When doctors have a simulated operating room

After a while, the girl was very happy.

(There are more words in the previous chapter)

The girl uttered a sigh.

Chen Fang and others beside her also helped Zhang Yi out:

"I'm sorry, beautiful lady, you recognized the wrong person, my friend is not Zhang Yi, she just looks a bit like him."

The girl blinked in confusion before slowly returning to her seat.

Seeing the girl leave, Chen Fang gently pushed Zhang Yi's arm and whispered:

"Why don't you thank me for helping you out?"

Zhang Yi immediately picked up a few leeks from the grill and put them in Chen Fang's bowl:

"Well, thank you, Teacher Chen, I'll give you these leeks to eat, and try to have two babies in three years."

"Hey, kid! Do you look down on me? Do I need to eat this?"

Zhang Yi pulled the corner of his mouth, leaned in front of him and whispered:

"Ahem, then don't eat maca either?"

Chen Fang raised his head and punched Zhang Yi lightly:

"Sure, you, you're talking nonsense after two weeks?!"

Opposite Zhang Yi, Wang Yufei was sitting next to Charlie Young with a cheeky face. Charlie Young was eating the barbecue in front of her and didn't want to pay attention to him.

During this period, Wang Yufei had been apologizing to her, but Charlie Young just ignored him.

Think about it, they used to be colleagues and could talk to each other. Ever since this guy pretended to be a boss and kissed her, Charlie Young has ignored him.

It's quite funny to think about it.

Zhang Yi looked at the two people opposite him and smiled softly.

At this time, Kang Yanming took the initiative to raise the beer glass in his hand, stood up and looked at everyone and said:

"Come on, let's drink one.

Today our department has a dinner party, I believe everyone knows the reason.

The doctors who went to the emergency training this time in Union Hospital performed very well.

Even Zhang Yi won the first place and won the title of excellent emergency doctor, haha.

I am very happy in my heart.

This year is almost the end of the year, and next Monday will be New Year's Day, and the new year will begin.

In the new year, at work, I still hope that everyone will continue to work hard and treat this job with a cautious and serious attitude.

I won't say much about the rest.

This is the first time we have dinner together since Zhang Yi came to our department.

Today, everyone can eat as they please, no need to be polite.

In addition, I am usually a straightforward person, and I also know what kind of image I have in everyone's mind.

Of course, I will not change, so let's help each other and supervise each other. "

Kang Yanming said, and the others around him laughed softly.

"Okay! Cheers!"

"Cheers!"

"Drink it, I've drunk it all, you must drink it to the bottom too!"

...

The capital is getting colder and colder at the end of December.

Zhang Yi glanced at the weather forecast, and it seems that it will snow in the capital these days.

Zhang Yi was so cold that he didn't want to ride his beloved motorcycle, so he planned to walk to work directly.

Anyway, walking a few more steps can warm up the body.

Early in the morning, when Zhang Yi left the community, it was still dark.

There was a light layer of white mist in the hazy sky, but there was no moisture in the air.

Oh, the capital is really dry.

Zhang Yi looked up at the sky:

"Good man, tomorrow is New Year's Day, it won't really snow on New Year's Day, right?"

If it really snows on New Year's Day, it's just right to take a walk around the Forbidden City during the holiday.

The Forbidden City with snow and the Forbidden City in autumn are another different scene.

Emergency Department of Union Hospital.

Zhang Yi's ears were frozen red when he arrived at the hospital.

Fortunately, the hospital had enough heating, and the moment he entered the hospital, he didn't feel so uncomfortable.

"Zhang Yi, is it time for you to see patients today? Then should I go with you?"

Chen Fang came to the office shivering, and he looked at the schedule before handing over the shift and said.

The two of them have been in Union Hospital for more than two months, and have been in the emergency department for a month.

I am almost familiar with the whole hospital.

Kang Yanming never praised Chen Fang's work performance, but he also didn't criticize her.

It seems that she has neither merits nor demerits.

"Why don't you come with me? It's just right..."

"Oh, no, no, no, Wang Yufei and He Xiao are both on vacation. Our emergency room is busy. Chen Fang can just go to the emergency room."

Zhang Yi was halfway through his words when Li Yong hurried over to interrupt him.

Now Zhang Yi is the assistant director of the department.

As long as Kang Yanming is not there, the emergency department's rest scheduling tasks and other matters are all his responsibility.

Zhang Yi is in charge.

"Okay, then Chen Fang will go to the emergency room to help."

Seeing Li Yong's request, Zhang Yi did not object.

Chen Fang spread his hands and said:

"It seems that I am just a brick, I can be moved wherever I am needed~???"

