Since 1981 Health School Chapter 595

  Chapter 595 Trial with sodium valproate

  Chen Qi's space operating room has this kind of black technology "capsule endoscopy", but he can't say it, not even his wife.

  He used to bring out those black technologies of later generations, all of which were "poor information".

   In China, it is said that this is a machine secretly developed by foreign countries, and in foreign countries, it is said that this is a device developed in China in secret, which is equivalent to hiding both sides.

  But if you walk too much at night, you will always encounter ghosts, so Chen Qi has to be careful.

   Fortunately, this is the 1980s. If it was 10 years ago, I would have been reported to the GW meeting by my wife, children, students, colleagues, and neighbors.

  Like Lao She, his wife and children did not let him into the house until his death, a tragedy in the world.

  Chen Qi doesn't want to be miserable. With so much money, he hasn't enjoyed his life well yet.

How to do it?

  Chen Qi thought of a good way, while everyone left, he quickly returned to the ward:

   "Wait, don't eat yet."

  Before doing a gastrointestinal endoscopy, the stomach and intestines must be cleaned first, so at this time Yu Sisi saw the doctor leave, and when she was about to eat, Chen Qi called her to stop.

   "Doctor Chen, here, what problem did you find?"

  Chen Qi smiled: "It's okay, it's just that we still need to do a few tests, so come here, little sister, and eat this capsule first."

  Yu Sisi took a capsule that Chen Qi handed over, and found that this capsule was a bit different from other pills, it seemed to be larger, and both ends of the capsule would emit light, as if there was an electronic component inside.

   "Doctor Chen, what is this? Is it a pill?"

   "Uh, this, it's a pill or not a pill. You swallow it and you'll pull it out tomorrow. Remember to take a net bag when you poop, so don't let the water wash it away."

  The toilets in the People's Hospital are not like the flush toilets or squat pits of later generations.

   It's a long sink. Everyone squats on it. There is a water tank at one end. If you want to flush, you just pull the line, and the water will quickly wash away all the dirt in the sink.

  Chen Qi didn't want his capsule endoscope to be washed away.

  Yu Sisi and her parents didn't suspect anything. They came to Yuezhong from Xi'an thousands of miles away. They knew that the treatment methods of Yuezhong Hospital were different and had their own characteristics.

  They think that this kind of capsule is also one of the characteristics of Vietnam Traditional Chinese Medicine Hospital.

   Besides, there is no Baidu these days, even if they have doubts, they can't find out, so Yu Sisi swallowed it readily.

  Chen Qi thought that the patients these days are really easy to talk about. If it was his previous life, the patients would not be able to ask clearly. After searching on Baidu for a long time, they would still wonder if you were doing some kind of experiment for his patients?

  Early the next morning, Chen Qi held his nose and retrieved the capsule endoscope wrapped in stool.

   Then, before the joint ward rounds of the two hospitals started, he quietly took out the laptop, read the data of the capsule endoscopy, and watched slowly from the entrance of the capsule to the discharge from the anus.

   Chen Qi looked constipated.

  The capsule endoscopy took a picture of Yu Sisi's upper and lower digestive tract from top to bottom, from inside to outside.

  Especially in the lower digestive tract, the ileum and jejunum, which could not be detected by colonoscopy before, were all checked, but the result was far beyond Chen Qi's expectations.

   There is nothing wrong with the intestines.

Seeing this, some readers will definitely say, look, a capsule endoscope costs several thousand yuan (the price in 2023), but after spending so much money, no faults are found. This is not to earn medical expenses, waste What about our money?

   In fact, it should not be understood this way.

  Although capsule endoscopy, gastroscopy, colonoscopy, CT, and B-ultrasound have all been performed over and over again, and indeed a lot of medical expenses have been incurred, you cannot say that these examinations are for nothing, redundant, and meaningless.

  At least now Chen Qi can use the method of exclusion to rule out some causes of abdominal pain.

  When you rule out most of the causes, the remaining answers are the correct answers, so in the final analysis of medicine, doctors use the method of exclusion to cure diseases, especially difficult and miscellaneous diseases.

In the morning, when the joint ward rounds of the two hospitals started, and everyone was still wondering if there was something wrong with the undetected intestine in the middle, Chen Qi already knew that there was no problem with the intestine, and the thinking of disease diagnosis was still spreading. go.

  Professor Tong put forward his own views at this time:

"How about we expand the scope of the inspection and keep our eyes off the gastrointestinal system. Diseases such as liver congestion, hepatitis, liver abscess, liver cancer, and splenomegaly will all cause increased capsule tension. Could this be the cause of Yu Sisi's abdominal pain? ?”

