Chapter 431： Tuberculosis diagnosis in doubt

Chapter 431 The diagnosis of pulmonary tuberculosis is doubtful

Li Chunsheng’s diagnosis, there are experienced doctors in the department who disagree:

"At present, we have not found tuberculosis bacteria, so if we directly take tuberculosis drugs, if it is not tuberculosis, the side effects will be even greater. Can the patient survive?"

Li Chunsheng disagrees:

"At present, time is waiting for no one. Patients trust us to come to the Fourth Hospital, and we must take responsibility. Clinical drug diagnosis is also in line with the norms, so let's decide."

The director of the department has insisted on it so much, and it is difficult for others to say anything.

If Li Chunsheng is considered a three-legged cat, then they are not even considered a four-legged cat. This is one of the main reasons why the internal medicine business of the Fourth Hospital has been unable to improve.

Another two weeks passed, but Jin Wenyao's body became weaker and weaker because of repeated inspections and heavy medication.

Although Jin Kangsheng is a local turtle, he is not so easy to bully.

Now it’s all right, a lot of money has been spent, half a month has passed, and not only has my grandson not seen better, but his treatment has gotten worse.

Can this be tolerated?

The longer the time, the more angry Jin Kangsheng became, and finally one day after Jin Wenyao coughed up a big mouthful of blood, he couldn't help it anymore, and the conflict completely intensified.

A large group of villagers from Xiaze Village rushed into the Internal Medicine Department and started making trouble.

Li Chunsheng was pushed back and forth like a rubber ball. The office was in a mess, and several pieces of glass were smashed.

"The one surnamed Li, do you know how to cure diseases?"

"That's right, your four courtyards are plotting money and killing your life. Our good people came in, but now they are dying on the hospital bed."

"I beat this **** to death, let him pay for his life!"

The disturbance in the internal medicine inpatient department, because the disturbance was caused by a fellow villager of the dean, this suddenly made it difficult for the security department.

Since the former chief of the security department was found fault and dismissed by Chen Qi, the entire security department is now paying special attention to their work, and will never allow the hospital to cause trouble again.

Before it was changed, they didn't care what kind of bird you were, and rushed to beat the patient's family members out.

But now facing the villagers of Xiaze Village and defending Ke Mazhao, is this arresting or releasing them?

Actually, Jin Kangsheng is also full of evil spirits. First, he is anxious about his grandson's illness, and second, he is also targeting Chen Qi.

The ant that he had stepped under his feet suddenly became someone he needed to look up to, and Jin Kangsheng was already upset.

Why can he be the dean? Why can he drive Santana? Why is his whole family in good health? why...

Jealousy has changed him beyond recognition.

Taking advantage of this opportunity, he managed to get hold of it, and if he didn't make a fuss, he would be sorry for his title of Emperor Xia Zetu.

So after a few rounds, internal medicine was completely messed up.

Li Chunsheng was mixed among the villagers. He was slapped several times on the face, kicked several times on the body, and his glasses were trampled to pieces.

There was trouble in the internal medicine department, and Chen Qi, as the dean, immediately knew about it.

Moreover, he also knew from Huang Daniu, chief of the security department, that it was the village cadres from his hometown who caused the trouble. This made Chen Qi look very strange, and asked Huang Daniu:

"So what if you are from my hometown? If you live in the same village as me, you can make trouble?"

Huang Daniu rubbed his hands awkwardly:

"Chen Tou, look at this incident, don't we want to investigate it clearly, hehe, everyone keeps saying that they watched you grow up Chen Tou, and they hugged you when you were young, and it was the villagers who threw **** at you. Urine is for you to go to medical school..."

"Fart, **** big shit!!"

After Chen Qi became the dean, he unconsciously had the language style of a model of Dean Guo, and began to swear at her mother.

"Confess me with **** and piss? Who is disgusting? Do you really believe what they say? Immediately organize all the people in the security department to coax them away. If you can't coax them away, call the police."

Chen Qi would be fine if he didn't throw stones into someone's well, but for the sake of his fellow villagers?

As soon as Huang Daniu heard what the dean said, he immediately ran to deal with it, and came back in less than half an hour.

"Chen Tou, no way, the patient coughed and vomited blood, and the family members refused to leave, saying, saying..."

"Say what?"

"It is said that Dean Chen Qi will not save him, and they will take the patient to the county to file a complaint..."

Chen Qi sighed, this Jin family can be regarded as finding his weakness, what do officials fear most? It's because I'm afraid that someone will go to the superior to make trouble.

Whether you are reasonable or not, the board will definitely hit his ass. He personally doesn't care, but the hospital will be canceled for excellent and advanced evaluation.

