Chapter 136

Xu Ze looked at the patient with progressive myasthenia gravis and listened to Qian Xuebin's introduction. A virtual patient who had been diagnosed and treated in the virtual space appeared in his mind. The patient and Qian Xuebin said the symptoms were very similar, which made him curious.

"After I received the patient, I first considered a periodic paralysis, but through various blood tests, potassium ion and other tests, nothing abnormal was found. And then we did the relevant neurological tests It was found that the limb was mainly involved and there was no other nervous system abnormality And it is a progressive aggravation. At that time, I thought it was a neurogenic problem... "

Qian Xuebin was somewhat complacent and said: "this should be a muscle weakness caused by neuromuscular origin. After half a month's treatment in Taoyuan City Hospital, there was no effect. When I transferred to our hospital, I began to accumulate abdominal muscles. However, I have been cured by anticholinesterase drugs and immunosuppressants. Now he has a little better No further upward spread If you continue to treat, you should still be able to get control and even recover slowly! "

At this time, the patient and his family members heard Qian Xuebin's words, but they said gratefully: "thanks to doctor Qian, my treatment there is not only not good, but also more and more serious. It's only when I get here that I can control it. I also ask doctor Qian to pay more attention in the future."

"Don't worry, since we are in our hospital, we will try our best to cure you!" Qian Xuebin nodded with pride, and then he said: "but this disease is extremely troublesome, and the effect is relatively slow. In many cases, it needs long-term treatment. You should have certain psychological preparation..."

"That thing It's natural that As long as it can be cured, we will listen to Dr. Qian! " The family members were in a hurry to say thanks.

"Well..." Seeing the respectful appearance of his family members, Qian Xuebin nodded with satisfaction. Then he said with a smile, "doctor Xu, do you want to check with him?"

Xu Ze smiles, but he has some doubts about the patient. Of course, he will not delay it. He nods at the moment, and then checks for the patient.

The patient is not very enthusiastic about Xu Ze. He looks like a 21-2-year-old doctor from the doctor's point of view. Although doctor Qian is very polite to the little doctor, he is like an intern who comes to study. Therefore, although he cooperates with Xu Ze, he is not very active.

However, Xu Ze didn't care. When he was just in Huimin clinic, those patients didn't do the same? When they ask you, their attitude will change completely. It doesn't matter if they get used to it.

After a detailed examination of the patient, Xu Ze's eyes were slightly narrowed. This patient had a slight decrease in the superficial sensation of the lower extremities, not just the weakening and disappearance of muscle strength. The simple neuromuscular myasthenia gravis should rarely have such a hypoesthesia.

At the moment, she asked the patient with a smile: "before you got sick, did you have any other bad conditions, such as a cold or other conditions?"

Hearing Xu Ze's words, the patient was not very enthusiastic, but he thought for a while and said, "it seems that two weeks before the onset of the disease, there was a period of coughing, but after some injections, he recovered."

"Oh?" Hearing that there was a history of infection before the onset of the disease, Xu Ze raised his eyebrows lightly, and then asked with a smile: "then before the onset of this disease, did you have the feeling of cold and pain?"

"Well It seems that I did. At that time, I felt this arm The neck and thighs are a little sore But it will be fine in two days! " The patient thought about it for a while, but said nothing. In his opinion, his feet are powerless, which has nothing to do with the arm and neck pain

However, Xu Ze is sure that this patient is not a simple neuromuscular weakness, but should be Guillain Barre syndrome.

This disease is a kind of acute onset, mainly nerve root, peripheral nerve damage, accompanied by cerebrospinal fluid protein cell separation syndrome. Also known as Guillain Barre syndrome. All ages and men and women can get sick, but most of them are young men.

The clinical features of the disease were acute nerve root pain (neck, shoulder, waist and lower limbs), acute progressive symmetrical limb paralysis with shallow sensory disturbance and tendon reflex weakening or disappearing.

Although the Guillain Barre syndrome has existed for a long time in the internal medicine teaching of Xiaodao, it has just been discovered in modern medicine. Xu Ze only knew this through the data collection on the Internet.

Information about the disease has just been published in the National Journal of medicine, and many people have not been exposed to the disease, or even heard of it.

Qian Xuebin next to him frowned when he heard Xu Ze ask some questions like this. He didn't know what Xu Ze meant because he thought for a long time according to Xu Ze's questions, but he didn't think about the relationship between the symptoms and the disease.

