My Medical Skills Give Me Experiences Chapter 190

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The ability to diagnose and diagnose hidden diseases based on naked eye observation and intuition was extremely popular in ancient times. A good doctor can almost know everything.

It's called visualization.

To see a doctor, the four most basic means of diagnosis are looking, smelling, asking, and cutting.

Inspection ranks first.

It treats the old of the four diagnostic methods.

By observing the patient's complexion, skin color, nails, tongue coating, body shape, etc., give the most intuitive first diagnosis impression. In order to delineate the types of diseases, it is convenient for subsequent focus diagnosis and pathological differentiation.

What Zhou Can gained from the three-month intensive care medicine training was beyond imagination.

At the beginning, I thought that after entering the training of other departments, I realized that the three-month study in the Department of Critical Care Medicine was of inestimable help to my practice.

No matter in terms of rescuing critically ill patients, or pathological diagnosis, emergencies encountered during surgery, etc., can give Bibie two points of confidence.

Vice President Ye personally extended the training period of the Department of Critical Care Medicine for two months, which he said was well-intentioned.

For example, following the ward rounds for a long time, the patient in the third bed, even Director Jia didn't find the cancer, but Zhou Can did.

Of course, this is only Zhou Can's preliminary diagnosis.

Also known as speculation.

Whether the patient really has cancer needs further verification.

Zhou Can can always tell Director Jia directly without evidence, so the patient has cancer, right?

This is the first time the two have met, and Director Jia's trust in him is still very limited.

If you want Director Jia to confirm the diagnosis opinion, you must give a reliable diagnosis basis, and it is best to point directly to the area of ​​the lesion.

According to Zhou Can's experience, diagnosing a recessive disease with a high probability can get an additional reward of 100 pathological diagnosis experience points.

"Doctor Zhou, Guess's girlfriend must be very beautiful! Very charming!" Qiu Hong suddenly smiled and said something to Zhou Can that made him scratch his head.

"Why do you say that?"

Zhou Canjie asked.

Su Qianqian is pretty, and there is probably no girl in the world who can use beautiful words.

"Looking at the appearance of the soul guarding the house, guess, I must be thinking of my girlfriend, right?"

Qiuhong joked in a joking tone.

Not malicious, but full of good intentions.

Because Zhou Can's answer to Director Jia just now seemed a bit perfunctory. Director Jia's face was actually quite happy.

Having followed Director Jia for five years, I know Director Jia's temperament very well.

It was intentional to help Zhou Can explain.

Ye Xin reminded Zhou Can not to go on business.

"Hehe, Senior Sister Qiu is really humorous. I was thinking about my girlfriend when I was on business just now, but I was thinking about the patient in the third bed. I feel that the patient looks like a simple duodenal ulcer."

Zhou Can is also smart, and he knows what's going on as soon as he hears it.

Taking a peek at Director Jia's slightly cold face, he quickly explained the reason for his distraction.

"That patient's duodenal ulcer is indeed very serious. They have a history of nearly 20 years. Can it be simple!"

respond.

"It means that the patient can still have other diseases!"

Zhou Can could only ask his questions.

It can make Director Jia misunderstand that he is doing nothing and concentrates on studying.

A very small matter, seemingly insignificant.

But it can damage Director Jia's image.

You may see through everything in a lifetime, but you can really underestimate one thing.

"Other diseases? Liver cirrhosis and chronic superficial gastritis, Director Jia has already diagnosed it!"

asked suspiciously.

Qiu Hong just met Zhou Can, so she deliberately made excuses to explain to Director Jia the reason for her business trip just now. Also really diagnose other diseases.

Leaning more towards one.

He thought Zhou Can was only making excuses so as not to give Director Jia a good impression.

After thinking about it, his perception of Zhou Can changed a lot.

Those who like to play smart are generally liked.

"It refers to other diseases, such as cancer!"

Zhou Can's true words shocked him to death.

Even Director Jia looked at him again.

Qiu Hong curled her lips, a hint of disdain appeared on her beautiful face. I didn't expect Director Jia's new students to be so flamboyant, it's fine to just make excuses, but now, in order to sensationalize the public, he actually directly said that the patient had cancer.