  When Yu Sisi's parents heard about liver cancer and hepatitis, their legs were so frightened that their legs went limp.

   "Doctor Chen, Doctor Lan, you must ask for my daughter, but Professor Tong said that your level is well-known in the world, you can't give up my daughter."

  The girl's mother was so anxious that she almost knelt down, and Chen Qi hurriedly supported her.

   At this moment, Chen Qi didn't know if it was because of nervousness or some discomfort. Once again, Chen Qi saw the corner of the girl's mother's mouth twitch unconsciously, and he suddenly felt as if he had caught something.

  But Luo Zhen was crying and kneeling, making a fuss, and Chen Qi was busy helping her up, forgetting that the corners of her mouth twitched, and her train of thought was interrupted.

  Zhang Weizhong also touched his chin:

   "Could it be some heavy metal poisoning, such as lead poisoning, or abdominal pain caused by diabetic ketoacidosis, uremia, porphyria, etc.?"

  Yan Changhong from Xijing Hospital retorted:

"The patient has been in pain for several years, and the pain can last for 1-2 hours each time, but it is estimated that it is not a malignant disease, otherwise it would have deteriorated already. You can see that she has not lost weight, and she does not have a cachectic face. On the surface It doesn't look sick at all."

  Lan Lijuan said softly to the doctor next to her:

"Could it be hysteria? The age of 16 happens to be the most rebellious time for children. Sometimes when they encounter difficulties in learning, or have troubles at home, or even fall in love with their boyfriends and quarrel with their boyfriends, they will have hysteria attacks. Clinically It's not uncommon either."

  Hysteria, also called dissociative conversion disorder, is a mental disorder caused by mental factors, such as life events, inner conflicts, suggestion or autosuggestion, acting on susceptible individuals.

  Director Liang of Xijing Hospital shook his head:

"It should not be hysteria, because when the patient's abdominal pain occurs, there is obvious abdominal muscle tension, similar to a plate-shaped abdomen. If it is hypochondriac, the abdomen should be soft when palpated. And the little girl has a good temper and a harmonious family. The grades are also quite satisfactory, and there is no social and academic stimulation.”

  The more you know, the more you guess.

  One sentence for each person, one diagnosis for each person, if all of them have to be done by the method of elimination, I am afraid that it will not be possible to find out in a few months.

   At that time, not to mention that the family members can't afford it financially, and the body can't bear it, they will collapse mentally.

   Didn't you see that the child's mother is crying so hard that she can't straighten up? Obviously, the daughter's condition could not be found out, and the pressure has reached the critical line.

   It's too late to say it's too soon. Yu Sisi was lying on the hospital bed and was fine, but the abdominal pain came at the first mention.

   "Ouch, it's hurting again, doctor, doctor~~~"

  Yu Sisi clutched her stomach tightly, her face was pale, and beads of sweat instantly covered her forehead.

  Chen Qi reacted quickly by the side, and immediately seized the time to lay the girl flat, and then pressed his right hand directly on her stomach.

   "Where does it hurt?"

   "This, it hurts here, it's like a knife is cutting, it hurts, it hurts."

  While pressing, Chen Qi found that the pain was not too fixed, it was around the navel for a while, and for a while in the upper abdomen, but it was strange that there was no obvious rebound pain.

  He knew that there was nothing wrong with the girl's intestines, so if his thinking continued to spread, what could be the problem?

   While Chen Qi was thinking, the corners of the girl's mother's mouth twitched twice in a row because of her agitation. It was so fast that she wouldn't have noticed it if she hadn't been face to face.

  Chen Qi's eyes lit up, and he finally caught the inspiration.

   "Sister Luo, I have a question to ask you. Don't take offense if I'm wrong. Everything is for the children."

  The girl's father was a little strange: "My daughter is sick, why do you ask her mother?"

  All eyes in the office are also focused on this talking WGO director. After all, diseases are two completely different individuals. Ask mother? Everyone can't figure out why.

  The girl's mother was so eager to save her, she didn't think about anything else, and nodded repeatedly:

   "Ask doctor, I will tell you everything I know."

  Chen Qi hesitated for a while, but still asked: "I have seen the corners of your mouth twitching several times, so I want to ask, do you have a history of epilepsy?"

  As soon as these words came out, Professor Tong Shanggao's eyes lit up.

  Although the girl's mother didn't know why the doctor asked such a question, she answered honestly:

   "Yes, I had epilepsy when I was a child, but I didn't have the whole body convulsions like other epileptics. My seizures are relatively mild, just like I still have a few involuntary twitches at the corners of my eyes and mouth."

