bookpower Chapter 347
Chapter 347
Mr. Zhang thought it was a common cold and fever, and bought some medicine at the pharmacy...
The effect of taking medicine is average, and repeated fever has a great impact on work and life.
So he went to a community clinic.
Because Mr. Zhang himself has a rejection of the hospital, because he can't get down to the hospital without 1,000 yuan every time.
(Two or three inspections, it really costs more than 1,000 yuan.) ）
So, he went to the community hospital.
Community hospitals are an effective supplement to large hospitals, if it is a minor illness, going to a community hospital is the most suitable choice, going to a large hospital is not that necessary.
After consulting Mr. Zhang, the community doctor took a routine blood routine and took a chest x-ray (X-ray).
Stethoscope: no wet rales in the lungs...
Chest radiograph: to rule out pneumonia, tuberculosis...
Blood routine: white blood cells are a little higher...
Final diagnosis: bronchitis...
Then, the community doctor prescribes fever reducers and cough medicines.
4 days later...
The effect of the medication fluctuated, and it was not cured...
Today
Mr. Zhang was at work, obviously felt fever and dizziness, lack of energy, affected the work, thought in his heart, go to the big hospital to see.
However, he felt that his disease, chest x-ray definitely not worked, CT is accurate. He was afraid of the big queues for days of CT in big hospitals.
"Go find Dr. Lin..."
A young female colleague, knowing Mr. Zhang's distress, recommended.
"Doctor Lin? That Dr. Lin Feng? "
"Yes, he is in the emergency room, I accompanied my mother to see a doctor, he opened the CT quickly, the results came out in an hour, no need to wait for the next day..."
Female colleagues strongly recommend Lin Feng.
When Mr. Zhang heard this, his heart was moved.
At this time,
"Uh-huh~~~~"
Mr. Zhang covered his stomach violently, and there was a throbbing pain...
Suddenly, the whole person squatted on the ground, severe pain struck, and cold sweat on his forehead suddenly came out.
"Lao Zhang, what's wrong with you?"
"It's okay, it's okay..."
......
Lin Feng's side,
Emergency department, sitting in the clinic.
"Please Zhang *xin to the No. 3 consultation room..."
And then
Mr. Zhang covered his stomach and walked into the consultation room.
"Doctor Lin, help me see what the problem is..."
While throbbing in pain, Mr. Zhang bent down and sat down on the stool.
Lin Feng's heart tightened.
"You have a stomachache?"
"Yes."
"Tell me about the situation..."
"I originally wanted to see the fever today, 5 days ago, I started to have a fever, and then went to the community clinic, the outpatient doctor took a chest x-ray, blood routine, and diagnosed me as bronchitis..."
Mr. Zhang spoke breathlessly, obviously very difficult, whether it was coughing, obviously not optimistic.
"After taking medicine for 4 days, it didn't work, and the fever kept repeating... And then this morning the stomach started hurting... Until now..."
Lin Feng frowned.
"How many hours..."
"3 hours..."
“............"
After such a long time, the condition must not be light!
Lin Feng quickly stood up: "Go to the hospital bed, go to the rescue room..."
Mr. Zhang was stunned all of a sudden: "Huh?? Emergency room, no, doctor, I just have a stomachache..."
Lin Feng shook his head: "I'm not sure yet, but it's safer to go to the rescue room first." "
Mr. Zhang was frightened and nervous.
soon
The patient was pushed to the emergency room.
The nurse had numb hands and feet and connected Mr. Zhang to ECG monitoring.
Blood pressure 140/80mmHg,
Heart rate 120 beats / min.
Lin Feng breathed a sigh of relief, although his blood pressure was a little higher, it was not very high.
There are too many causes of abdominal pain to count.
Simple acute gastroenteritis, severe myocardial infarction, aortic dissection can even quickly kill people.
Myocardial infarction is an emergency disease that Lin Feng needs to investigate at the first time.
"Here, let's do an electrocardiogram first... Let's see if there is a problem with the heart first..."
(The monitor is definitely not as accurate as the electrocardiograph...) ）
Experience: Patients over 40 years old, abdominal pain, chest pain, should be prioritized to check the electrocardiogram.
Mr. Zhang linked to the electrocardiogram.
At a glance,
No problem with ECG!
There are no signs of myocardial infarction, and the waveform is okay...
Lin Fengxin breathed a sigh of relief.
Aortic dissection?
Measured the blood pressure of the left and right arms.
It's not like...
"I'll check your abdomen... You endure a little..."
Physical examination:
Lin Feng pressed Mr. Zhang's abdomen, the overall abdomen was still soft, the muscles were not too tense, and the bowel sounds were relatively weak.
Now it's hard to say what the reason is.
"Have you ever had any illness before, have you ever had pain?"
"For example, what appendicitis, stomach ulcers, cholecystitis ..."
"No, I've always been healthy." Mr. Zhang was really a little nervous at this time, feeling that Dr. Lin Feng was very serious, could it be that his illness was very serious?
Panicked.
Lin Feng asked about the detailed diagnosis process of the outpatient clinic...
"Dr. Lin, my cough and fever, could it be a lung problem?" Pulmonary tuberculosis? Lung cancer...... I looked for X-rays, but the outpatient doctor said that the X-ray accuracy was not as high as CT..."
Pulmonary tuberculosis? Lung cancer...... It is the disease that Mr. Zhang is most afraid of.
Lin Feng did not answer, but picked up the X-ray chest x-ray from the community outpatient clinic.
Then I took a look at the medication in the outpatient clinic.
The outpatient doctor's diagnosis is that the tracheal infection, cold, are all viral infections, and only antipyretics and cough medicines are used.
Lin Feng had one more idea.
"Is it pneumonia?"
Pneumonia is a bacterium and requires antibiotics, while fever reducers and cough medicines are useless.
Lin Feng held a stethoscope and listened to the patient's lungs.
Well
Crackles.
Although a small amount, the probability is pneumonia.
Lin Feng instructed the nurse:
"Inject him with an amoxicillin..."
Amoxicillin is a commonly used antibiotic,
Pneumonia is a minor problem for Mr. Zhang, as long as antibiotics go down, it will be cured quickly, unless it is a seriously ill patient.
Solve the problem of fever and cough...
Lin Feng set his eyes on the abdominal pain.
"Let's go for a CT..."
"As soon as the abdominal CT is done, what liver, gallbladder, spleen, pancreas, intestines, and intestines, everything comes out..."
Mr. Zhang nodded repeatedly: "Good, good." "
He has long wanted to do CT ...
Payment
Then endured the pain and limped to the imaging department.
......
30 minutes later...
The CT report came out.
"Dr. Lin... Here are the CT results, you see..."
Mr. Zhang limped and came back clutching his stomach.
Lin Feng looked at CT,
Suddenly looked serious!!
· CT film: see the edges of the spleen and kidneys, both have low-density shadows (white), 6.
• Infarction foci.
Infarct!
The so-called infarction refers to something blocking the blood vessels, the blood cannot pass, and the tissue is ischemic and hypoxic, and necrosis.
Although, there are only 6 of these lesions, each of which is only a little bit of soybean!
But that's definitely a big problem!
An organ cannot be a good infarction!
Definitely because of ischemia!
There is a problem with the blood supply!
Other words:
Either a blood clot (or a foreign body) is blocking the blood vessel!
Either there is a problem with the blood supply to the heart!
Either way, it's very serious!
Mr. Zhang's abdominal pain, which can now be explained, is infarction.
"Doctor Lin, am I serious now?"
。