bookpower Chapter 376
Chapter 376
Blood sugar is too high,
Obviously, this patient little girl has "diabetes"!
PS: Diabetes is a disease, and hyperglycemia is a test result.
In Lin Feng's mind, he began to review the knowledge of high blood sugar:
It is currently believed that the occurrence of hyperglycemia is mainly related to the following mechanisms:
The β cells of the pancreas do not secrete enough insulin, and α cells secrete too much glucagon.
Insulin resistance in peripheral tissues, including liver, muscle, and adipose tissue.
Intestinal absorption, intestinal flora, and intestines affect blood sugar-controlling hormones, causing them to be abnormal.
The kidneys absorb sugar excessively.
Abnormal regulation of glucose metabolism by the nervous system.
And the most common,
It was the first one, there was a problem with insulin.
Then it was linked to another disease:
"Diabetic ketoacidosis"!
It is one of the most serious diseases of diabetes!
"Doctor, what's going on with my daughter?"
When the two couples saw Lin Feng's serious look, they suddenly felt bad.
"At present, it can only be determined that it is diabetes, and you need to urinate on her immediately and send her for testing!" Be quick! "
"Huh? Can children also have diabetes? "
The mother was flabbergasted.
Lin Feng explained: "Children can also get diabetes, and the incidence of diabetes in children is increasing every year. "
Mom still didn't believe it: "Doctor, could it be a mistake?" My daughter, you see that she has lost 10 pounds, how can she be diabetic? "
Lin Feng shook his head: "It won't be wrong, your daughter's blood sugar is too high, there is no other explanation except diabetes!" "
"Hurry up and keep urine, draw blood, speed!!"
Lin Feng quickly opened the order,
Kidney function, liver function and so on, all examinations must be done!
Why?
Because the little girl patient has been for 1 month,
Persistently high blood sugar may have very desirable consequences.
High blood sugar, many harmful:
Increased blood sugar, increased urine glucose, can trigger osmotic diuresis, thereby causing symptoms of polyuria;
Increased blood sugar, because of osmotic pressure, cells will lose a lot of water, hyperosmotic can stimulate the thirst center of the hypothalamus, thereby causing symptoms of thirst and polydipsia;
Due to the relative or absolute deficiency of insulin, glucose in the body cannot be used, protein and fat consumption increase, resulting in fatigue and weight loss; (So there will be reasons for the weight loss of little girls)
In order to compensate for the loss of sugar and maintain the body's activity, the amount of food eaten will increase, and the more you eat, the hungrier you get.
This forms a typical "three more and one less" symptom.
Summary: The more the patient eats, the higher the blood sugar, the more sugar is lost in the urine, and the more hunger is strong, which eventually leads to a vicious circle.
"When you're done, come back right away and give her fluids and insulin!"
"Okay, okay, let's go right away!"
Seeing Lin Feng's demeanor, it was not like faking, and the couple was also anxious, and quickly took the child to check.
......
A hectic time,
After the blood is drawn to urinate, the baby is taken back to the office by the parents.
Lin Feng asked the nurse to rehydrate the baby and give insulin to lower the blood sugar first.
But
Lin Feng still did not take it lightly.
Now wait for the results of the examination.
After 20 minutes,
Urinalysis came out:
Ketone body 3+, urine sugar 3+
normal, it should be negative, and now, all reality 3 +,
Obviously, this little girl is "diabetic ketoacidosis"!
Lin Feng guessed it!
Diabetic ketoacidosis is the most severe form of diabetes and can lead to death if you don't see a doctor in time.
And then there's the treatment.
The child is admitted to the hospital first, because it will take several days to undergo a complete examination and systematic health assessment.
The little girl has been ill for a month, and there will definitely be various acute or chronic complications: diabetic ketoacidosis is one of them, as well as diabetic nephropathy, cardiovascular disease and retinopathy...
Severe cases can be disabling.
All kinds of inspections must be done,
Of course, the most important thing is to check what exactly causes diabetes, is it insulin deficiency?
