bookpower Chapter 650
Chapter 650
"By the way, check the blood routine..."
Lin Feng instructed.
Although the patient Chen Juan's vital signs are normal, Lin Feng is still a little unable to hold it in his heart, and he feels as if he has not considered anything.
Back to the duty room, change clothes...
Preparing to leave work,
But thinking about it, Lin Feng was still a little relieved.
"Forget it, leave work later..."
Lin Feng returned to the ward and showed the patient Chen Juan.
Student Xiaoru saw that Lin Feng did not leave work, and she was embarrassed to leave work, so she followed this to work overtime.
After half an hour,
Expedited blood routine, out.
The tube bed doctor took a look and was taken aback!
"Doctor Lin, look, platelets!"
Lin Feng looked at the computer screen, "Blood routine report":
White blood cells, still falling...
Platelets, platelets 76!
Platelets, the normal value of the human body, are 100-300...
If it is less than 100, it will be called "thrombocytopenia"!
What is the function of platelets?
Blood clotting!!
With fewer platelets, it is naturally easier to bleed!
With so few platelets, it is no wonder that the patient will cough up blood, coupled with a severe cough, it is really easy to cough up the blood vessels in the lungs and cause bleeding.
But
Why are platelets lower?
The reason?
Lin Feng thought of "serious infection", which inhibited the production of platelets.
But
CT of pneumonia shows that it is obviously not serious!
Will there be blood disorders?
Like leukemia?
Lymphoma?
"If you want to determine leukemia, you need to do a bone marrow aspiration..."
"If you want to confirm lymphoma, you need to do a new CT all over the body..."
Lin Feng thought about it,
Slowly.
Bone marrow aspiration is not easy...
And CT has already been checked once before, try not to do it, after all, there is radiation ...
"Do you usually have night sweats?"
"No..."
Night sweats are one of the typical symptoms of lymphoma.
In addition to this, there is dry and thin...
Lin Feng observed the patient Chen Juan, the body shape is not dry and thin, slightly fat...
Lymphoma can be ruled out temporarily.
Lin Feng thought about it, the bone marrow aspiration was put first, and he continued to consult first to see what the situation was first.
Asked for a few more minutes,
suddenly
The patient Chen Juan said a new situation, which had not been said before.
"Doctor Lin, I seem to have some rashes on my chest and back, I don't know if it matters..."
It immediately attracted Lin Feng's attention.
"When did it happen, itchy or not?"
"There were some two days ago..."
"Can I take a look?"
Lin Feng asked, but did not seem obscene.
"Yes, trouble Dr. Lin."
Patient Chen Juan agreed without hesitation.
Then lift your clothes to reveal the area of the rash.
Lin Feng looked at it, did not see anything special, and for a while there was no way to determine what kind of rash it was.
Because red rashes are also very complex, there may be more than a dozen rashes for the same manifestation.
Lin Feng synthesized all the previous clues:
Fever, cough, coughing up blood, joint pain, rash, hair loss, thrombocytopenia, decreased white blood cells...
It is certain: pneumonia is certainly not the main cause!
Tuberculosis is also not right!
Leukemia doesn't work either!
suddenly
Lin Feng thought of a disease!
"Systemic lupus erythematosus"!
It is a rheumatic immune disease!
At the beginning, the reason why Lin Feng did not consider it was because the patient had a high fever of more than 39 degrees, and the diseases in rheumatism and immunity were mainly medium and low fever, and there was rarely high fever.
But
The crowd seeks him a thousand degrees,
Rule out other diseases...
It seems that only rheumatic immune diseases, especially "systemic red lupus spots", are more consistent.
monism
It explains all the symptoms of the patient.
However, "systemic red lupus sores", a typical red rash, is - butterfly erythema.
And the patient in front of her, Chen Juan, did not.
"Wait for tomorrow..."
"A set of rheumatism has already been sent to the laboratory department, and the rest is to wait for the results tomorrow..."
Lin Feng calmed the patient,
This is just off work.
......
The next day,
morning
After Lin Feng went to work, after receiving 15 patients, the nurse ran to tell Lin Feng.
Patient Chen Juan's rheumatic immunity set, the results came out.
Antinuclear antibodies, anti-double-stranded DNA antibodies, anti-extractable nuclear antigen antibodies... All positive.
Confirmed: Systemic lupus erythematosus!
And the patient Chen Juan's hair loss, is it related to this systemic lupus erythematosus?
Yes!!
This disease can cause changes in the skin and hair follicles!
Many patients with "systemic lupus erythematosus" have symptoms of hair loss!
As for the decrease in platelets and low white blood cells, it should also be the scourge of "systemic lupus erythematosus", and there is a problem with systemic immunity.
Lin Feng informed the patient Chen Juan of his consideration and diagnosis.
"Huh? Is my hair loss caused by this disease? "
Chen Juan was a little surprised!
She had been looking for the cause of her hair loss, and now the answer had been found.
Just find the answer, you can solve it, and then let yourself stop hair loss!
Although she was lying on the bed, she was pleasantly surprised in her heart!
Lin Feng is not good to hit her,
"Systemic lupus erythematosus" is not an ordinary disease!
It is an autoimmune inflammatory connective tissue disease involving multiple organs that occurs in young women, which produces a large number of antibodies, attacks the immune system, and then causes damage to organs and tissues throughout the body.
It is a very serious disease!
In front of her, this patient Chen Juan, whether it is a decrease in platelets or a decrease in white blood cells, indicates that her "systemic lupus erythematosus" has progressed to a more serious point.
Lin Feng instructed the tube bed doctor:
"Then treat it according to "systemic lupus erythematosus"..."
"Besides, she's a little sick, don't be sloppy... I'm over there in the consultation room, call me anytime if there is any situation..."
......