People in the 1980s still attached great importance to this kind of honor, and it was also related to the distribution of year-end bonuses.

And there is another key point, someone caused trouble, and finally the ball was kicked to the fourth hospital, requiring the hospital to immediately solve the needs of patients.

What's more, it is an objective fact to see death without help, and Chen Qi is also guilty, isn't he?

After thinking about it for a long time, Chen Qi sat on the chair and stood up, and said to his left and right protectors:

"Let's go, let's go and have a look together. So who, Bian Meng, you go and call the director Bian, he will have a medical consultation, he vomits blood, it must be a surgical disease, this Li Chunsheng is just like Yu Chuandong. .”

When Chen Qi brought everyone to the internal medicine department, Jin Kangsheng seemed to be waiting for him, and said with a smile:

"Xiaoqi, long time no see, hehe, look at the talented person now, I was right at the beginning, you can see that he is a promising kid."

Chen Qi nodded, then looked at Jin Wenyao on the hospital bed, a little surprised:

"Hey, how did the little fat man become so thin? Is this a deficiency? I remember that you were the fattest child in the village back then."

Jin Kangsheng narrowed his eyes: "Yes, my grandson is seriously ill. Please, Dean Chen, for the sake of fellow villagers, help treat him."

Chen Qi stared,

"Come on, Party Secretary Jin, take a look for yourself, beat up our internal medicine department like this, beat up our internal medicine director until his head is swollen, do you think I have to treat your grandson with just one word from you?"

Jin Kangsheng sneered: "I haven't said that this Dr. Li made my grandson worse and worse, and how much money he lied to us. Why, want to shirk responsibility?"

"Whether it is cured, or the little skinny man is seriously ill, we have to..."

"Chen Qi!"

Before Chen Qi finished speaking, he was interrupted by a voice outside the door. Secretary Huang Ying walked into the internal medicine department quickly.

Huang Shuji knew that Chen Qi and the Jin family had conflicts. After all, they had worked together for so many years, and they always knew each other a little bit.

So when he heard that the Jin family in Xiaze Village was making trouble in the internal medicine department, he knew that Chen Qi's temper might not be tolerated, so he rushed here.

Sure enough, Chen Qi was about to quarrel with them before entering the internal medicine department.

A dean didn't want to save him, and even quarreled with the patient's family.

Huang Ying glared back at Chen Qi, with a very clear look in her eyes, you boy, wait for me.

She turned her head and said to Jin Kangsheng: "Secretary Jin, you see that the experts from our fourth hospital are here today, how about you, how about a consultation on the spot?"

Huang Ying appeared very timely. If Chen Qi insisted on refusing to treat the patients, he, the dean, might be beaten again.

Patient's family members beat the doctor, and they don't even have to sit in detention, it's so arrogant!

The patient's X-ray film was put on the film reader, and a large group of doctors surrounded him head to head.

Chen Qi is a doctor after all. Although he despises the Jin family, he likes to see the Jin family suffer from intractable diseases, so he also crowds around.

He is the dean, and he must have the attitude he should have.

Huang Ying flipped through the medical records and asked the pig-headed Li Chunsheng next to him:

"Director Li, what is the basis for your initial diagnosis of pneumonia?"

Li Chunsheng knew that he had overturned his car, so he could only answer honestly:

"Huang Shuji, Dean Chen, it's like this. Before admission, the patient had a history of fever, chest pain, and cough for 3 years. After admission, the films I took and a chest X-ray showed the right middle lung. There is an obvious film here. symptoms, so I started to suspect inflammation."

Chen Qi didn't speak. Looking at the X-ray film, he always felt that the white shadow was a bit weird.

It's a pity that the film is too blurry to see clearly.

Huang Ying took pictures of the medical records and said sternly:

"You used antibacterial drugs to no effect, and on what basis did you make a diagnosis of tuberculosis? You were given anti-tuberculosis drugs directly?"

Li Chunsheng continued to reply honestly:

"It is mainly based on the film. This effect does not seem to be a consolidation, so I think whether lung cancer should not be considered first, coupled with the patient's long-term history of fever and cough, so I think the diagnosis of tuberculosis is no problem."

Director Bian nodded after hearing this: "I also feel like tuberculosis."

Another internal medicine director, Dong Gaoyan, also said uncertainly:

"You can see that the shadows are of different sizes and densities. They are large at both ends and thin in the middle. They seem to be fused together. It really looks like type I pulmonary tuberculosis."

