Great doctor starts with adding points

Although Wu Xie was already lying on the bed, she was still carefully listing the few patients she met today.

Except for Liu Chunhua, who has been dealt with for the 11th bed, and the result is relatively clear, the other four beds have their own merits.

Infections after surgery are complicated and mottled, and there are many factors to consider. In addition to simple infections, concomitant diseases must also be considered, such as heart disease, gastrointestinal diseases, etc. in addition to infections .

Thinking about it now, the reason why Jinping had a rare rickettsial infection before, but the gain in knowledge points was only a little, because Jinping's infection was relatively simple, as long as it was accurately diagnosed and prescribed medication, it would not be difficult to control it.

After all, the key to anti-infection treatment is to find sensitive antibiotics, and then use them in sufficient quantities for a sufficient course of treatment. After the diagnosis and medication are accurate, the treatment is not complicated.

On the contrary, it looks simple like Liu Chunhua, but it actually contains fatal elements in it. On the contrary, it is easy to perforate and extremely difficult to deal with. If the abscess breaks out, it will be extensive and diffuse peritonitis.

When Wu Xie took another inventory of the four patients admitted to the hospital today, he kept some important points in mind.

Although none of the 8910 beds are in charge of him, in fact, these infected patients were all 'fiddled' by him, so he still has to be responsible to the end.

From today's performance, it can be seen that Lu Junyin and He Ling still lack a certain amount of experience and skill in the diagnosis and treatment of infections.

And although the referral relationship between Xuan County Hospital of Integrated Traditional Chinese and Western Medicine and the higher-level hospital was not his own, and he didn't even know about it, but Professor Duan is his master, and what he does is equivalent to what he does, so he can't escape of.

Not just the relationship between master and apprentice——

The 8-bed Mei Xiaoqing is not only difficult because she is a self-funded patient and has financial burdens, but also her weight loss, which must also be considered carefully.

Wu Xie had a vague speculation in his heart, that is, Mei Xiaoqing might have been malnourished before he was hospitalized.

There are two main reasons for this speculation. First, young girls love beauty, like to lose weight, don’t like to eat meat, and may even go on a diet to lose weight. Among adults, eating breakfast irregularly may cause gastrointestinal problems. Lesions, such as gastric ulcers, etc., not to mention regular dieting?

Second, Mei Xiaoqing has no history of trauma, and spontaneously developed an abscess in the anterior soft tissue. This kind of situation is actually not common. Wu Xie actually wanted to ask if she couldn't afford meat and rice, and then she was embarrassed to ask The family asked for money, and was over-nourished when preparing for the exam, which led to problems with the overall immune system.

However, the normal flora in the intestinal tract enters the blood through the ulcer on the surface of the gastrointestinal tract, and settles in the soft tissue layer before the femur. When the body's immunity is weakened, a soft tissue abscess occurs spontaneously, without warning, and without trauma. One of the common reasons.

If it is not for this reason, common soft tissue infections should start from the superficial skin——

This will not be known until I read the medical records tomorrow, or ask about the medical history myself, so I have to have a good talk with this little girl.

Mei Xiaoqing is a few years younger than Wu Xie, so it is correct to call her that.

Bed 9 is the superficial infection of the skin, which looks the easiest. At present, it is safest to continue to use antibiotics, but it is estimated that she also has a gain of 2 points of knowledge points, so it is difficult for Wu Xie to speculate on her specific situation.

Not even a direction to doubt and consider.

Let's hang the water for now, and then slowly think about how to deal with it——

Uncle Zhou in bed 10 can suspect infection, but Wu Xie still thinks that Uncle Zhou caused a local infection after taking a bath, not an infection of the wound. Local infection and unclean water invaded the surface of the wound, resulting in restorative Inflammation overlaps with allergic inflammation.

This led to the abnormal proliferation of collagen fibers, resulting in a scar-like physique reaction, which may continue to proliferate later, but it is not actually an infection...

Even if there are no bacteria in the water, it can’t be done like this. If it’s all done like this, why do doctors still use sterile saline, and wash it directly with tap water, how cheap is it?

Wu Xie complained helplessly.

10 beds, preventive anti-infection, keep dry, must call Uncle Zhou's son to the department to accompany him, these three points of doctor's advice, the last point is especially important.

No one can change Uncle Zhou's temper, not even his wife, it must be his son!

Then there is the 11th bed. After Liu Chunhua in the 11th bed underwent surgery, there was no need for special treatment.

The rest is the 12-bed patient who was transferred from the County Hospital of Traditional Chinese Medicine after the rupture of the Achilles tendon and the wound was slightly leaking. Considering infection.

This patient is in charge of Wu Xie himself, but it is not simple.

At least, currently, Wu Xie suspects that the bacteria he was infected with is Pseudomonas aeruginosa.

Pseudomonas aeruginosa is a Gram-negative bacterium that often exists in soil and water and can cause wound infections and urinary system infections.

The patient had a ruptured Achilles tendon. Before admission, he had a medical history of Shimoda, and then accidentally stepped on the ground. Under the violent contraction of the gastrocnemius muscle, the Achilles tendon was broken. This suspicion is well-founded.

