Since 1981 Health School Chapter 597

  Chapter 597 Another acute abdomen

  Yi Zewen continued to ask the doctor while writing the outpatient medical records: "Do you have vomiting and diarrhea?"

  Cui Tongzhi refused: "No!"

   "Apart from abdominal pain, is there any other pain? For example, is there pain in the lower back?"

  Yi Zewen stared at the patient's face closely, trying to find some problems from the face, but he saw nothing but the patient's painful expression, no pale face, yellow skin, etc.

  The answer is no.

   "Then do you usually have high blood pressure, diabetes, coronary heart disease, etc.?"

  Cui Tongzhi hesitated for a while, but still answered firmly: "No, not at all."

  Yi Zewen was relieved when he heard this, and said indifferently:

   "It's probably common acute gastroenteritis. I'll prescribe some medicine for you. You'll be fine after going back to rest for two days."

  But Cui Tongzhi refused: "Hey, I said Xiao Yi, did you give me some checklist? What if there is something wrong with my stomach."

  Yi Zewen smiled: "You old Cui, if you are so afraid of death, then go for a B-ultrasound scan, and you will know if there is any problem."

  In 1989, although ordinary people could eat enough to eat and had a little spare money in their pockets, ordinary people who were used to living a poor life were still reluctant to spend money.

   It costs 10 yuan to do a B-ultrasound, which is more than 5 catties of pork. The general idea of ​​​​patients is not to do it if they can.

  But Cui Tongzhi is from the Post and Telecommunications Bureau, and his medical treatment is public-funded, and his unit reimburses him.

   What checks are there? Do! What good medicine? superior! Health is the most important thing.

  Of course, when you are so poor that you only boil water to make cold rice every day, who cares about whether you are healthy or not?

   Cui Tongzhi clutched his stomach and hurriedly went to pay the bill. Yi Zewen looked at his watch. Although it was already time to get off work, he still planned to wait a little longer.

   Half an hour later, Cui Tongzhi came back with the report, "Xiao Yi, come and see, how am I doing? Is there any problem?"

  Yi Zewen looked at it: no gallbladder stones, no kidney stones, no obvious exudation of the pancreas, and no swelling of the appendix.

  This preliminarily dispelled Yi Zewen's doubts, because the whole course of illness was already very clear.

   Cui Tongzhi's abdominal pain was induced after eating breakfast. In addition to gastroenteritis, he should also be alert to cholecystitis, pancreatitis, appendicitis and other abdominal organ inflammation diseases.

  For example, typical acute cholecystitis will have positive Murphy's sign and percussion pain in the gallbladder area, while pancreatitis is often induced by eating and drinking, and appendicitis is usually pain in the lower right abdomen.

   But these are typical cases, and there are many clinically atypical cases. If you do not pay attention to observation and do not take necessary auxiliary examinations, it is very likely that the diagnosis will be missed.

  This is what doctors are most afraid of.

   Now the abdominal B-ultrasound is normal, and Yi Zewen is much calmer.

  At least preliminarily rule out the above-mentioned diseases. Other fatal diseases, such as liver rupture and spleen rupture, are not supported because there is no history of trauma.

  Yi Zewen suddenly thought of a question, "By the way, Lao Cui, have you ever had gastritis or gastric ulcer before?"

  Cui Tongzhi: "I had stomach pains when I was young, and I was poor and couldn't eat enough. I haven't had it in the past 10 years, and my body is great."

  Yi Zewen hummed, thinking in his heart, if this is the case, then this abdominal pain does not support the possibility of gastric ulcer, gastrointestinal perforation, etc.

  Although abdominal plain films were not performed to exclude it, if it was true gastrointestinal perforation, digestive juice would leak into the abdominal cavity, causing obvious peritonitis, severe abdominal pain, and symptoms of acute peritonitis such as abdominal muscle tension. None of the patients had any symptoms.

  So even without inspection, this possibility can be preliminarily ruled out.

  Since the most serious digestive system diseases have been ruled out, what else is there to say?

  Yi Zewen prescribed some antispasmodic painkillers and digestive medicine: "Okay, old Cui, it's nothing, I'll make some medicine for you and you can just take it."

  Although Cui Tongzhi still felt pain in his abdomen, he nodded out of trust in the doctor:

   "Success, then I'll go back first, hey, I guess the wonton meat is not fresh today, I have to talk to old man Li tomorrow!"

   Seeing the patient leave, Yi Zewen took off his white coat and returned to his director's office.

  Since he was promoted by Chen Qi to be the director of the emergency department, he has also become the youngest department director and middle-level cadre in the People's Hospital besides Lan Lijuan.

  But he always kept Chen Qi's words in mind, the director of the department is just the beginning, don't relax, don't be satisfied, and don't be complacent.

   This is almost an explicit statement, meaning that as Chen Qi's confidant, he must fight for his breath and promote him again in the future.

  So Yi Zewen really devoted himself to the emergency department, day and night, if his income was not 3 or 4 times that of other departments, his wife would have quarreled with him.