Fortunately, the family members, otherwise it is very likely to quarrel.

"Director Jia, may I ask you for 20 minutes of leave? I want to check the examination report of that patient. If the patient really has cancer, I am afraid that the feasibility of the operation plan needs to be re-evaluated. The patient is so young and has a very high memory. Surgical risks. Look at the surgery room you set for the patient at 1 o'clock in the afternoon, and then check it again at noon, I'm afraid it will be too late."

Zhou Can explained the reason in detail.

The tone is sincere and the expression is sincere.

Qiu Hong almost didn't sneer, and said it as if it was true, it's a pity that the new Doctor Zhou is acting.

The favor towards Zhou Can also disappeared.

"Bar!"

Director Jia readily agreed.

Zhou Can talked nonsense again, quickly returned to the inpatient department, and went to the third bed to check the patient's examination report.

"The patient had a history of smoking for nearly 50 years. His father died of typhoid fever in 20 years, and his mother died of a lump in her abdomen in 10 years. Because no pathological examination was done, the nature of the lump was unknown."

In other words, the patient's mother is likely to die of cancer.

The patient was hospitalized for routine examinations such as X-ray barium meal examination, gastroscopy, blood and stool tests.

In addition, a B-ultrasound examination of the liver was also done.

"The liver borders 6 intercostal spaces, the oblique diameter of the right lobe is 13. The costal margin of the clavicular line is thick and long 1. The left lobe is thick and long with the xiphoid process thick and long.

A B-ultrasound examination of the liver.

Visually, rule out the possibility of liver cancer.

Because the liver has no pain-sensing nerves, it is called the most silent organ.

Many patients with liver cancer, once confirmed, are in the late stage.

In short, there are almost no obvious symptoms.

Zhou Can squinted and carefully checked Zhang's B-ultrasound film.

Deny, the diagnostic basis of the Western medicine system is mainly based on the comprehensive dialectical results of various examinations.

One point, we must blow a wave of medicine.

Experienced doctors only need to press the Cunguan ruler on the patient's wrist, and they can quickly get a clear picture of the patient's condition. It is comparable to Western medicine doing a full body checkup for a disease.

Now why are ordinary people willing to go to the hospital? Once they go in, no matter if they are sick or not, they will go for a routine checkup first.

If you are hospitalized, do more tests.

A few hundred yuan, a thousand yuan is gone.

As a result, there was a queue, and it was considered lucky to be able to catch the doctor's shift and get the test results.

Although there is also a consultation fee for medical treatment, it is often very cheap.

Many doctors are even more noble in medical ethics. When they meet poor people to see a doctor, they even pay for the medicine themselves.

Looking at the current Western medicine system, if you have no money, you can basically wait for death.

Don't really think that public hospitals are in arrears anyway, and pay after treatment.

Those are emergencies.

Moreover, all emergency diseases are in arrears.

Because in case the illness and the family renege on their debts, the doctors and nurses in that department will be unlucky.

It is difficult to see whether the patient has liver cancer only from the B-ultrasound film.

At least with Zhou Can's current level, after watching it, I think the patient's chances of getting liver cancer are very high.

Since liver cancer, then what kind of cancer?

There are many cancers.

Excluding liver cancer, if there are cancer tumors in other parts, the patient will feel pain and abnormality to some extent.

Zhou Can read the patient's symptoms again.

Simple questions such as whether the patient has pain elsewhere are then asked.

The patient responds to the onset of the disease, and there will be pain in the back, which should be radiating pain.

At this point, liver cancer, abnormalities in other parts or severe pain are basically ruled out, and only the last case remains.

The symptoms caused by the cancer site are merged into the duodenal ulcer.

Gastroscopy has been checked, and gastric cancer is basically ruled out.

At this time, Zhou Can suddenly realized that he might have a gallbladder problem?

The second reason is that the liver and gallbladder are blood brothers. If the liver is hardened, the gallbladder will be more or less affected. But cirrhosis of the liver is directly related to gallbladder cancer.

