bookpower Chapter 662
Chapter 662
「662」
Lin Feng did not deliberately make a different diagnosis in order to scare Wang Lin.
He is well-founded.
"Do you wake up in the morning feeling stiff in your limbs?"
Miss Liu nodded repeatedly: "Yes, you have to rub for a long time or move a little to slowly unfold." "
Lin Feng smiled: "Then it should be right, this is called morning stiffness, which is a manifestation of rheumatic immune diseases invading joints." "
Then Lin Feng asked again.
"Is it that when you exercise, it doesn't hurt so much, and when you rest, it hurts more?"
"That's right, that's it, I feel motor every time, which can alleviate the pain..."
Lin Feng nodded.
"That should be right, it may be a rheumatic immune disease, specifically ankylosing spondylitis..."
"Ankylosing spondylitis" is a chronic autoinflammatory disease, generally only involving joints, the most common is inflammation of the sacroiliac joints and spine, so there will be low back pain and hip pain.
This is why it is misdiagnosed as "lumbar disc herniation".
(Mention "rheumatoid immune disease": it is a series of diseases in internal medicine, mainly including rheumatoid arthritis, ankylosing spondylitis, systemic lupus erythematosus (written in chapters 648-650), osteoarthritis, gout (written many times), primary Sjogren syndrome, etc.) ）
Miss Liu was stunned: "Doctor Lin, rheumatism, isn't it only for the elderly?" I'm still so young..."
Now on TV spam ads, most of them are elderly ads, and then rheumatism is the kind that accounts for a large proportion of spam ads.
Therefore, when she heard rheumatism, she thought it was an old man's disease.
Lin Feng shook his head: "Rheumatism is not an old man's disease..."
Miss Liu nodded.
Anyway, she still trusted Lin Feng very much.
At this time, Miss Liu's mother couldn't help but ask, "Doctor Lin, then what should my daughter do now?" Is the disease serious? "
Lin Feng shook his head.
"I'm just guessing, let's check it first, confirm it before talking..."
Check the items:
Blood routine, erythrocyte sedimentation rate, C-reactive protein
liver and kidney function,
Rheumatoid factor (rheumatoid factor is an antibody, an increase in rheumatoid factor means that the body's immune function is abnormal)
HLA-B27 (HLA-B27 is a genetically encoded protein, its function is to transmit characteristic recognition signals to the body's guardian - T cells, so that T cells can characteristically kill the tissues that need to be killed, and positive patients are particularly prone to lose the ability to identify "self" and "non-self", treating some of their own substances as foreign invaders, resulting in an attack by the autoimmune system, which in turn produces ankylosing spondylitis or diseases of similar spectrum (such as spondyloarthropathy))
· CT。
Lin Feng opened the order,
The nurse obediently went to draw blood and sent it for examination.
After doing all this,
Lin Feng left.
Wang Lin, who was very faceless, saw Lin Feng leave, and returned to the ward angrily.
I looked at the checklist.
"Ankylosing spondylitis?"
Wang Lin was stunned for a moment.
I couldn't help but feel a pang of shame.
He realized that he seemed to be too arbitrary to even consider ankylosing spondylitis!
"Hopefully it's not ankylosing spondylitis..."
"Otherwise, my face will be lost!"
......
The fight between Lin Feng and Wang Lin soon spread throughout the emergency department.
"I'll go, the style is awesome!"
"Well done!"
"Laugh at me to death, don't care what director you are not a director, the patient just doesn't want you."
"Gee, this face, it really hurts to beat~~"
"Blood has been drawn and sent for examination, and if it is really determined that it is ankylosing spondylitis, it will be a second time in the face."
"If you hit your face for the second time, I'm afraid that this Director Wang will lose face."
"Tomorrow the result, everyone please wait quietly, haha~~~"
"This melon, sweet!"
The entire department, some bold or unhappy doctors and nurses, all said loudly.
It can be clearly seen that the director of this heart and the three team leaders are not popular.
After all, the matter of replacing medical equipment is in everyone's eyes, and they are unhappy in their hearts.
......
Time flickered,
By the next day,
The results of the patient's much-anticipated examination in the emergency department came out.
· CT and CT are the first to come out, and bilateral sacroiliac joint localized erosion and sclerosis can be seen. (The MRI in front is not to look at the sacroiliac joint, but to look at the lumbar spine, so I didn't see it)
Erythrocyte sedimentation rate and C-reactive protein are elevated: This means that the patient does have inflammation in the body.
At present, with Miss Liu's condition, it is definitely not inflammation caused by bacterial virus infection, because there is no sign of infection.
So, to eliminate "infectious inflammation",
All that remains is "infectious inflammation".
This is the rheumatic immune disease.
At last
Hit the nail on the head!
· HLA-b27 gene, positive!
Didn't run!
Proven to be ankylosing spondylitis!
soon
The inspection report was sent to the group.
The whole department knows it.
Where is this waist disc protruding!
There is no need for 'tens of thousands' of surgery at all!
This face, snapping ~~ beat Wang Lin to the point of redness and swelling.
The doctors and nurses in the department are simply happy to hear it.
"These bastards!!"
"Boom~~~"
Wang Lin exploded in anger, patting the table and his face was livid!
Gnash one's teeth!
Unexpectedly, he would be educated by a small master.
I, but from the lighthouse nation!
......
At this point,
Lin Feng is in the ward,
Miss Liu already knew the results of the examination.
"Ankylosing spondylitis"!
However, she panicked.
This disease, she Baidu checked, terminal illness!
Didn't save it!
"Doctor Lin, can I save this disease?"
She'd rather have a protruding disc at the waist!
Lin Feng smiled.
"Don't worry, it can be cured..."
At present, there are still many studies on ankylosing spondylitis in the world.
The occurrence and development of this disease is related to many molecular substances, such as IL-17, tumor necrosis factor (TNF), etc., as long as it can antagonize one or several of these substances, it can antagonize the occurrence of joint inflammation.
And antagonist drugs, there are no less.
There are expensive ones, cheap ones, and health insurance.
Injections are given once a week at first, and later once a month.
It doesn't have much impact on life.
This disease is different from those diseases that can damage the internal organs and brain, it only affects the joints, does not affect the life expectancy.
Of course, the medicine must be used according to the doctor's advice, otherwise it may cause joint deformation or even disability.
"Really?"
Miss Liu was pleasantly surprised.
This is much better than surgery!
After all, if the operation is unsuccessful, the person will be finished.
"Don't worry, I'll give you an injection later and see the effect... It is estimated that it will get better in a week..."
Lin Feng said with a smile.
。