did you find cancer in the third bed patient?" Qiu Hong stared at Zhou Can with her beautiful eyes.
Zhou Can's name has changed from the unfamiliar Doctor Zhou to Junior Brother Zhou.
It was only at this moment that he took the initiative to accept Zhou Can's call as Senior Sister.
"Just observe! Check the ward and see that the patient's complexion, eyes, hands, and face complexion are all right. I suspected cancer. Then I asked Director Jia for leave. After carefully reviewing the inspection report, we used the method of exclusion and finally locked it. gallbladder."
Zhou Canfang shared his diagnosis experience.
"The main patient's cancer symptoms are just covered by liver cirrhosis and duodenal ulcer. However, it is easy to find out."
Stealing Director Jia's limelight will naturally give the family a higher level.
Experts also miss or omit.
"Qiu Hong, you know! Zhou Can's other departments are also well-known, and those chief physicians praised him highly, and they all want to keep them in their own departments."
Director Jia's news is quite well-informed.
The deeds of Zhou Can's other departments are all known.
It is said that Zhou Can gradually became famous, and he probably ended up training outside the gods. At that time, it had already aroused the great attention of Vice President Ye, and Yu Cai received special attention from the regular training of the Department of Critical Care Medicine.
Up to now, with the help of director Zhou Canxueyan, she is frantically making up for the shortcomings in basic medical knowledge.
In the past two months, initial results have been achieved.
The gaps in knowledge in the fields of immunity and digestion have been filled a lot.
For the first time, the cancer of the patient in the third bed can be accurately located to the gallbladder, which shows that initial results have been achieved.
Immediately, two groups of patients walked into the consulting room together.
The young female patient walking behind was the woman who was initially diagnosed with enteritis.
I've had my barium enema done.
"Old Jia, the inspection results are in, please help me to look again!"
The colleague who handed over the test results to Director Jia showed an apologetic smile at another patient who was visiting the doctor.
"The barium shadow shows a sign of jumping... the disease is troublesome!"
Director Jia frowned after watching it.
The disease described is very difficult to treat.
After Zhou Can read the results of the barium dose, his heart trembled slightly. The symptoms were highly similar to enteritis, but now the barium shadow showed jumping signs, which was basically diagnosed as ulcerative colitis.
However, combined electrolyte test results show that it is not common ulcerative colitis, but potentially fatal Crohn's disease.
The clues can already be seen from the CT results.
A proliferative lesion that penetrates all layers of the bowel wall, has involved regional mesenteric lymph nodes, and is limited to both the enterocolon.
Lesions were characterized by segmental distribution.
It is separated from the normal intestinal segment and has a clear boundary, showing the characteristics of a jumping zone.
All indications are already pointing to the so-called "green cancer" of Crohn's disease.
The disease is not a real cancer, but with the purpose of medical technology, patients need life-long medication. The cost is also quite high.
If you use imported medicine, the cost is about 15,000 to 20,000.
It takes about two months to get a drip.
Such an expensive medical bill, and once every two months, is an absolute disaster for an ordinary young girl.
"You can just say it directly, and you can bear it."
The girl was quite brave. Seeing Director Jia's expression and tone of voice, she already knew that the result was good.
Director Jia pondered, organizing his words.
Doctors communicate with patients, and most of them will try their best to take care of patients' feelings.
"It's okay, tell me! There is nothing else in the family anyway. My parents divorced when I was very young, and my grandparents took care of me. Now my grandparents are already in the world. Even if I have cancer, there is nothing in the world worth cherishing. So, Any outcome is acceptable."
I dare to imagine, these words are spoken from the mouth of a young girl in her twenties.
Listening to the words and looking at the expression, Zhou Can felt particularly sympathetic.
Xi's medical skills are still very limited, and no doctor can cure Crohn's disease until now.
The only way is to take medicine for life.
Western medicine has been developed for so many years, and many fields such as diagnosis, surgery, medication, and pathological mechanism have been very advanced. Doctors who have lasted for thousands of years, and witch doctors in the Western world, were directly wiped out by it.
But many chronic diseases can be cured.
According to statistics, at least more than 80% of chronic diseases are cured.
Shocked to hear the result?
Take a tumor as an example. After being cut, it will grow again.
Medicine calls it relapse.
Why can cancer be cured only when it is detected early? That is actually a cure, and relying on the body's immune mechanism to overcome the disease.
At the advanced stage of cancer, like a fire in a forest, it has shown the potential to start a prairie fire. Either the immune mechanism of the body is destroyed, or the opponent of the disease.
So waiting for surgery, radiotherapy and chemotherapy, the final result is basically up to fate.
Western medicine treats the symptoms and cures the root.
The treatment principle of Chinese medicine pays attention to the balance of yin and yang. Maybe then, the whole world will highly recognize medicine, and let medicine become the mainstream medicine in the world, and western medicine become the auxiliary treatment method.
When it really gets there, the doctor may be the strongest in China, but not the developed countries in the West.
Because it is very aware of the value of medicine, it has already begun to lay out.
There are many famous doctors left in China, UU Reading www.uukanshu.com has already had many famous doctors directly poached by foreign countries.
Let very helpless lost.
Good foreign actions have attracted the attention of relevant parties, and various policies to protect and develop medical care have been launched.
Compared with the serious decline and exclusion of doctors from the late Qing Dynasty to the modern war period, the situation of doctors is much better now.
"Girl, the disease is called Crohn's disease, an intestinal inflammatory disease with an obvious cause. Theoretically, it can occur in any part of the gastrointestinal tract, but it mostly occurs in the right colon of the terminal ileum. The clinical manifestations are abdominal pain, diarrhea, intestinal obstruction , accompanied by extraintestinal manifestations such as fever and nutritional disorders. Symptoms of anemia, constipation, and even vomiting after eating are all related to the disease."
Director Jia announced the diagnosis results.
Apparently he had never heard of this disease, so he asked in a daze, "Can that disease be cured? Is it cancer?"
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Chapter 191 Junior Brother Zhou, Incurable Crohn's Disease Read for free.https://
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