"Lao Lin, just now we had a consultation. We didn''t ask about two very important diseases. Do you know what they are?" Wu Mian asked.
"Little martial uncle, don''t test me. I don''t know." Taoist Lin said, "just say I listen."
"Phlegm and stool," Wu Mian said.
“……”
"If I guess correctly, the patient''s stool may be accompanied by light green, and there are occasional symptoms of diarrhea recently."
"Don''t be kidding." Taoist Lin said with a smile, "little martial uncle, you''re holding a snake gall and sticking it up. It sounds like fun."
"Why do you think I''m hard up?"
"The patient has been eating snake gall for more than 3 months and has digested it all. Moreover, the snake gall is dark green, not necessarily the stool is dark green. It''s too direct to supplement what you eat." Taoist Lin smiled.
"Lao Lin, do you feel that no matter what you say today, you are like a cat with its tail trampled on."
Taoist Lin was stunned when he wanted to refute.
The idea passed through in my mind, and then realized that if I were what martial uncle said at ordinary times, I wouldn''t put forward so many opinions.
But today is different. I always want to refute what little martial uncle said intentionally or unintentionally. Strange, is it because of Wei Dabao?!
Laogua mountain is very close to jianxie hospital. The speed is very slow at midnight, but it also drives into the hospital yard in half an hour.
Li Zhong stood at the door of the inpatient department in the middle of the night, waiting for the patient from laogua mountain. He had no anger and showed great docility.
"Miss Wu, what patient?" Li Zhong went up at the first time, opened the door and asked.
"Patients with suspected spontaneous pneumothorax caused by pulmonary parasites should go to CT first, and then go to the ward to take oxygen and blood test. The cost... Take my special fund for scientific research." Wu Mian said simply.
Li Zhong looked at Wu Mian in a daze. He didn''t understand.
Pulmonary parasite refers to many parasites that are transmitted to all parts of the human body through blood circulation, often stay in the lung and cause lesions.
The main parasitic species is Pneumocystis carinii, which is commonly seen in
It has nothing to do with spontaneous pneumothorax.
But Li Zhong said nothing else. The patient pulled by Mr. Wu in the middle of the night got out of the car and gave a diagnosis. What are you talking about? If you discuss it with Mr. Wu here, you will be ill.
After arriving at the jianxie hospital, Li Zhong, nicknamed black bear, has seen the situation clearly. There is only one department director, Mr. Wu, in the whole jianxie hospital.
No matter what department has been, Wu has the final say. This is not a document, a hard and fast rule, but teacher Wu''s strength. Even the two presidents are furnishings, and they have to listen to Mr. Wu.
Li Zhong pushed the patient to do lung CT first, and the film came out soon. The left lung tissue was compressed by 10% and the right lung tissue was compressed by 20%.
According to Wu Mian''s doctor''s advice, Li Zhong took the patient to the ward, took a hospital bed and let the patient lie flat and take oxygen.
Wu Mian and Taoist Lin sat in Li Zhong''s office, not busy.
Taoist Lin also heard what Wu Mian said to Li Zhong after getting off the bus. He wanted to recall the information about pulmonary parasitic disease, but his mind was blank.
This is an uncommon disease. Even Li Zhong, who has worked in the chest department for decades, has not seen a few cases, let alone Taoist Lin''s two knives.
Wu Mian seemed to be thinking. He didn''t say a word. The air in the office was a little depressed.
Quietly, an hour passed like water.
There was a knock on the door, and then Li Zhong pushed the door in.
"Miss Wu."
"Sit down." Wu Mian smiled and found, "how about physical examination?"
"There are a few acne like papules on the face and back of the patient; the respiratory sound of both lungs is still stable, the tactile language tremor on the left side is significantly weakened, the left side of percussion is too clear, the left respiratory sound is significantly reduced, no dry and wet rales are heard, the heart rhythm is neat, and no pathological murmurs are heard in each valve."
"Leukocyte 14.9 × 10 ^ 9L, neutrophils 0.55, eosinophils 0.118, eosinophils direct count 1.7 × 10^9L。”
"Schistosoma antibody hasn''t returned yet. We have to wait."
"HMM." Wu Mian looked at Li Zhong and asked, "is there anything else?"
Li Zhongning knows that teacher Wu''s question is simple. In fact, he is examining himself.
"I think your diagnosis is correct." Li Zhong sat in his chair like an iron tower, but he didn''t show a sense of oppression. Instead, he was very modest and docile.
"First, the patient had a history of eating snake gall raw, and the symptoms occurred after eating snake gall raw."
"Second, the patient has intermittent expectoration. The sputum color is heavy and rusty. The amount is not large. The patient can''t describe clearly. I''ve asked the patient to leave sputum for test."
"Third, the patient has intermittent symptoms of abdominal pain and diarrhea in the near future. During diarrhea, he has loose stool and the color is light green."
Taoist Lin looked at Li Zhong in a daze. The key points he said were exactly what little martial uncle said in the car that he had not asked about the patient''s symptoms.
Is it really spontaneous pneumothorax caused by snake gall?! Don''t mention how uncomfortable Taoist Lin is.
At the thought of Trinket''s obscenity, Taoist Lin''s anger flourished.
"Director Li, I''ll trouble you next," said Wu Mian.
"Mr. Wu, you''re welcome. I''m going to observe the patient''s status first and wait for the parasite test results. If the results are positive, give tinidazole, albendazole, mebendazole and other related treatment. You see... What else to do?" Li Zhong asked.
"You can give prednisone for a few days."
"OK." Li Zhong put his hands on his legs and replied seriously.
"When will the parasite test return?" asked Wu Mian.
"Six hours," said Li Zhong.
Generally speaking, in several hospitals of Medical University, the return of parasite examination in three days is fast, and the return of the results of most hospitals that can do this kind of examination takes a week.
But the sword association hospital is different. Yishui''s latest testing machine has appalling efficiency.
"I''ll wait with Lao Lin," said Wu Mian.
Li Zhong doesn''t understand why teacher Wu has to pull Taoist Lin of laogua mountain. As a result, the diagnosis of the patient has been very clear. "Spontaneous pneumothorax" is because the insect body invades the small bronchus, causing the destruction of the bronchial wall and involving the visceral pleura, resulting in pneumothorax.
Now as long as symptomatic treatment can be, after the parasite is solved, the eroded bronchus will heal itself without surgical intervention.
In fact, this kind of patient''s income from thoracic surgery is very reluctantly, but the Department composition of jianxie hospital is not complete, so it is impossible to achieve the model of large-scale third-class hospital.
But Li Zhong doesn''t care. Treat it first. It''s just a pulmonary parasitic disease. It''s not difficult.
The most difficult thing to diagnose this disease is that it appears less, so the misdiagnosis rate is very high. If it is in Medical University, Li Zhong believes that there is a half chance of misdiagnosis.