When doctors have a simulated operating room
Chapter 421
The patient was in a panic, but the doctor said that he was not happy.
"Zhang Yi, there is a medical record in the group. Do you want to take a look? It's quite strange."
Chen Fang took the phone and quickly flipped through the medical record.
Just now, Chen Fang also took a look at the medical record. The symptoms of the patient were simply unbearable to look at.
He thought that since the director of the respiratory department asked the whole hospital to participate in the discussion, Zhang Yi should take a look at the medical record.
What if Zhang Yi can find the reason?
But Zhang Yi shook his head and said:
"I don't have time now. There is a limb replantation waiting to go into the operating room."
After Zhang Yi finished speaking, he didn't even look at the phone and just passed Chen Fang.
"No, wait a minute, this patient is really weird, with skin ulcers and pus all over the body for unknown reasons, not only the skin, but also the lungs, respiratory tract, lymph nodes and even bones are corroded."
Chen Fang said while chasing Zhang Yi.
Only then did Zhang Yi stop.
Hmm? ?
Skin ulcers? And pus?
Even bones are involved? ?
What's so weird? ?
"Which medical record, let me see it?"
Zhang Yi turned his head and looked at Chen Fang's mobile phone.
The patient's name is Li Xiaojun, male, 29 years old.
The main complaint is 'skin and organ ulcers all over the body for more than 2 months, fatigue, poor appetite and multiple lymph node enlargement all over the body for more than 3 months'.
Transferred from Didu City Infectious Disease Hospital to our hospital for treatment.
Physical examination upon admission: T38.5℃, P116 times/min, R24 times/min, BP88/58mmhg.
Blood oxygen saturation: 92%.
Blood examination upon admission:
White blood cells 21.5×10^9/L,
Neutrophils 70.0%,
Lymphocytes 17.3%,
Hemoglobin 101g/L,
Platelet count 273×10^9/L.
Virus test: Anti-HCV (Hepatitis C) positive, HIV (AIDS) negative, TPPA (Syphilis) negative.
At present, it can be seen that this person has inflammation, low fever, and high white blood cells.
And as a 29-year-old young man, hemoglobin 101 is already anemia.
In addition, the patient also has the infectious disease of hepatitis C.
But Zhang Yi thought about it, the liver is the most affected by hepatitis C, and it should not be the case that there are multiple ulcers all over the body.
Zhang Yi glanced at the pictures of the wounds on the patients in the group.
It was an infection at first glance.
Viruses, bacteria, or fungi must be one of them.
But how could it not be cured?
Zhang Yi was puzzled, but he continued to read on patiently.
PET-CT: Emphysema, bilateral consolidation, multiple small translucent areas in the lung fields, like worm-eaten. Accompanied by systemic lymphadenopathy.
The range of this systemic lymphadenopathy is still very wide, including the supraclavicular fossa on both sides, the left axilla, the right hilum of the lung, and the mediastinum, the retroperitoneum, and the porta hepatis. The largest size is 2.92cm×2.94cm.
Zhang Yi frowned at the test results.
Why is it getting more and more strange?
There is also a bacterial culture picture detected by the laboratory, which looks like tuberculosis!
They are all in the shape of a red flower.
But the diagnosis and treatment record says that the anti-tuberculosis drug treatment is not effective?
What's going on? ?
Zhang Yi was puzzled.
After anti-tuberculosis drugs were ineffective, the infectious disease hospital changed to drugs such as Rocephin and Teicoplanin to fight infection.
The treatment effect was not good.
The final diagnosis given by the infectious disease hospital was:
1. Pulmonary tuberculosis to be investigated? 2. Bloodstream infection to be investigated? 3. Systemic lymphadenopathy to be investigated? 4. Bilateral lung congestion 5. Hypoproteinemia.
Wow, a row of diagnoses is full of question marks.
"This medical record is interesting." Zhang Yi became interested after reading it.
Chen Fang pursed his lips and said:
"I'll tell you, you didn't read it just now, the whole hospital is helping to discuss this medical record.
I heard that the infectious disease department can't treat it, and they can't find the cause and can't prescribe the right medicine, so the patient's condition is getting worse and worse.
Director Kang looked unhappy when he came back from the consultation just now. I asked Xiao Long about it.
Do you know why Director Kang and Director Tian divided the department into two?"
Chen Fang became mysterious as he spoke.
Zhang Yi shook his head: "I don't know, why?"
Chen Fang looked around carefully and whispered in Zhang Yi's ear:
"Because five years ago he
A patient with symptoms very similar to Li Xiaojun appeared in our emergency department.
I heard that it was a 17-year-old girl, still a minor.
Although the situation was not optimistic when she came, the girl had a very good mentality.
She smiled every day, and you couldn't tell that she was dying.
Alas, she died in the end, in less than a week.
Her condition deteriorated very quickly, and no one had time to react, and the girl was gone.
It seems that because of this incident, there seemed to be some feud between the two directors, so the departments were separated. "
"Oh, it turned out that it was because of the two patients that they quarreled so much? "
Zhang Yi also gossiped for once.
Whether he was an intern or an intern in the emergency department, or other college classmates were doing internships in the emergency department.
He had never heard of such clear divisions in the emergency department.
Never seen two leaders of a department quarreling in the department so tensely.
Sure enough, there must be some unmentionable past between them!
Just at this time, the worker with a broken hand in the treatment room also came out with a painful face supported by his colleagues.
"Doctor, when will I have the operation... My hand hurts so much..."
The patient and other workers were urging him.
Zhang Yi had to hurry to prepare for the operation.
As for this patient named Li Xiaojun, Zhang Yi remembered it in his heart.
He planned to take a good look at the medical records after the operation. If possible, he also wanted to go to the respiratory department to see Li Xiaojun in person.
This patient's condition is too Special.
Zhang Yi has never seen such a disease that corrodes the inside and outside.
And this pathogen is strangely similar to tuberculosis bacteria, but it is not tuberculosis bacteria?
It's really strange!
After I go back tonight, I will go to the simulation library to see if I can find a book related to microbial pathogens.
...
Soon, Zhang Yi went to the emergency operating room.
Zhang Yi was the main surgeon, and Chen Fang was the assistant.
There is also Xiao Long.
Xiao Long is now a famous brand and wants to stand on Zhang Yi's side.
Just because he said something for Zhang Yi in the morning, he is now completely unwelcome in front of those old employees.
I can only follow Zhang Yi.
Xiao Long looked at Zhang Yi and prayed silently in his heart:
God~
Please bless~
Make sure Zhang Yi gets promoted~
Otherwise, I will flatter the wrong person~!
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