I Spent Those Years In the Operating Room Fighting Monsters
Chapter 481: Never feel like you understand a new disease...
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Lu Cheng looked at the name written on the other party's clothes, it was Lan Lingzhi. He nodded and said, "Yes, Teacher Lan."
"Now that there are no people in the department, I will come to the clinic."
"Mr. Lan, you may not have the corresponding equipment here. I have to go to the orthopedics department to get it and come back."
Before Lu Cheng brought a tool for skin traction, he thought it was enough, but this was not enough, so he had to change the tool.
"It's hard work for you, Dr. Lu." Lan Lingzhi was originally from the Second Xiangya Hospital, so she had heard Lu Cheng's name earlier, and now, as the attending physician of the Department of Respiratory Medicine, she listened to Lu Cheng's ear. The name almost sounds like a cocoon.
Whether it's a professor or a meeting, the name Lu Cheng will always be chanted by his ears.
Then, I found out that he was an orthopedic doctor.
Some time ago, Lan Lingzhi felt that Lu Chengcheng was the kind of person who likes to show off very much. Otherwise, as long as he is a normal orthopedic doctor, he would not think about going into internal medicine.
However, after contacting him now, I feel as if my previous thoughts were not quite right.
Lu Chengcheng said: "It's okay, Teacher Lan, these are what I should do."
"Mr. Lan, this patient, I think you still have to find a way to scan him with a CT scan and 3D reconstruction." Lu Cheng said as he walked out.
Lan Lingzhi nodded first when she heard the words: "Okay, we will arrange for a nurse to make arrangements immediately."
Nowadays, patients are not allowed to have family members together, and if it is not convenient for them to do the examination alone, they can only hire nurses to transport the patient.
Lan Lingzhi habitually nodded and agreed with Lu Cheng's professional opinion, and then asked, "Doctor Lu, this patient has already been diagnosed. Should CT be performed? He is also not suitable for surgery?"
In fact, Lan Lingzhi is reluctant to make such a trip. It is quite troublesome for a patient to go out at this time, especially a doctor of respiratory medicine.
The path should be disinfected throughout the process, and the used CT room should be temporarily closed, and disinfection with ultraviolet rays will increase a lot of workload.
Lu Cheng said: "Oh, that's right, this patient is not very old now, only sixty-one or two years old, and from the plain film, although I have a certain degree of osteoporosis, it is judged by bone density. ."
"He shouldn't fall into a fracture so easily, so I want to take a CT to see if there is any bone damage at the broken end of the fracture."
"The current pelvic plain film is taken after the fracture. After the fracture, there will be bleeding shadows in the vicinity, and the bleeding shadows will block the shadow of the bone destruction itself."
"Of course, this is just my worry." Lu Cheng just stated his speculation.
But it is well-founded and logically clear.
Lan Lingzhi smiled and replied, "Oh, okay. Doctor Lu."
"I heard your explanation very clearly and clearly."
…
After giving the patient bone traction, Lu Chengcai took off the protective suit and the double-layer surgical gloves he was wearing. .
Most of the patients in the Department of Respiratory Medicine are UID patients, and these things are not dared to be brought back to the Department of Orthopedics for reuse.
When leaving, Lan Lingzhi took the initiative to say, "Doctor Lu, if there is any situation later, I will contact you directly through vx?"
"Okay, Teacher Lan." Lu Cheng nodded back and walked towards the intensive care unit.
That is Fang Nixin's ward.
It wasn't that Lu Cheng went to see her on purpose, but Chang Weilong just called and said that there was a consultation over there too. He couldn't leave for the time being, and hoped that Lu Cheng could go and have a look.
Lu Cheng nodded and agreed, with a strange thought in his heart.
Chang Weilong didn't come to the respiratory department or the intensive care unit. Did he deliberately send me to a dangerous place?
But then, Lu Cheng shook his head again, Chang Weilong should not be such a person, everything is just a coincidence. And it just so happened that he could also use these two opportunities to include the cases in the intensive care unit into the scene skills.
…
After arriving in the intensive care unit, it is still necessary to change into new protective clothing!
Although Lu Cheng felt that this was a bit wasteful, there was nothing he could do about it.
After entering the room and seeing the patient to be consulted, the doctor in charge of the bed happened to come, and it happened that Fang Nixin was in charge.