  Back to the office, Yi Zewen just fell asleep for an hour when there was a knock on the door.

  A little nurse outside shouted: "Director Yi, there is a patient with abdominal pain outside. You treated him before, but now he came back and said that the stomach pain is even worse."

  Yi Zewen opened his eyes and quickly opened the door: "Go, have a look!"

  On the hospital bed, Cui Tongzhi, who was able to walk out of the hospital just now, was already lying on the emergency bed humming, surrounded by several colleagues.

   "Old Cui, what's wrong?"

   "Xiao Yi, Director Yi, hurry up, brother, my stomach hurts more and more, do I have appendicitis?"

  In this day and age, people in Vietnam are accustomed to refer to appendicitis, colitis, intestinal obstruction, as long as the abdominal diseases are collectively referred to as "appendicitis".

   Before Yi Zewen could speak, Cui Tongzhi hummed again and said:

   "Director Yi, I was embarrassed to say something earlier. In fact, I have diabetes and have been taking medicine."

  Yi Zewen was speechless when he heard it: "Then why didn't you say it just now? Isn't this a waste of time?"

   "There were so many people around me just now, I didn't have the nerve to say that."

  Vietnamese people still avoid diseases and avoid medical treatment. When it comes to diabetes, it feels like a terminal illness or an infectious disease.

  If in a rural area, someone with diabetes urinates in someone else's latrine, the owner will scoop out the “bubbles” because the common people think that the urine of diabetics is poisonous.

   This was caused by the young man's lack of medical knowledge, so Cui Tongzhi felt a little inferior in his heart, and he didn't want others to know that he had diabetes.

  To be honest, Yi Zewen was shocked when he heard Cui Tongzhi say that he had diabetes.

  Diabetes will have an acute complication called ketoacidosis, which is caused by the accumulation of acidic metabolites produced after the patient's body cannot fully utilize glucose and begins to use fat, causing organ dysfunction.

   And ketoacidosis has a rare symptom, which is abdominal pain.

  If it is severe ketoacidosis and the rescue is not timely, it will be fatal.

  Yi Zewen immediately directed the little nurse next to him: "Hurry up, take an emergency blood sugar test."

  Blood glucose testing at this time is not like in the later generations. A needle is pricked in the finger, a drop of blood is squeezed, and the result is available in a few seconds.

  Now blood sugar needs to be drawn, and then taken to the laboratory, and finally the report is issued, and dozens of minutes have passed at the fastest.

   "Director Yi, the patient's blood sugar is 5.9mmol/L."

  5.9, this index is no problem, postprandial blood sugar is generally within 11 points is normal.

  The blood sugar of the patient is normal, and the possibility of ketoacidosis is basically ruled out. Because blood sugar is often very high during ketoacidosis, often exceeding 30mmol/L.

  For the sake of safety, Yi Zewen didn't care about it. Anyway, while checking the condition, he checked his income, including liver and kidney function, electrolytes, trace elements, ketone bodies, and blood routine.

  Abdominal CT was also scanned, and almost all of them were scanned.

  Anyway, it was reimbursed from public funds, so Cui Tongzhi didn't care. Several colleagues ran up and down busy paying the fee and checking.

   As a result, after the blood was drawn, Cui Tongzhi's abdominal pain still didn't improve, and even worsened, and he began to roll on the hospital bed.

   "Hey, mom, hello, it hurts so much, I need it, please ask for medicine~~~~"

  Patients become irritable due to pain, and their mental state deteriorates. This often indicates that the disease is getting worse, and there must be a problem in some link.

  Yi Zewen was also in a hurry, but he couldn't figure out where the problem was. He checked everything that should be checked up and down, inside and out, and everything was normal.

  Although he also graduated from a university, Yi Zewen was born in surgery after all, and the limitations of specialists limited their clinical thinking.

  At this time, Zhang Xing just came to take over the shift. Seeing Yi Zewen's commotion, he quickly got up.

  After he looked through all the medical records, he could only say helplessly: "Old Yi, why don't you invite Dean Chen to take a look."

  Yi Zewen was right when he heard it. "If you are unresolved, go to the director." This is a popular slogan in the People's Hospital.

   "Okay, help me keep an eye on it, I'll go to the dean."

  In the emergency room, Chen Qi had already taken over the patients.

   At this time, Cui Tongzhi was already covering his stomach with his hands in pain, rolling around on the hospital bed, and his face was very pale.

   "Hey, old Cui, why does it hurt? Is this? Is this?"

   "Dean Chen, hurry up and help me, it hurts me to death."

  Chen Qi hastily touched the patient's belly, then began to look through the examination report, thinking about possible situations.

   At this time, the doctors of Xijing Hospital, led by Professor Tong, also came to the emergency department of the People's Hospital.

As soon as they arrived at the emergency department, Professor Tong and the others keenly noticed that the emergency building looked ordinary, but when they walked inside, they found that both the internal layout and the diagnosis and treatment equipment seemed to be different, very advanced, and a bit like a foreign emergency department. Section meaning.