The duodenum is very close to the gallbladder, which is equivalent to the relationship between cousins.

Gallbladder problems, there will be symptoms of abdominal pain. Jaundice is also common.

But the patient's liver cirrhosis also presents jaundice.

It is equal to the very occasional high overlap of the symptoms.

It was also a coincidence that even Director Jia, an old doctor with extremely rich experience in diagnosis and treatment, went astray.

Zhou Can carefully checked the B-ultrasound film again, the gallbladder sound transmission was good, and there was no abnormal reflection.

Since Zhou Can did not take a special photo of the gallbladder, Zhou Can was unable to check the condition of the cystic wall and common bile duct very clearly.

Let the patient do another B-ultrasound, the idea is very tempting, but the family members will have doubts.

Moreover, Zhou Can did not give patients the right to apply for examination.

You have to go to Director Jia or the treating doctor.

"Show the film to Director Jia for a review, and the questions will be given back in time."

Zhou Can went to Director Jia with the patient's B-ultrasound sheet.

Perhaps with Director Jia's level, it is certain that he can find the abnormality.

At least visually, the shape of the gallbladder is slightly abnormal.

Back in the outpatient room, Director Jia has already started seeing patients.

Although the special-needs expert account is limited in supply, it is famous and has more patients.

In order to prevent patients from waiting for a long time, or even find scalpers to buy high-priced numbers, they often try their best to increase a few patient numbers.

In addition, frequent midday consultations and midday surgeries lead to very tight schedules.

Holding the film, Zhou Can stood behind Director Jia, and waited patiently for a patient who was seeing the doctor to see the doctor before showing the B-ultrasound sheet to Director Jia.

"Director Jia, just now the ward has carefully checked the patient's condition. The patient has both symptoms of jaundice and abdominal pain, and he has expressed it. There is an obvious mass in the abdomen, but he has not expressed anything. It is suspected that the patient may have gallbladder disease or even cancer. It happened to coincide with the symptoms of duodenal ulcer and liver cirrhosis, so I didn't check it.”

Zhou Can also dared to speak out.

Because the basis for diagnosis is less.

A medical diagnosis requires at least one hard diagnostic basis.

Such as B-ultrasound, MRI, CT, blood routine, urine routine and so on.

In the actual course of diagnosis and treatment, doctors often need more than two hard diagnostic evidences before they dare to give a preliminary diagnosis opinion.

What is a first opinion? It's the kind with a question mark behind the diagnosis result.

"Gallbladder cancer?"

Director Jia took the B-ultrasound sheet and took a serious look at it.

Then his face became slightly dignified, he picked up the magnifying glass, and began to examine it carefully.

Qiu Hong, a young and beautiful doctor standing next to her, was smug at the gallbladder cancer that Zhou Can said at first. Because of preconceived views, I think Zhou Can is still acting.

When I noticed that Director Jia's face became a little bit serious, and even took a magnifying glass to check the B-ultrasound sheet carefully, my heart began to feel like a tickle.

Should it be a real problem?

Difficult to regulate Pearson acting?

"There seems to be a problem with the gallbladder. Qiu Hong, immediately call the B-ultrasound examination room to see if the B-ultrasound film of a patient is clearer than the gallbladder."

Generally speaking, the imaging results of the examination are archived.

And after printing it to the patient, the hospital will not keep it on file.

In some responsible hospitals, doctors in the medical technology department can even archive multiple copies. The actual printed one for the patient can be one sheet, or only a part of it is better.

Qiu Hong hesitated, "Is your outpatient work temporarily suspended?"

"If the patient is really suffering from gallbladder cancer, that's fine. It doesn't matter if the outpatient service is delayed a little bit. Now, take a lunch break and work overtime."

The work of a doctor is relatively active.

When encountering a problem, the safety of the patient's life must be the priority.

"Okay! Ma called to ask."

After finishing speaking, he looked up at Zhou Can.

"Doctor Zhou, tell the guide outside, don't call your number yet."

Qiu Hong's tone changed obviously, and Zhou Can could feel it.

He opened the door, explained to the guiding nurse outside, and returned to the outpatient room.