She was stunned for a while, patted Lu Cheng on the shoulder, and said in a somewhat inappropriate tone: "Lu Cheng, why are you here? Isn't Brother Long on duty today?"
"I just called him."
Fang Nixin used to stay with Chang Weilong in the fourth department of bone, so she naturally knew that the person who answered the phone was Chang Weilong, not Lu Chengzhuang.
"Brother Long went to another place for consultation, so he sent me here to see. What's the situation of your patient? Why do you still call Brother Long for consultation?" stunned.
Thinking of this, Fang Nixin is a person from the Department of Orthopedics, and she is always hospitalized. She is familiar with the consultation process. Is there no one in the intensive care unit who knows about this?
Let Fang Nixin see for herself, won't you have to?
He also specially called an orthopedic consultation, doesn't this seem a bit painful?
As soon as he met Fang Nixin, Lu Cheng simply asked directly in person, without too much estimation.
Fang Nixin's eyes blinked, but instead of returning to Lu Cheng's words, she said: "It seems that the rumor is true, Professor Chang really doesn't plan to work in the clinic, and will focus on transferring to the functional department in the future. So Now it is a one-day shift if you can escape a day, and if you can run away from dangerous places, run to dangerous places.”
Lu Cheng's expression flashed: "Ah? Is there still such a thing?"
Fang Nixin sighed: "After Professor Min Hong served as the chief director of the Department of Orthopedics before, he later promoted Associate Professor Zhu Lihong to be the director of the fourth department of Orthopedics. At that time, Mr. Zhu was still attending."
"Chang Weilong naturally has certain thoughts in his heart. Although he hasn't shown it, he definitely thinks so in his heart, so he seldom went to the department after that, and rarely performed operations. Even the number of outpatient visits was reduced."
"Even the students, haven't they been lost to you for several months?"
"As soon as the uid came out this time, Chang Weilong immediately applied for the idea of leaving the clinic and wanted to devote himself to teaching."
"It's just that I haven't shied away for a while, and then others have come out to support other places one after another. Now the hospital is understaffed, and the graduate students are all staying in their dormitories. There is not much student work that needs to be done in the office."
"Brother Weilong just returned to the department, but he seems to be reluctant."
After Fang Nixin sighed, she shook her head.
He muttered: "It's not the position of the ward director that makes trouble. Professor Chang thought that after Professor Min Hong became the chief director, he would be the most suitable to take over the fourth department of orthopedics. After all, he is the only one with the right title and age."
"I didn't expect that Professor Min Hong would make Zhu Lihong an exceptional promotion."
"In the department, there is a truth that, if it is not the director of the ward, it is a part-time worker, and no one is convinced. Mr. Zhu is not good at saying anything about Mr. Chang's choice. Basically, he doesn't care. ."
Chang Weilong was already a vice-senior. When Zhu Lihong took over as director, he was not a vice-senior, and he was not on the same level. What do you do?
Lu Cheng asked, "Then Professor Huang, didn't you say anything?"
"What do you think?" Fang Nixin asked back.
Lu Cheng thought about it, but it's really hard to say. Although Professor Huang You is old, how can he intervene in the affairs of young people, and Chang Weilong has already withdrawn voluntarily. Aggressive mean?
Moreover, what Chang Weilong lacks is not high-tech technology, but is too defensive and does not have the same fighting spirit as Min Hong.
Therefore, it may not be so to Min Hong's appetite.
"It's hard to say, but. I think we should not speculate. When I went back to the department, Brother Long took good care of me." Lu Cheng shook his head, not planning to continue arranging Chang Weilong.
Before everything is settled, KW should not add his own subjective emotions without authorization, otherwise it is very likely that a good person will be wronged.
This is not what Lu Cheng wants to see.
In this world, there are too many things that reverse.
"Well, good." Fang Nixin opened her mouth, holding back what she wanted to say.
Lu Chengcai asked, "Fang Nixin, can you be a patient yourself?"
"Bone destruction." Fang Nixin said.
Then he took out the results of the CT scan and handed it to Lu Cheng to see: "Look, it's all eroded here. This patient has no trauma, but he broke a bone on the way out for an examination."
"Now the Department of Orthopedics is not open, so I can only call the general ward."
"Come and see."