After handing over the shift in the morning, Zhang Yi also led the ward rounds.

From a distance, Zhang Yi walked in front of a group of doctors, with a kind of high-spirited temperament of a big boss.

In addition, there are many doctors older than Zhang Yi behind him.

Looking at it this way, it seems that Zhang Yi seems to be very awesome.

The old men and women who came to see the doctor couldn't help but think that Zhang Yi was a powerful person who had returned from studying abroad at a top university abroad.

At the door of the emergency room No. 3.

A middle-aged couple sat on a bench waiting for their number to be called.

Among them, the husband looked at the group of doctors making rounds not far away and said:

"Hey? Is that the doctor Zhang Yi who was on the news some time ago?"

His wife looked over there perfunctorily: "Yeah, it seems so."

"This guy is quite handsome, and I heard that he is also very skilled in medicine. How about I change my number and see if I can make an appointment with him?"

His wife's eyes revealed a trace of impatience:

"Oh, you can still choose an emergency number? The doctor is so famous, how can you make an appointment today?"

The man looked around and whispered:

"It's okay, I'll make a phone call to find a relationship."

...

Half an hour later.

Zhang Yi, who was sitting in his own clinic, received a call from the Department of Nephrology.

"Hmm? There is a patient who wants to see me? So, okay, let him come."

After hanging up the phone, Zhang Yi was still thinking that this person must be a relative.

After a while, the name of the seventh patient waiting for treatment became Jiang Yimin.

The patient came in after being called.

Zhang Yi looked up and saw that it was a middle-aged couple.

"Jiang Yimin, right? Please sit down. What's wrong with you?"

Zhang Yi's tone was unfamiliar and a little polite.

Jiang Yimin sat down with a smile, but his wife had no expression on her face.

The husband covered his stomach and said:

"Doctor Zhang, I have always felt very uncomfortable in my stomach for some time, and I always feel nauseous and want to vomit.

I also urinate very frequently, and I have to go to the toilet several times a night.

I feel very weak, and there is a dull pain in my lower abdomen. I don't know why, so I want to come to the hospital today."

Zhang Yi nodded, and while writing the main complaint on the computer, he asked:

"Frequent urination? How is your sex life?"

——

When asking this question, the patient's wife was a little embarrassed.

The patient answered generously:

"About once every two or three weeks..."

"Once every two or three weeks, you are 46 years old this year, how long does it last?"

"The length... is a bit short..."

"How short is it? You need to explain this question clearly, don't be embarrassed, your frequent nocturia must be related to kidney function, you know?"

"Oh... it's just a few minutes at ordinary times, and I feel that in this period of time, at least in the past six months, my sex life has always been getting worse and worse."

"Okay, you only have nausea and vomiting in your stomach? Do you have a burning sensation, or a foreign body sensation when eating?"

The patient shook his head: "No, I always feel nauseous and want to vomit, and I don't have much appetite, but I don't have a fever."

"Do you have a fever? Is your blood pressure high?"

"I don't know about that. I have measured it before, but I forgot."

Then, Zhang Yi took a manual blood pressure monitor and measured the patient.

A manual blood pressure monitor needs to be listened to with a stethoscope.

Squeeze the air bag and slowly deflate it. When deflation occurs, a sound similar to a pulse will be heard from the stethoscope.

The first sound is the systolic pressure, which will gradually become louder and louder until it gradually weakens. The weakest sound is the diastolic pressure.

When the sound is heard, the mercury scale on the sphygmomanometer should be marked.

For example, for this patient, when the first sound was heard, the mercury was at 160mmhg, and then the weakest sound was at 95mmhg.

Then the patient's blood pressure is 160/95mmhg.

Zhang Yi took off the stethoscope:

"Your blood pressure is quite high, 160/95. Have you ever had a cardiovascular examination?"

While asking Zhang Yi, he scanned the patient's body calmly.

There is no problem with the heart, and there is no ulcer or polyp in the stomach.

If you really feel nauseous and want to vomit, you can consider indigestion or insufficient gastric motility.

Kidney function...

Hmm?

Why do both kidneys look so strange?

It doesn't look like edema...

No

It's strong, the kidney should have some inflammation, but it's relatively mild.

"Heart disease? I don't know, I haven't had any serious illness before, usually a little illness or a hemorrhoid surgery, not so serious, right?"

Zhang Yi retracted his gaze and nodded:

"Okay, your first consideration is kidney function problems, frequent nocturia and sexual dysfunction are all related to the kidneys, you didn't eat breakfast this morning?"

"No, I guessed that I would have to draw blood or something when I came to the hospital for treatment, so I came here without eating breakfast."