Medical guides are also nurses, and their status and salary are lower than those of department nurses.

Generally, the guides get 4K for one month, and the nurses in the department get at least 5K.

In terms of status, the guide nurses are also full of sadness.

In fact, any unit is much worse. For example, the assistant police, the treatment status is also worse than the official staff.

After Qiuhong contacted the B-ultrasound department of Shanzi, the other party quickly sent all the B-ultrasound films of the patient.

Sure enough, a very clear picture of the gallbladder was taken.

As if finding a treasure, Director Jia hurriedly checked it with excitement, and looked at it very carefully.

"There is indeed a problem with the gallbladder, and it can be very malignant. You must immediately notify the treating doctor and communicate with your family members to see if you can do multi-slice spiral CT. If necessary, do an endoscopic ultrasonography. The patient's operation arrangement Cancel it for now."

Director Jia realized the seriousness of the problem.

The patient's condition was good, but after Zhou Can's reminder, it was discovered that the patient could have gallbladder cancer.

The operation must be canceled first.

Must be reassessed.

"The doctor who treats this patient is like Dr. Tang, let me tell you immediately." Qiu Hong called and communicated on the spot.

After the communication, notify the outside guide to continue calling.

Many of these diseases have taken special leave, and even traveled thousands of miles to seek medical treatment.

Definitely a registration that can be canceled.

What should be read, must be read in its entirety.

Doctors should have a sense of professional ethics and responsibility.

After this incident, Zhou Can's status has obviously improved a lot.

Director Jia's eyes became more cordial.

Qiuhong's attitude towards her has also changed subtly.

Strength is such a good thing to help Zhou Can quickly establish a position in the new department time and time again.

, a young woman with a slightly pale face walked into the outpatient room.

The registration fee for the special needs expert account is several hundred yuan. For ordinary patients, if they have difficult and miscellaneous diseases, they will choose the more economical general doctor's consultation account for the registration account.

The woman alone, did not accompany.

"Hello, Mr. Jia, I heard that you are very good at treating gastrointestinal diseases, and I came to see you from other provinces."

"Beauty, let's sit down and talk. Director Jia will definitely help you to take a good look at it when we get here!"

Qiuhong comforted her warmly.

The girl looked to be in her twenties, she was quite young, and she was very stylishly dressed.

Looks bad.

"Thanks!"

After sitting down, he began to talk about his illness.

"I know what's going on recently. Recently, I have diarrhea. Yesterday it was even worse. I vomited after eating. It was very uncomfortable. The local hospital did an examination and said that I might have enteritis. I prescribed some medicine, and it worked."

Take the inspection list to Director Jia for review.

Basically, the diseases that need to be treated by specialists have already been checked by other hospitals and can even be treated.

Therefore, there is basically one common feature, and you can seek medical treatment with the inspection report from other hospitals.

After Director Jia took it, he carefully checked each one.

"Is diarrhea suitable for long-term use?"

Freezing three feet is not a day's cold.

Some of the more serious diseases happen instantaneously. It accumulates slowly and eventually erupts like a volcano.

The situation belongs to vomiting ~ www.mtlnovel.com ~ cold can also cause some symptoms.

Experienced doctors will diagnose and treat diseases one by one.

And a conclusion.

The higher the level of experts, the more comprehensive their consideration. Therefore, do not question the level of experts.

Maybe it's just for a more comprehensive consideration.

"I don't have any other symptoms, but I have been constipated for a long time. It can last for more than two years. I searched on Baidu and said that I should eat more fruits and vegetables to relieve it, so I adopted diet therapy. It has indeed been relieved to a certain extent, and I have been suffering from constipation. The phenomenon."

Speaking of constipation, somewhat embarrassing.

After listening to Director Jia, he nodded and carefully recorded the medical records.

Zhou Can began to think about what kind of disease the female patient had?

To provide you with the fastest update of my medical skills that can add experience points to the great **** Jiangbian Yuweng, so that you can check the fastest update of this book next time, please be sure to save the bookmark!

Chapter 190 You continue to act, so he is not acting for free read.

Chapter end