Great Doctor Ling Ran
Chapter 583: diagnosis
"Speak if it hurts." Ling Ran palpated the abdomen for the patient.
Compared with technical means such as B-mode, slightly old-fashioned palpation can still get a lot of information. Therefore, it is still frequently used in medical examinations.
Of course, imaging and palpation are not the only relationship, and more often the doctor's choice.
Ling Ran is now a master-level physical examination level. When performing abdominal palpation, the accuracy is higher than that of B-mode, so there is no need to occupy the equipment.
The patient was lying on the examination bed, looked at Ling Ran happily, and said in the mouth, "No pain, no pain."
"Don't bear the pain. Sting, swelling and so on, all have to say it." Yu Yuan stood on a small bench on the other side of the examination bed, reminding the patient for the Nth time.
The patient looked at her with disapproval, an "en" in his nose, and then looked at Ling Ran.
"Does it hurt here?" Ling Ran now has her own opinion on the physical examination, and the order and mode adopted are slightly different from before.
The patient had to remind him before taking a breath and said, "It doesn't hurt so much."
"Say a little pain, do you have any pain after eating?"
"Occasionally."
"An hour or two after a meal?"
"Yes, you can guess that, Dr. Ling is so good ..."
"Stomach ulcer." Ling Ran did not wait for the other person to finish, interrupting him: "I will give you two more tests, you go to confirm the diagnosis, the ulcer is not serious at present, but technical means should be used to intervene."
At this time, the man lying on the physical examination bed froze and said, "I exercise three or four times a week, how can I get sick."
Ling Ran gave him a suspicious look and asked, "Why don't you get sick when you're working out?"
"Fitness ... fitness is good for the body."
"When it's time to get sick, you will still get sick." Ling Ran issued a list and urged him, "Tenseness, fatigue, careless diet, climate change, or tobacco and alcohol may cause and aggravate gastric ulcers. You need to be careful and not take it lightly. "
Yu Yuan said: "If it is not treated well, once the gastric ulcer is bleeding or perforated, it will be very troublesome. Maybe the stomach may be removed. In addition, there is also the risk of turning into a malignant tumor."
"Cancer?" The man being examined screamed.
"No, but there are risks." Yu Yuan said: "I want you to go back and take a good look at gastric ulcers. You can do it right, you understand?"
The man asked rhetorically, "Do you really get cancer?"
"Gastric ulcer has the risk of canceration, but the probability is relatively low, generally below 3%." Ling Ran now has enough energy and medicaments, often reading books with peony medicine, and also read a lot of books in internal medicine. Can remember.
"Not three percent ..." The man felt relieved at all, and jumped off the examination bed dumbly, and asked, "What now?"
"I suggest you go to the hospital for a digestive medicine." Ling Ran gave the referral opinion.
He can do this for patients with gastric ulcers, but he is not professional. On the other hand, in order to confirm the diagnosis of gastric ulcer or related diseases, a carbon breathing test may be performed, and maybe a gastroscope may be needed, which is not what the current free clinic can do.
Referrals are a common practice in emergency departments, but they are a little more troublesome today.
Ling Ran handed the list to the other side and let Yu Yuan explain it. The little nurse Wang Jia next to him asked another patient to come forward.
While still inquiring, do a physical examination and make a basic judgment.
Ling Ran's diagnostic skills are not high, and the experience of outpatient clinics is near to nothing, but it is more than enough to do this kind of community diagnosis.
Unlike patients who come to Yunyi, there are often serious illnesses that need to be treated carefully. The free clinics in Bazhai Township are of a physical nature. Most of them are normal healthy people. They have more or less diseases, and they are not serious. They are mainly common diseases.
To date, the development of modern medicine is still intractable, and no amount of examination methods are just auxiliary. The much-respected evidence-based medicine is an intractable opposition party.
Today's doctors, in fact, prefer to deal with certain common diseases. When you hear the sound of a horse's hoof, the first thing you think of is a horse, not a zebra.
For Ling Ran, the current technology for identifying horses has gradually matured.
"Doctor Ling." Wang Haiyang, director of hand surgery, called out and called Ling Ran over.
"This is ..." Ling Ran saw a finger that was obviously wrong.
"Would you like to have an operation?" Wang Haiyang pointed to Ling Ran, and said, "Dr. Ling is the best doctor we have replanted with Yunyi's finger. If you refind your finger, you won't be able to do it every day It hurts. "
The young man who saw the doctor, like a hot hand, snapped his hand back and asked, "How much money?"
"Do you have health insurance?"
"Just 120 a year."
Wang Haiyang nodded slightly: "The entire operation is done, probably more than 10,000 yuan."
"Then I think about it again." The patient didn't dare to take a break, stood up, and hesitated to leave.
Wang Haiyang smiled helplessly: "I thought it would be possible to have an operation, look at these outpatient clinics."
Wang Haiyang shrugged to Ling Ran and continued to see the next patient.
They are all specialist doctors, but in this kind of free consultation, they are not so particular.
And people who see a doctor don't care.
Unlike the higher-end ideas of foreign specialists, the Chinese generally believe that an expert doctor should be comprehensive. At least, a burdock cardiologist should be able to easily treat a gastric ulcer or something ...
This is somewhat influenced by the traditional Chinese medicine atmosphere ~ www.wuxiaspot.com ~ For the old doctors, there are both convenience and inconvenience. The same goes for Ling Ran.
After completing physical examinations for most young people, fewer people lined up in front of Ling Ran.
Ling Ran did n’t have to sit at the table all the time, and he went back and forth to help other doctors deal with mild patients—for two hours, he had seven or eight people with corneal and paronychia. .
This kind of small surgical illness is placed in Yunyi, that is, sending only resident doctors and even interns to practice their hands. There is really nothing to do, it was originally the simplest surgical procedure.
Ling Ran didn't mean to let go today. There are mild patients who can do it on the spot and they will do it.
Several doctors who came to the free clinic nodded.
Among the surgeons present, Ling Ran was the youngest. He took the initiative and the other doctors had better senses.
"Looking at it like this, Ling Ran is still quite sensible." Director Hong of the respiratory department saw that Ling Ran had gone to the cubicle again, and opened the third pack of cigarettes today, and lit while laughing.
"It's also said, without a word of silence, doing things very well." Pu Wai came to a deputy high, and nodded in agreement.
"The main thing is to see the patient's feelings. Ling Ran is still very serious about seeing a doctor." Wang Haiyang was most familiar with Ling Ran, and smiled and said something.
"This is true."
"Still young, if you are older, you can collect at least a few pennants."
As soon as Director Hong's words fell, he saw a pennant and reached out from the door first.
The big character on the pennant reads "Rescue the wounded and help the wound, noble medical ethics".
"Is Dr. Ling in? I'll send a pennant." The water fighter Hua Tao who came in was confident. When he stood on the land in Bazhai Township, he felt countless strengths, and all the gifts he gave were justified.
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