"That's fine, first draw blood for your blood routine, liver and kidney function, and then do a color Doppler ultrasound and urine test."

The patient hesitated for a while and then asked:

"Then... how do I treat my high blood pressure?"

Zhang Yi explained:

"Some patients have low renal function If there is a problem, the heart and liver will also have problems.

For example, patients with renal weakness or renal failure will experience fatigue, poor appetite, anemia, renal hypertension, etc.

The human organs are all connected, and one hair can move the whole body, right?

Now I mainly suspect that you have a problem with your renal function, so you should check your kidneys first. If you are not assured after the test results come out, I will give you another cardiac ultrasound.

If you still want to see if there is any problem with your stomach, you can also give you another gastroscopy. "

"Okay, I understand, thank you, Doctor Zhang!"

"It's okay."

After typing the consultation content on the computer, Zhang Yi printed out several payment slips and examination slips.

"Go, go to the laboratory to draw blood, and collect midstream urine when collecting urine."

"Okay, thank you, Doctor Zhang!"

After that, the couple took the slips and went out.

Zhang Yi looked at the patient's back.

It should be renal weakness.

Fortunately, he came to the hospital early and did not develop renal failure.

If it was just renal failure, he could recover with timely treatment.

But... this man is only 46 years old. How could he have renal failure so early?

Did he take any medicine? Or was it caused by irregular diet and daily routine?

Doctors sometimes have to not only treat but also help patients find the cause of the disease, so that patients can avoid coming to the hospital again for the same reason next time.

...

An hour later.

Jiang Yimin came back with the examination form.

Zhang Yi looked at several important indicators.

Hemoglobin: 115g/L.

For an adult male, 115 is a bit low, a bit of mild anemia.

Decreased renal function can indeed lead to renal anemia.

Blood creatinine: 148μmol/L (133-177μmol/L)

According to the test indicators of Union Hospital, 148 is slightly high, which is consistent with the first stage of renal insufficiency compensation, that is, renal failure.

Urea nitrogen: 9.6mmol/L (1.7-8.4mmol/L)

Urea nitrogen is also slightly high.

Urine sediment is also slightly high.

In the blood routine test, white blood cells and neutrophils are also elevated.

Blood potassium: 5.7mmol/L (3.5-5.5mmol/L)

After reading the results, Zhang Yi raised his head and asked:

"How are your eating and sleeping habits in the past six months? Have you taken any food or medicine that is not good for the kidneys?"

The patient shook his head repeatedly:

"No, I didn't take any medicine, and I ate normally.

I have never had any serious illness. I just had a hemorrhoid removed when I was in my thirties. Oh, and I was hospitalized for a few days of intravenous drip for appendicitis. I have never been to the hospital at other times.

I am usually very healthy, in good health, and I don't feel uncomfortable.

It's just that in the past six months, it's not right. It should be these three or four months. I feel something is wrong with my body.

Hey...doctor...do I have kidney cancer?"

The patient is very worried about his condition.

"It's not kidney cancer, you have renal failure, also called renal insufficiency.

Don't be so nervous, you came to the hospital early, this disease can be cured."

"That's good, that's good, but why is my kidney function weakened? Is it because I'm old? Is it because I'm old so I can't do it?"

Zhang Yi shook his head and said:

"That's not necessarily true, some old men in their sixties and seventies are still strong.

Your blood routine shows that both white blood cells and neutrophils are high, indicating that your kidneys still have a slight inflammation, of course, poisoning cannot be ruled out.

Because the neutrophil count is also elevated, it means that it may be caused by bacterial infection or poisoning.

This needs further examination, and because of renal insufficiency, the potassium in your body cannot be excreted, which is more dangerous.

Your blood potassium is high now,

I dare not let you go back, you know?

You have to be hospitalized. If your blood potassium is not high, I can let you receive intravenous treatment in the outpatient clinic.

But your blood potassium is high, so you have to be hospitalized.

You always feel weak, nauseous and have polyuria, which is the reason for high blood potassium.

High blood potassium can kill people, and it is easy to cause arrhythmia and cardiac arrest.

So, I suggest you be hospitalized.

In addition, I will also prescribe some Chinese patent medicine for you, such as Jinkui Shenqi Pills and Liuwei Dihuang Pills, which are all for protecting the kidneys.

In addition, you can also eat more kidney-protecting foods, such as pig kidneys, sea cucumbers, black rice, and leeks. "

"Ah? He still has to be hospitalized?"

At this time, the patient hadn't spoken yet, and his wife, who had been silent throughout the whole process, immediately said with an unwilling expression.