The little girl's mother asked another question at this time: "Doctor, that little baby's stomach hurts... Did you eat the wrong thing? "
According to her understanding, high blood sugar, should not have stomach pain?
Lin Feng explained: "This is a change in osmotic pressure caused by high blood sugar, microangiopathy, problems in the blood supply of various organs in the abdomen, and natural severity can lead to organ damage and acute abdomen... So the stomach hurts..."
......
It took 3 days,
The results of the little girl's tests came out.
Fortunately, the child is relatively young, the body can carry it, and a month's high blood sugar has not damaged her organs and eyes...
As for the cause, it was also found,
It is "type 1 diabetes"!
It is the genetic defect of the parents, which leads to the defect of the patient's own immune system and insufficient synthesis of insulin...
......
(ps: how to diagnose: stomach pain, anorexia, easy thirst, polyuria, eating more, weight loss...) These are signs)
......
After this one patient,
Lin Feng continued to sit in the clinic,
This time
The patient still has a fever!
The parents looked worried and walked into the consultation room with the baby,
"Dr. Lin, my baby has been with a fever for 4 days, help me take a look..."
Patient, baby, 1.5 years old,
Repeated fever for 4 days, the highest 39.5 degrees, four days not good, usually eat "Merrill Lynch" to suppress high fever
Pediatric diseases, either colds, fevers or stomachaches, account for 80% ...
Lin Feng took a look,
The baby is not in good spirits, and his face does not feel healthy and rosy, indicating that the condition is more serious.
(Generally good spirits, there is no problem, taking medicine is almost the same)
Lin Feng checked,
I didn't find out that my baby's fever was caused by a cold, flu or respiratory infection!
The baby's high fever does not subside, there may be a big problem!
Lin Feng: "Let's check the blood routine... Also, Do you still wear diapers now? "
Wife: "Yes, in diapers ..."
Lin Feng: "Try it, can you keep urine..."
Blood routine and urine routine are the simplest and cheapest tests (more than twenty pieces), and they can indicate whether there is a disease.
Soon, the family of three went to draw blood.
As for urine, the two couples worked hard and did not succeed in urine.
......
1 hour later, (Lin Feng called the laboratory to see, greeted)
The results of the blood routine test are in.
Abnormal blood routine: C-reactive protein, direct explosion, more than the upper limit of 160!
Lin Feng was shocked!!
C-reactive protein (CRP) (written earlier) is a protein (acute protein) that rises sharply in plasma when the body is infected or damaged by tissues, and the sensitivity is ultra-high!
It has more clinical significance, and can be seen in purulent infection and malignant tumors, connective tissue diseases and acute rejection of organ transplantation.
Lin Feng immediately became vigilant.
Hurry up to give the baby first, stick to the heart and lungs.
"No, how does your heart rate run so fast?"
"What happened just now?!"
Lin Feng found that the heart rate of the little baby exceeded 180!
Although children's heart rates are generally faster than adults, 180 is outrageous!
Lin Feng looked at the little baby,
I saw the little baby, mentally weak, eyelids shrugged...
Combined with CRp and heart rate!
"Is it..."
"Is this going into shock?"
Lin Feng was taken aback!
Only shock one explanation!
It should be a serious infection (CRp), resulting in septic shock!
As for what infection?
I can't take care of it now!
Rehydrate first, anti-shock!
Then I called the ICU.
"I'm here in the pediatric clinic, Lin Feng, now there is a patient who may want to go to the ICU, do you have a bed over there?"
"Doctor Lin?" The nurse at the nurse's station on the other side of the phone raised her voice an octave.
"Yes,"
"Dr. Lin, what is the condition of the patient?"
"Septic shock!"
"We still have beds in our ICU, just left a patient, I'm looking for the director now... Dr. Lin waited for me, very quickly. "
Lin Feng hung up the phone,
The couple next to them were already shocked.
Want to send ICU?
The couple had elders who had been in the ICU before, so they knew what ICU meant.
"Dr. Lin, what's wrong with my baby?"
However, Lin Feng did not mean to stop, directly picked up the baby, and directly rushed out the door, shouting while going out
"The situation is complicated, the road said..."
......