bookpower Chapter 438
Chapter 438
If it is "sickle cell anemia", then the little boy's disease in front of him can be explained clearly.
Small cell hypochromic anemia is caused by thalassaemia + sickle thalassaemia
One of the classic manifestations of sickle crisis: inflammation of the fingers.
One of the classic manifestations of sickle poverty crisis: hepatosplenomegaly.
· Hb-F (fetal hemoglobin) is much higher than normal, which is a combination of thalassaemia and sickle poverty.
all
It's all smooth!
Clear and clear!!
Lin Feng seemed to have drunk a cold spring water, cool!!
Lin Feng's own discovery told the young mother.
"Huh? Isn't it thalassemia? How did it run out again what anemia? "
The young mother can't remember what kind of sickle this ...
Lin Feng said: "It's 'sickle cell anemia'... Now, all the evidence points to this "sickle cell anemia." "
Young mother: "Well, Dr. Lin, you can treat it as you arrange, as long as it can cure my son, I will listen to you in everything..."
100% trust.
Lin Feng: "Wait... Before the treatment, I still have to confirm again..."
Young mother: "Confirm what?" "
Lin Feng: "The disease of "sickle cell anemia" is high in Heizhou and Kaihang Country, which is rare in our country, and in the absence of family history, the probability of mutating a new person is too low... Therefore, you have to ask clearly, in the end the male family, the female family, which side has this genetic disease? "
This is also Lin Feng's doubt.
If this is not solved, Lin Feng does not dare to easily judge that it is "sickle cell anemia".
The young mother said at this time: "There is no country in Kaihang, there is no Africa ... I know that my grandmother's grandmother is a Southeast Asian..."
Lin Feng pondered: "Southeast Asia, there are a large number of Kaihang people mixed in, maybe your ancestors have Kaihang country blood, not necessarily..."
Young mother: "I'll call right away and ask..."
After 2 minutes,
The young mother hangs up.
Determined.
My grandmother's grandmother's mother is a Kaihang countryman ...
And the news of "sickle cell anemia" soon fryed in the family's chat group, causing a panic.
This is a dominant genetic disease!
Most likely, it will run to the next generation.
Moreover, some relatives combined the symptoms of "sickle cell anemia" and found that their usual symptoms were very similar, that is, they should also be "sickle cell anemia".
It's a thunderbolt!
......
Lin Feng found the 'real murderer! ’
Breathed a sigh of relief.
Now,
It is 99% certain that it is "sickle cell anemia".
But
A "sickle test" is also done: red blood cells are incubated and then checked for sickle red blood cells.
This time, it takes four or five days...
The little boy needs to remain hospitalized and wait for the results of the test...
Once the "sickle test" is positive, targeted treatment can be performed.
......
......
Got a special patient,
Lin Feng's heart is excited, and the sense of achievement is +1+1+1+1+1...
Continue to receive medical appointments.
Just returned to the consultation room,
A male patient with abdominal pain walked in.
Zhang Wei, 30 years old, male.
"Doctor Lin, help me see what the problem is, it hurts..."
The patient Zhang Wei was sweating profusely at the moment and his face was pale.
Holding his right lower abdomen, he bent over and walked into the consultation room.
It looked painful.
"Lying in bed, I'll see..."
Lin Feng directly let him lie in bed.
"Where does it hurt?"
"It hurts everywhere..."
"I'll see... Don't be nervous... Relax..."
Lin Feng pressed all the way over...
The face is serious.
The patient's Zhang Wei's abdominal muscles are obviously very tense, and there is obvious tenderness in the whole abdomen, as well as rebound pain, and the Mai's point pain in the right lower abdomen is the most intense.
Mai's point?
(The Mai's point, the projection point on the body surface at the base of the appendix, is also known as the appendix point.) ）
Lin Feng's first reaction was appendicitis.
"Wait... You have a few scars here (Mai's point position + 2 other scars)... Do you have laparoscopic appendicitis surgery? "
"Yes, I did, appendicitis half a year ago, and then I had an excision in the hospital ..."
Lin Feng wondered.
Mai's point, let's talk about appendicitis...
Then, the patient says that the appendix has been removed!
So strange?
Where does that hurt?
"Did you have your medical records?"
"Brought ... Every time I go to the hospital, the doctor asks, so I will sort it all out later..."
"This is the best, the medical records must be sorted out... Otherwise, I will repeat more tests for you and waste money..."
Lin Feng began to look at the medical records.
Six months ago, a laparoscopic appendectomy was performed, and the postoperative pathology showed "acute purulent appendicitis".
Back, constant right lower quadrant pain, accompanied by fever.
Went to three hospitals, three appendiceography scans, none of which showed appendices, and finally improved after anti-infection treatment.
Lin Feng saw this,
Rich experience, let him subconsciously give a judgment:
・The first appendicitis surgery was not done clean, resulting in "appendicitis residue"!!
"Appendicecinitis": It is written in textbooks that it is caused by the long stump during the first appendectomy, similar to turning a long appendix into an appendix and then further inflammation.
Appendectomy is the most common surgery and the most entry-level surgery!
Many ordinary people who are not doctors and nurses know that it is a minor operation.
In the clinic, it is basically done by the front-line doctor on duty, it is easy to get started, and the new colleagues, after three months, are basically independent masters.
Lin Feng used to be in the first hospital of the city, and this situation was similar, and the surgical trainees were very early on this operation and practiced their hands.
But
It's small, but it's also risky!
Reason: Doctors are too young!
......
"I suspect it's appendiceal remnants, you do a few tests..."
Lin Feng prescribed several tests to the patient...
· CT abdominal enhancement
Abdominal ultrasound
Blood routine + hypersensitivity C-reactive protein
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ps: The update ends today.
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