But the problem is, when Wu Xie was not sure what hidden disease the 12-bed bed had, when he checked the literature, he also saw a very rare complication, which was very similar to the 12-bed bed—

Calcaneal compression after Achilles tendon rupture!

This complication is a lesion in which excessive friction occurs at the interface between the Achilles tendon and the heel bone, causing inflammation and pain.

Calcaneal compression is usually due to abnormal pressure distribution or friction at the contact surface between the end of the Achilles tendon and the calcaneus during the reconstruction or repair of the Achilles tendon after Achilles tendon rupture, resulting in a gap between the Achilles tendon and the calcaneus tissue damage and inflammatory responses. In addition, factors such as improper activities and excessive activities of patients during postoperative recovery may also lead to calcaneal compression.

The diagnosis and treatment of this complication is actually not related to infection surgery. Strictly speaking, it belongs to a relatively deep disease in trauma surgery.

So tomorrow I have to add up the total. It would be great if I could take an MRI, but the hospital doesn’t have it, and it’s not easy for patients to go to the county to take another scan. It’s very troublesome.

Wu Xie pressed her temples, and after recalling some key points of calcaneus compression disease through physical examination again, she fell into a deep sleep.

the next day.

October 27th is Friday, and there are four days before the next month.

Wu Xie got up early, and when she went downstairs, she didn't see Xiang Mei combing her hair at the door of the store. After looking around, there was no one there, and there was no breakfast at home, so she simply went to Xu Huifang's store to finish eating. The department rushed.

It was still early, when Wu Xie arrived in the department, it was only 7:45, and there was still a quarter of an hour before normal work.

When he arrived at the door of the department, Wu Xie also found that there were many people gathered in the direction of the doctor's office of the department, including Lu Junyin, Chang Quansheng, and Lin Yaolong and his group.

Chang Quansheng seems to be still doing work for Lin Yaolong and Lu Junyin: "Director Lu, after acupuncture, although the wound is not big, it is still an open wound. Now there are too many infected patients in the department. For Lin Hua, it is truly irreversible."

"Now Lin Hua's condition has basically stabilized. Lin Hua's son Lin Yaolong and I both want to transfer Lin Hua to the Department of Traditional Chinese Medicine for further diagnosis and treatment!"

Lu Junyin's face was slightly dark at the moment, but he did not directly refuse, looking at Lin Yaolong: "I can understand your mood, but our department has deliberately arranged infected patients in other wards, not in the same room, the chance of cross-infection Still small."

Lu Junyin didn't say anything to death, but the department has tried its best.

You can't let our department admit new patients, let you be alone in a room, this is VIP-level treatment, now that it has improved, I want to transfer to the Chinese medicine department, Lin Yaolong can really do it.

"Director Lu, I know what you're thinking, but my father's life is really bad. He has suffered so much in his old age, and now he's finally getting better. I really don't want him to make any more troubles. risk."

"You also know that this infection is still very scary. It is very painful for normal people, let alone my father's current situation."

When Lin Yaolong explained this to Lu Junyin, when he saw Wu Xie coming, he hurriedly greeted him: "Doctor Wu, you are here too."

"I want to come here today and transfer my father to the Department of Traditional Chinese Medicine. You won't take it seriously, will you?"

"It's definitely not, Brother Yaolong." Naturally, Wu Xie didn't take it to heart, but Lin Yaolong turned around for this reason, which made him feel a little uncomfortable.

In order to take care of you, the department has turned the 13/14 beds away. When your father moved in, he suffered from incontinence of feces and urine, and the two infected patients, Jinping and Dong Lianghe, were sick to him, right?

Oh, you didn’t think it was scary to infect patients before, so you just wanted to come to the hospital to be looked after by nurses, which is convenient for your family members.

Now that you are better, you start to dislike the infected patient in the next room. Your family can tell you all the truths in this world.

Wu Xie's tone was calm, with a faint smile on his face.

Lin Yaolong continued to explain: "Thank you, Dr. Wu, for your understanding. It is mainly because of the current Chinese medicine department, and some patients who are like my father. They can also chat with each other and discuss some recovery experiences."

"They are all old acquaintances, and it is more convenient."

"Director Lu, Dr. Wu, I have caused you trouble during this time." Lin Yaolong smiled enthusiastically, and his attitude of gratitude was still very sincere.

It's just that when Lin Yaolong said this, Wu Xie couldn't bear to take a look at Quansheng.

The Department of Traditional Chinese Medicine admitted such paralyzed patients again, and since the hospital did not have a rehabilitation department, it did not invite the surgeon for consultation.

It's normal, and surgery is not a rehabilitation specialty. It is estimated that Chang Quansheng has a disdain for modern rehabilitation medicine. He feels that the reason why Lin Hua's condition improved this time is all thanks to Xiong Yao.

Lu Junyin saw that Lin Yaolong's son was already determined, so he also said decisively: "Doctor Wu, then you can make up a transfer record later, and write down our department's transfer opinion."