  For example, three lines of different colors are drawn from the door, red, yellow and blue, extending to the emergency room, outpatient room and auxiliary department respectively, so that patients can know where to go after entering the door.

  In addition, in the emergency department of Yuezhong People's Hospital, all imported medical instruments are used, and even the electrocardiogram is made in the United States.

   Xijing Hospital alone cannot meet this condition. They basically use domestic products, but whoever uses them knows the quality of domestic products.

  Director Liang Sting looked at the advanced instruments in the room and couldn't help feeling:

   "I really don't know whether our Xijing Hospital is too backward, or the coastal areas are too rich. A local hospital actually has so many imported goods. There are two CT machines alone. What kind of life is our Xijing Hospital!"

  Director Zhou Qifa also smiled wryly:

   "Don't look at the equipment in this emergency room. I just went to the operating room to take a look. Good guy, all the surgical tools are Japanese products. Damn it, this Yuezhong People's Hospital is really a big dog!"

  Professor Tong coughed a few words: "What are you talking about, the comrades from Yuezhong are still here."

  The Dean Liu Huijuan, who was accompanying him, burst out laughing when he heard this:

   "Professor Tong, it's all right. I thought that our Dean Chen always scolded others for being a bigot. I didn't expect that one day he would be called a bigot. If he heard it, he might change his face, hahaha~~~

  Actually, you have also misunderstood. You see, just like the ventilator monitor and so on, these are all second-hand goods from the Mayo Clinic, and they were all brought back by Director Chen himself, without spending any money. As for the surgical instruments, they were provided by the sponsors for free, and we also did not spend any money.

In addition, have you seen that our hospital is doing a lot of infrastructure construction, and soon there will be two 20-storey buildings erected here, one will be used as an endoscopy center, and 20 new operating rooms will be built, and the other will be our people. The hospital's new inpatient building.

  But the money for building a new hospital is also not paid by itself. What money does our Yuezhong People's Hospital have? There are thousands of hospitals all over the country. Who dares to say that they are rich now? The money we built the hospital was donated by foreign friends, and we didn't spend any money. "

  A doctor from Xijing Hospital couldn't help asking:

   "Section Chief Liu, how much did the foreign guests donate to you? You dare to build such a tall building, and you will build two as soon as you build it!"

  Liu Huijuan proudly stretched out two fingers.

   "2 million?"

   "No, it's 20 million!"

   "Hey~~~ What kind of **** is this, can't you run out of money?" The eyes of the doctors in Xijing Hospital were all red!

  Liu Huijuan shook her finger: "It's 20 million dollars!"

  The scene was silent, and Professor Tong waved his hand:

   "I hurt my self-esteem, let's go and see the patient's condition!"

  It's more than an injury to self-esteem. The doctors in Xijing Hospital felt that they had been bruised to the point that they had been shattered, and even their spiritual world had been shattered.

  Especially when they found out that the doctors in the emergency department of Yuezhong People's Hospital earn about 500 yuan a month, they all began to wonder whether Xijing Hospital is the best hospital in the country?

   Otherwise, why do they only earn more than 100 yuan a month? How big is the income gap?

  The 1990s is about to enter, and the national economy is developing rapidly, especially the Yangtze River Delta and Pearl River Delta. As economic leaders, hospitals are built taller and taller than each other, but there is a lack of good doctors. What should we do?

   It is impossible to train an experienced expert director by yourself without more than ten or twenty years.

what to do? Isn't that cheap off the shelf?

  So hospitals in the south and east have set their sights on the midwest and northeast.

  Especially in the Northeast region, as an old-fashioned industrial zone, it is quite the boss of the Republic. What kind of high-level doctors can't be produced?

  The doctors in the Northeast region are also troubled at this time.

  Feng Shui takes turns, the old Big Brother can't play anymore now, everyone knows what happened in the Northeast in the 1990s, how can a doctor be alone? After all, doctors also have to support their families.

  So the hospitals in the south waved their hands, and the doctors in the north flirted with each other. They hit it off and moved the family to the south.

  The brain drain in the Northeast is the loss of various industries in various places, and doctors are also an important part of it.

Of course, the first batch of doctors who dared to resign from the public office to go to the south were brave, and they also gained the most. When they came, they were professors and directors. Full support.

  The cowardly doctors who will follow after a few years can only drink soup.

   This phenomenon of talents "flying southeast" still exists even in later generations.

  For example, in 2023, the tertiary hospitals in the central and western regions and the northeastern region will not even be able to recruit doctors.

  So the backwardness in the Northeast has almost no hope of rescue, because all the blood has been shed.

  When Professor Tong came to the emergency room with all the angry people, he saw Chen Qi thinking hard.

   "Xiao Chen, how is it? Is there anything special about this patient?"

  Professor Tong Shanggao of the old Jianghu saw Chen Qi's embarrassment at a glance. The disease that can embarrass a director of the International Medical Association is definitely not simple, so the doctors of Xijing Hospital have a strong sense of participation.

  (end of this chapter)

Chapter end