Lu Cheng took a look, and sure enough, there was a semi-open cavity in the middle of the femur, and the contents inside could not be swept out, but this vacancy was very clear on CT.
"Have you scanned the nuclear magnetic field?" Lu Cheng asked.
Whether it is an infection or a bone tumor, it is very important to determine the plane and size of the MRI scan.
"I scanned it, and I didn't see a solid mass. There was no periosteal reaction on the plain film, and even edema, which is common in infection, was not seen, so it was quite strange."
"I just called for a consultation."
Fang Nixin returned, pointing Lu Chengzhi to the key points she saw.
She would not have any problems with conventional orthopedic problems, but in this case, it belongs to the category of very intractable diseases.
I'm not sure, of course I have to ask someone with more experience, but I didn't expect that Lu Cheng was called by a phone call. If I knew earlier that it was Lu Cheng, he might as well send a video to Lu Cheng directly. place.
Lu Cheng took a serious look, frowning fiercely.
There are not many signs of edema on the bone, and bacterial infection is unlikely. Bacterial infection will cause large areas of bone marrow edema.
There is no substantial tumor, but there is a real defect in the bone...
This is quite strange, can this bone still disappear out of thin air?
Lu Cheng then asked, "Does this patient have any history of lower extremity pain before?"
Not now, does not mean that it has not happened before, but the symptoms may have been eaten accidentally after taking oral antibiotics, but the bone destruction has not been filled.
When I was admitted to the hospital, I did not do a routine pelvic plain radiograph, so I would not know that there was a bone defect. This can only be speculated from the medical history.
Just like investigating a case, it's slack.
Fang Nixin shook her head: "I have considered this, the patient has never had a history of leg pain and fever. He does manual labor, and he relies on this to eat. If there is bone destruction before, with his workload, It's already broken!"
"Is it the uid?" Lu Cheng then asked.
"Yeah!" Fang Nixin nodded.
"This patient is in a relatively critical condition. It has been nearly a month now, and it has been 26 days since the diagnosis."
Lu Cheng thought about it and said, "Without the comparison of the test results before and during hospitalization, it is not easy to draw conclusions."
"However, if the edema signal and the boundary of the tumor are not found on the MRI scan, it is not easy to perform even bone marrow puncture. This patient should be treated as a conventional fracture, and then a CT scan of the chest and abdomen is performed. Look."
"Look if it's a special ca or other metastases like tuberculosis..."
In fact, Lu Cheng had a very bold guess in his heart, but this guess was a little absurd, and it was difficult for him to confirm it, let alone find evidence.
However, he still has a way to prove it.
"Okay!" Fang Nixin felt that this was the only way at the moment. Now the patient's current condition, even if the doctor is willing to perform surgery on him, UU read www. uukanshu.com His own lung function is not suitable for surgery.
Pulmonary infection, which affects patients with respiratory function, belongs to a category of contraindications to surgery.
…
After coming out of the intensive care unit, Lu Cheng returned to the ward as soon as possible, and then did one thing, which was to evolve in the scene skills—
The type and frequency of the various complications that can arise without the patient doing anything about it.
Let's see if this vi is a very special kind. They will devour a strange type of osteoblasts. If so, you have to take precautions in this regard, and you have to supplement calcium and promote the activities of osteoblasts.
The reason why Lu Cheng didn't consider this aspect before was that he only thought about how to cure the patients, and never thought of referring to their possible complications first.
This is a place that Lu Cheng overlooked.
As a doctor, it is natural to instinctively want to cure diseases and save people.
But unfortunately, it is a fact that everyone will face. To understand a disease, we must first thoroughly understand its complications, and then we can prevent and treat it…
Leave it alone, the time in the scene skill is accelerated.
Five hours later.
Lu Cheng's face was slightly heavy and he withdrew from the battle scene skills.
Sure enough, bone destruction is one of the complications of vi, and in addition to bone destruction, the increase in calcium ions in the body is also one of their common complications, and it can also lead to hypercalcemia in a short period of time. disease.
High calcium is likely to cause a variety of abnormal electrical activity and sudden death.
The electrolytes of patients are checked and adjusted every day, so they may not be in such danger, but if they are medical staff, they have no obvious symptoms, but they are infected.
Gao Ca, Teacher Nie, and Lu Cheng suddenly had a very bad warning...
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