bookpower Chapter 547
Chapter 547
Lin Feng asked the patient Huang Chen: "What kind of poop do you pull?" What about color shapes? Is it molded? Or sparse? Or is it watery stool? Is there any bloody stool? "
Accustomed to jpg
The patient Huang Chen was a little embarrassed: "Yellow, not sparse, but not hard..."
"Is there fever, is there abdominal pain, is there nausea and vomiting?"
"No, everything else is fine, it's just wild, and the amount is not large..."
Huang Chen said, very bitter, because it was really pulled until the legs were soft.
Lin Feng groaned.
No nausea, vomiting, abdominal pain...
This doesn't feel like enteritis.
Could it be another disease??
"Here, take your blood pressure..."
Why take blood pressure?
Because patients with this diarrhea for a long time are still weak and their blood pressure may be affected.
Xiaoru took the sphygmomanometer and measured the blood pressure of patient Huang Chen.
Blood pressure: 90/50mmHg
Heart rate: 110 beats/min.
"Teacher, this blood pressure is a little low, and the heart rate is not right..."
"It's a bit of a problem, I feel like I'm going into shock... Do you usually eat and drink enough? "
"Ahhh... I don't have much appetite to eat, and I don't drink much water..."
"That's supposed to be low-volume shock..."
That is, usually eat less, blood volume is insufficient, blood pressure naturally cannot go up, the heart has to speed up pumping, and the heart rate is high...
In addition, diarrhea + low intake, there will be a loss of water, electrolytes, such as possible hypokalemia... The most severe point is arrhythmia, the most severe is ventricular fibrillation, and then cardiac arrest.
So
Lin Feng was vigilant.
Grab the bull by the horns.
"Let's go to the rescue room... Correct the shock first..."
"Huh? Rescue room? "
The patient Huang Chen was stunned.
Why should I go to the rescue room?
......
Come to the rescue room,
Pick up the instrument and start rehydration against shock.
Directly open two intravenous channels, a large amount of rapid rehydration, as soon as possible to replace the lost water.
"Go pull an electrocardiogram..."
Lin Feng is afraid that the patient Huang Chen has hypokalemia, which will further lead to heart problems, and the electrocardiogram is cheap and painless.
In addition, a very small number of patients with myocardial infarction will only present with diarrhea abdominal pain, but no chest pain, only with the help of electrocardiogram.
Therefore, Lin Feng opened this examination without psychological pressure.
soon
The nurse pulled an electrocardiogram on the patient.
ECG Results: No problem!
The patient is young, the body is great...
Next, Lin Feng ordered the nurse to draw blood to test various indicators.
The first is naturally the examination for enteritis.
No matter how impossible it is, the first thing to do with diarrhea is to test for enteritis.
Bacteria, viruses, fungi, etc. can cause enteritis, and antibiotics prescribed in community hospitals can only treat bacterial infections, not viruses and fungi. And other possibilities are not excluded, such as whether there is "food poisoning", "chronic intestinal inflammation" ...
There is also liver and kidney function, myocardial enzyme spectrum...
"Do you have any previous medical history?"
"Yes, I suffered from acute pancreatitis 3 years ago, and I was hospitalized for almost 1 month before I got better and was discharged."
Lin Feng nodded.
Consider: Pancreatitis that simply causes diarrhea may also be present, and pancreatitis is more problematic.
Therefore, it is better to be safe and draw blood to make a pancreas.
The nurse was instructed to add a blood draw (amylase, lipase) for the pancreas.
(PS: Amylase is mostly hidden in the pancreas, and once the pancreas is damaged, these enzymes are released into the bloodstream.) ）
After the command,
Lin Feng: "You will be hospitalized today and observe in the hospital... I'll give you an admission slip, and when the infusion is over, you go to pay for the procedures..."
Patient Huang Chen: "Okay, okay, thank you Dr. Lin..."
......
Lin Feng returned to the consultation room and continued to see the patient.
An hour later,
The results of the patient's blood draw came in.
Liver and kidney function: normal...
Blood routine: mild anemia...
Electrolytes: hypokalemia, blood potassium only 3.2 mmol/L (normal 3.5-5.5).
(Potassium supplementation when already infusion...) ）
Pancreatitis two: normal...
Myocardial enzyme profile: normal...
Lin Feng: ".................."
It wasn't.
Can't help sighing:
Digestive diseases are really stripped of their cocoons, and they are difficult in every way!
"Xiaoru, open a bill and make a colonoscopy for that Huang Chen."
Diarrhea may also occur for intestinal tumors.
So you can do a colonoscope.
"The colonoscopy won't be done until tomorrow..."
"Then wait for tomorrow..."
......
The next day,
Lin Feng on the day shift,
On ward rounds, after the patient Huang Chen was rehydrated, the blood volume came up, the blood pressure came up, and the heart rate was still a little fast, but it was not too obvious.
Diarrhea, it continues!
Took antidiarrheal drugs, but the effect was only a little ...
By noon,
The colonoscopy results of patient Huang Chen came out.
Result: No signs of tumors, no ulcers, ulcers...
Lin Feng: ".................."
Patient Huang Chen breathed a sigh of relief.
It's good that there is no tumor, otherwise he would be in big trouble.
"Neither..."
Lin Feng can't help,
You can only continue to check for more items.
Check one by one.
For example:
Rheumatic immunity systemic lupus erythematosus, with the possibility of intractable diarrhea,
Chronic pancreatitis, pancreatic cancer
So, go ahead and check:
Rheumatic immunity set of examinations...
CT of the pancreas...
When the patient heard, there was even a possibility of pancreatic cancer... The mentality is simply collapsing...
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PS: That's it for today...
。