As soon as Li Chunsheng heard that there were supporters, and changed his previous decadence, he immediately got excited:

"Nao Nao Nao, Lao Bian and Lao Dong also think so, don't they? I just said that the shape is a bit like a dumbbell shape. What an obvious manifestation of tuberculosis. I have been a doctor for decades, how could I make a mistake? "

Huang Ying actually felt that this was like tuberculosis in her heart, but as a leader, she always raised objections.

"Did you find Mycobacterium tuberculosis in the sputum?"

Li Chunsheng blushed:

"I haven't found this one yet, but the absence of acid-fast bacilli in the sputum does not negate the diagnosis of tuberculosis. After all, there are so many tuberculosis patients, only about 20% of them can really find acid-fast bacilli in the sputum.

In clinical practice, most people cannot find it in sputum, because their Mycobacterium tuberculosis hides relatively deep and will not be excreted through the bronchus, so it is possible that we cannot find it. "

Director Bian and Director Dong also nodded slightly, obviously agreeing with this point of view.

Pulmonary tuberculosis is still very common in China. Especially in the 1980s, there were more than 3 million new cases of tuberculosis every year, and 80% of them were concentrated in rural people.

Tuberculosis is also the disease with the highest mortality rate among infectious diseases in my country, and it is very harmful.

Pulmonary tuberculosis is actually a kind of pneumonia, but the pneumonia caused by Mycobacterium tuberculosis is not quite the same as that caused by ordinary bacteria.

Common bacterial pneumonia is acute. The general course of the disease is only 1-2 weeks, at most 2-3 weeks. The symptoms are obvious fever, cough, sputum, and chest pain.

Pulmonary tuberculosis is often chronic, and there may be a cough for several months, especially recurrent and long-term fever.

So according to the symptoms and course of the disease, combined with X-rays, and recently the patient has a bit of hemoptysis, with blood in the sputum, lung cancer, pulmonary fungal infection, common pneumonia, etc. have been ruled out, and tuberculosis is gone.

Li Chunsheng was diagnosed with tuberculosis and there was nothing wrong with it.

Chen Qi stood together, listening to the discussions of several old directors, always felt that tuberculosis should not be used as an explanation.

Otherwise, how can it be explained that the patient has undergone more than half a month of anti-tuberculosis treatment, and why the symptoms have not been relieved at all, but have a tendency to worsen?

The idea of ​​clinical diagnostic medication is correct, but it doesn’t work after you try it. In fact, it can also prove that there is a problem with the diagnosis of “tuberculosis” instead of continuing to fight tuberculosis.

Hearing Chen Qi's question, Director Li hurriedly explained:

"This patient has seen too many doctors in the past 3 years. After taking this medicine or that medicine, it is estimated that there are certain antibodies in the body. Maybe it is drug-resistant tuberculosis?"

When Chen Qi heard it, there was some truth to it, so he nodded and said nothing.

If another patient is changed, he will definitely take out the bedside portable CT in the hospital in his own space to scan the patient, so that the disease can be quickly clarified.

But now it’s the Jin family, anyway, it’s enough to be superficial. If you can save it, you can save it.

Huang Ying heard that everyone's thinking has been unified, so she made a decision directly:

"Since everyone agrees, continue anti-tuberculosis treatment and make it clear to the patient's family. In addition, the smashed things must be compensated. If we don't pay, we will die. What do we want?"

When the old lady heard that the internal medicine diagnosis was correct, she felt confident and her tone hardened.

Outside the ward, Jin Kangsheng felt relieved when he heard that all the experts in the hospital, especially the dean Chen Qi, thought it was tuberculosis.

So he said to Huang Ying with a smile all over his face:

"Okay, Huang Shuji, this matter is our fault, I will apologize to Director Li immediately, and I will pay for whatever is broken."

Jin Kangsheng's wishful thinking was well planned. Now that the diagnosis is clear, there will definitely be no major problems in the treatment. As long as the grandson's illness can be cured, everything can be discussed.

After all, Jin Wenyao is the only grandson of his branch, the only heir of the family, and his status is extraordinary.

The anti-tuberculosis treatment continued, and Li Chunsheng even increased the dose in order to increase the curative effect and prevent the emergence of drug-resistant strains.

Good guy, in the next month, in addition to the daily hemoptysis, the blood test showed that the white blood cells continued to decline, but the indicators of liver and kidney function rose sharply.

Li Chunsheng checked the wards every day, and his heart became more and more empty. After getting the test report, he knew that this time he had completely turned over.

The family members of the patient did not know the test indicators, but the patient Jin Wenyao became more and more haggard and weaker, and finally fell into another high fever of hemoptysis.

The sufferings of the past have passed, and the future will be even better. Friends, come on, be optimistic.

(end of this chapter)