He was very confident in himself. He attached the title of a new generation of representative figures, which was not a fake. Basically, most of the diseases in internal medicine had been studied and deeply studied. He also understood some new progress. His knowledge was even more comprehensive than many senior doctors with high qualifications.The questions that Xu Ze is asking now, at least in his current knowledge field, should have no such impression. Therefore, Qian Xuebin also chuckled. Xu Ze is afraid that he has nothing to do. Find something to ask. Is it difficult for you, a newly graduated rotational doctor, to see what can be done?

At this time, Xu Ze also chuckled. He did not easily tell his own judgment. After all, he overturned the diagnosis of others. Unless he was a superior doctor, he was extremely taboo. Moreover, although he now has a rotating doctor's brand, he is still much worse than Qian Xuebin's official independent management of patients.

In this case, if the two people have a good relationship, they can remind them in private. But Xu Ze is confident that he has no feelings with Qian Xuebin. If he reminds him rashly, he is afraid that he will destroy the stage with sincerity. Moreover, Qian Xuebin should not know the existence of this disease. He just said it in vain, so Xu Ze hid the idea in his heart There was a rash appearance.

After asking these questions, Xu Ze nodded with a smile: "doctor Qian Let's go and see the next patient... "

It can be seen that Xu Ze didn't ask any questions, but Qian Xuebin didn't care at this time. He secretly laughed that Xu Ze also liked to pretend to be unpredictable. Then he said with a smile: "good Let's go to see the next patient! " After that, he led Xu Ze out of the ward and went to the next ward.

But as soon as they came out, they heard director Qu call, "Xu Ze Here comes the patient. Come and have a look... "

"Good!" Xu Ze quickly answered, and then with a sorry smile towards Qian Xuebin, he went in the direction of director Qu.

Qian Xuebin looked at Xu Ze's whereabouts, but the enthusiasm on his face quickly faded, revealing a faint sneer, and then walked with Xu Ze behind him.

Xu Ze went to director Qu's ward and saw a new patient. At this time, the patient was lying on the side of the hospital bed panting. The nurse was busy giving oxygen to the patient.

Seeing Xu Ze coming in, director Qu wanted to know about Xu Ze's real level. Although it was recommended by the old man, at least he had to have a background in his mind. He then laughed at Xu Ze and asked, "Xu Ze, how about dealing with this patient?"

Listening to director Qu's words, Xu Ze understood what director Qu meant. If he had no confidence, he could directly tell him, and if he was sure, he could take over the treatment of the patient.

At present, naturally, she nodded with a smile. For such patients, Xu Ze saw quite a lot of them. In the virtual space, she had seen Huimin clinic, but the patients in the virtual space were more serious than this.

Seeing Xu Ze's face nodding confidently, director Qu was also a little relieved. Since Xu Ze dares to take over, it shows that he still has some foundation. In the next two months, he should not be too hard.

Xu Ze took the stethoscope and went forward, and then asked about the history of illness to the family members nearby. After a brief inquiry, Xu Ze had a general understanding of the disease. He also looked at the patient half lying in the hospital bed with difficulty in breathing and cyanosis. At this time, Xu Ze had the bottom of his heart.

Then through a system for the patient's heart and lung examination, without the cooperation of other photos, ECG and other examinations, Xu Ze can basically confirm what the disease is by now.

Have a history of coronary heart disease, and usually after a little activity, it is easy to have shortness of breath. This time, I caught a cold a few days ago, and then my breath got worse. Now I can't sleep. I can only sit on the bed to breathe every day.

Physical examination did not show obvious changes in jugular vein, but small moist rales at the bottom of both lungs could be heard. Percussion showed that the heart was enlarged and the heart rate was extremely fast, reaching nearly 120 beats per minute.

"Coronary heart disease, cardiac enlargement, cardiac function level 4..." Xu Ze got the following judgment, but in order to make his diagnosis clear and reassure director Qu, Xu Ze took the ECG on the side, quickly put on the electrode for the patient, and began to do the ECG.

Seeing Xu Ze's skillful physical examination and ECG, director Qu couldn't help nodding in secret: "this boy is really good. At least he should not be the kind of guy who worries about his life. As long as we wait to see how his diagnosis is, if it's good, then I'll be relieved!"

PS: first watch, new day continue to ask for monthly tickets, monthly tickets .

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