bookpower Chapter 668
Chapter 668
Chen Li read the patient's medical record information in the medical record system.
· History of type II diabetes, more than 10 years.
A year ago, the patient's elderly (61 years old) developed hyperpigmentation, accompanied by symptoms such as loss of appetite, bloating, constipation, dry skin, less sweating and insomnia.
Because these symptoms have basically no impact on daily work, patients have always treated their symptoms according to the traditional old methods at home.
The disease was not cured, but the symptoms worsened.
New developments have also emerged.
Symmetric pitting edema, numbness of the lower extremities, weakness of the left lower extremity
The patient's old man, at this time, still did not go to the hospital to see a doctor.
Continue to use other traditional recipes and treat yourself.
And then
The problem is getting worse.
The edema is getting worse.
Both lower limbs are about to turn into giant radishes.
At this moment, the patient's family could not sit still.
Rush to the hospital.
The lower-level hospitals (the poor hospitals, in the eyes of the large hospitals, do not deserve to have names) questioned and examined the patients' elderly homes.
Finalization:
· Addison disease (primary chronic adrenal insufficiency)
Hypothyroidism
The two diseases are mixed.
adrenal insufficiency, resulting in loss of appetite, bloating and constipation;
Hypothyroidism, resulting in dry skin, less sweating, and edema of the lower extremities.
As for skin hyperpigmentation, it is because of one of the symptoms of Addison disease (the specific explanation is a bit long, probably the oversynthesis of adrenocorticotropic hormone, which then triggers a large synthesis of α-melanocytes hormone).
Kennedi, the president of the lighthouse country, has this disease and has very dark skin.
......
Chen Li, a doctor in the Department of Endocrinology at Harmony Hospital, after reading this medical record,
I couldn't help but wonder.
This diagnosis,
Very clear, symptoms correspond,
The next step is just to supplement hormones and symptomatic treatment.
"Then why did the patient transfer to Harmony Hospital?"
"Is the patient cured?"
With curiosity, Chen Li continued to look through the medical records of the lower-level hospital...
You can see the corresponding treatment of the lower level hospital in the medical record.
Hydrocortisone (also known as cortisol): treatment for adrenal insufficiency
Levothyroxine: corresponding to the treatment of hypothyroidism
Diuretics: correspond to edema, urination
All correspond to treatment.
Chen Li saw this treatment and recognized it very much, because even if he came, he used the medicine like this.
Then there's the medication result.
The patient's old man, sure enough, quickly 'cured' and discharged.
But also continue to take medicine.
But!
Later, the problem reappeared!
The patient's condition in the elderly family recurred again, and it worsened!
Increased edema of the lower extremities,
Increased pigmentation,
Increased numbness in the lower extremities
The lower hospitals are out of rut.
It can't be cured.
Transfer can only be made to a higher hospital.
Then I came to Harmony Medical Hospital.
"This disease..."
"What the hell is going on?"
Chen Li scratched his head.
Because even if it is him, the diagnosis and treatment will not be much worse than that of the lower level hospital.
"Forget it, go and ask the patient..."
soon
The patient's elderly family arrived at the hospital, then admitted to the ward of the endocrinology department, entered Chen Li's group, and then Chen Li was the doctor in charge of the bed.
As a bed doctor, Chen Li began to find patients and family members to inquire about the situation and understand the condition.
· Asked about a new condition: insomnia...
And then I went to a psychiatrist to diagnose,
Diagnosed with a new condition: depression...
......
Got to know everything,
Doctor Chen Li began to prescribe medicine.
Considering that his patient has a history of type II diabetes for more than 10 years, perhaps because the diabetes is not well controlled, resulting in poor drug effects, Chen Li increased the drug dose on the basis of the original in the lower level hospital.
Psychiatrists for starting treatment with haloperithioxine melitraxine tablets.
billing,
Medication
soon
A week passed.
During the period, the professor who led the group also questioned the patient during the ward rounds, and finally affirmed Chen Li's treatment plan.
Finally, after a week of medication.
The result was unexpected by Chen Li!
The patient's condition has not improved significantly!
And then
A new situation has emerged:
Anemia!!
This kind of patient can only make Professor Chen think a little bit in the end.
Professor Chen considered: "Addison disease has not improved after treatment, coupled with anemia, consider autoimmune diseases. "
Then, I spent another 2 days to get tested for immune antibodies, but nothing came of it.
Then, starting from refractory pitting edema, hyponatremia, heart failure, hypoproteinemia were excluded...
At last
The patient is still the same, not cured!!
Chen Li: ".................."
Professor Chen: "..........................."
Department of Endocrinology: ".............................."
Scratching your head!!
This patient,
It's so weird!!
"What kind of disease is it?"
"Isn't it an endocrinology disease? Are it other diseases? "
Professor Chen, who led the group, finally thought about it:
"Let's consult... Find neurology, psychiatry, gastroenterology, brain, kidney... All internal medicine, and..."
Professor Chen thought about it and couldn't help but think of Lin Feng.
"Call Dr. Lin Feng in the emergency department and ask him if he is free to come for a consultation..."
"The time is set for 12:30 noon..."
"Yes!!"
The nurse led the way...
Calls to various departments to go.
......
......
Emergency Department,
Lin Feng is still sitting in the clinic today,
Not long after, the nurse's station came running over and said that the endocrinology department had asked him for a consultation.
"Consultation?"
"Okay, I'll go over at noon..."
......
Not far away,
Doctor Wang Lin heard this,
“........................"
Lin Feng is an emergency and runs to go for a consultation?
Odd.
......
midday
Endocrinology General Consultation.
All departments of internal medicine are basically here.
Lin Feng walked into the endocrinology ward.
"Doctor Lin..."
"Doctor Zhang..."
Greetings are ~~~
Soon, many doctors surrounded the patient and began to consult with the patient.
The patient was a little nervous when he saw so many doctors. But he was also very happy, because this disease afflicted him for a long time, repeated repeatedly, and was hospitalized several times without cure.
Lin Feng first looked at this patient:
Thin, mentally weak, with a painful and frustrated expression on his face, several pigmentations on his skin are very conspicuous.
。.