   Oh~~~

   After all, it was a doctor from the top hospital in the country. The doctors from Xijing Hospital all made a burst of enlightenment beside them, obviously they had already guessed something.

  As for the Yuezhong People's Hospital, except for a few senior doctors, the other junior doctors have not yet realized the reason for Chen Qi's questioning.

   This is the gap.

  Chen Qi also breathed a sigh of relief at this time, so he explained:

   "Epilepsy is not a genetic disease, but epilepsy may have a genetic predisposition, which means that your daughter may also have epilepsy."

"What?"

  The girl's parents exclaimed at the same time, Yu Kejia couldn't accept it:

   "We know that epilepsy can be inherited, but my wife's epilepsy is very mild, so it is also inherited? Besides, even if my daughter has epilepsy, it can't explain the patient's recurrent abdominal pain."

  Chen Qi coughed lightly: "Yes!"

  Professor Tong next to him also nodded slightly:

   "It may be related. Typical epilepsy, of course, is mainly convulsions, disturbance of consciousness, and foaming at the mouth. Everyone understands it. But atypical epilepsy may indeed manifest as abdominal pain.

  Because of the abnormal discharge of the brain, it may be related to the nerve disorder in the abdomen, which then leads to abdominal pain. Such examples are rare, but they have happened, and I saw them when I was young. But that's all suspicion. "

  The girl's parents are all stupid. My precious daughter's abdominal pain has not been cured yet, and now she has another epilepsy?

  No one can accept the change. Even if the abdominal pain cannot be cured, it will hurt. And with epilepsy, the girl was completely ruined.

  Specifically refer to that Comrade Bai Xue, who was just newly married, but her in-laws divorced the engagement because of a suspected epilepsy.

  16-year-old Yu Sisi was lying on the hospital bed. When she heard that she might have epilepsy, she burst into tears.

   All of a sudden there was chaos in the ward.

  As a doctor, Chen Qi must ensure his calmness in the first line. This is why outsiders always think that doctors are ruthless. Could it be that doctors are made to cry with their family members? Can the disease be cured?

"Don't cry, I'm just suspicious, I need to do a few tests, Lijuan, you ask the doctor in the EEG room to come over and do a bedside EEG for her, wear it for one night, see if you find anything .”

  Everyone is looking forward to the situation that night.

  If there is an attack of abdominal pain that night, and if the EEG can record typical epileptic waves at the time of the abdominal pain, then it is definitely epilepsy and the case has been solved.

  Unfortunately, things backfired. The girl did not experience abdominal pain that night, and the EEG showed normal results.

  While the girl's family breathed a sigh of relief, Chen Qi gasped. This was not the result he wanted, and failing to find out would mean finding a needle in a haystack again.

   Just when everyone was discouraged, Yu Sisi had another abdominal pain in the afternoon.

   This is really a friend. You don't have seizures while wearing the EEG, but you have seizures twice before and after wearing it.

   And this time the abdominal pain was more painful than the previous few times, and it was more bearable.

  The girl's mother was anxious: "Doctor, please give me some painkillers, I can't watch my daughter die in pain."

  Chen Qi sighed inwardly:

   "We have tried painkillers, but they can't relieve the abdominal pain, but now I have an idea, I want to use a kind of medicine, if it works, the abdominal pain will stop immediately, I want to try it."

  The girl's mother hurriedly replied: "Yes, I will use it right away."

  The girl's father was a little wary, and asked one more question: "Dean Chen, what medicine do you want to use?"

   "Sodium valproate!"

  Professor Tong, Zhang Weizhong, Lan Lijuan, and Liang Wenwen were all taken aback. Obviously, the young dean still did not give up and insisted on the diagnosis of abdominal pain-type epilepsy.

   (nonsense, the intestines have been photographed all over, it is definitely not the intestines that have a problem)

   "What kind of medicine is sodium valproate?" The girl's father asked a little strangely.

"This is a drug to treat epileptic seizures. In my opinion, if the abdominal pain can be relieved by using anti-epileptic drugs, it can also be regarded as abdominal pain epilepsy. This is called diagnostic treatment. Professor Tong and so many doctors are here, I won't use drugs indiscriminately."

  The girl's father turned to look at the "fellow townsman" Professor Tong.

  Professor Tong nodded slightly: "Xiao Yu, I think you can trust Dr. Chen once, just give it a try, there won't be any major problems."

   "Okay, let's try sodium valproate then!"

  (end of this chapter)

Chapter end