"So...... Is it sickle?" Xu Yourong heard Sun Lien's explanation, and she even said the name of the disease with Sun Lien. But she was obviously still a little unsure about the diagnosis, "So how did his lung symptoms come about? Capillary blockage?"

Sun Lien glanced at Xu Yourong helplessly, "How else could it be?" The cold dragged on for a month without taking medicine, and it was dragged out. ”

Generally speaking, when encountering a patient with a very complex condition, Sun Lien, as a doctor, will try to find the only explanation for this bunch of symptoms—that is, the only solution—like a traditional physicist. It is at this time that the doctors behave like a real science student, almost brainlessly insisting on the principle of simplicity, which means that all symptoms should be caused by the same disease.

Of course, there will definitely be exceptions to this case. For example, if a bacterial infection is caused by an injury to the end of a limb, the symptoms shown by the average person and a diabetic person are likely to be very different. HIV patients and diabetic patients may present differently from each other. The same bacterial infection can behave very differently in different patients. This is also known as an "underlying disease". At this time, if the doctor is still obsessed with his own experience, it will inevitably cause missed diagnosis and misdiagnosis, or even wrong diagnosis. Modern medicine, the reason for advocating evidence-based medicine, is also related to this.

"His problem isn't just sickle cell disease. Sun Lien explained his views to Xu Yourong, "First of all, I think he has sickle cell disease, not the more serious sickle cell anemia. In the case of sickle cell anemia, his symptoms have already appeared and may be more severe. ”

Sickle cell disease is the one with a worse prognosis. Patients will show more severe symptoms at an early age, including avascular necrosis of organs, severe hemolysis and so on. Most patients with sickle cell anemia will die before adulthood, and those who can survive adulthood will basically not survive the age of 30.

Rawls is 21 years old. And he didn't even know that he had this hidden danger in his body. This is enough to prove that his disease should be a relatively mild sickle cell disease, not sickle cell anemia.

However, the relatively mild symptoms do not mean that the disease has no effect on him, and Rawls's physical condition is not optimistic after being in a state of anemia for a long time. And when the cold is delayed into pneumonia, this lack of optimism quickly turns into "severe". People with sickle cell disease are already susceptible to infections – the hemolysin released by pneumococci has a huge impact on normal red blood cells, not to mention the twisted and fragile sickle cells. Chronic malnutrition due to sickle cell disease also weakened Rawls's immune system.

A weakened immune system, a body base that is more susceptible to infections, and adverse reactions to antibiotics. Together, the three smashed the young Rawls from the training ground to the lying down, and even now they need to rely on suspension of red blood cells and oxygen to maintain their vital signs stable.

"And the problem of antibiotics?" Xu Yourong wondered even more, if the diagnosis of sickle cell disease plus pneumococcus was correct, then it should be able to explain the patient's symptoms. Where did this antibiotic problem come from?

"The course of the disease, the change in the course of the disease. Sun Lien sighed, "Rawls's cold has dragged on for a month, and he only entered the training ground hospital because he has been sick for a long time, right?"

Xu Yourong nodded, she seemed to have grasped some key points.

"Then for a patient with a weakened immune system and sickle cell disease, his physical condition, although poor, should at least deteriorate in a relatively smooth curve. But Rawls's condition deteriorated rapidly after being treated at the training ground hospital. Sun Lien felt a little awkward when he said this, as if he was saying bad things about other hospitals.

"Rapid deterioration?" Xu Yourong grasped a suspicious point, "How did you make a judgment?"

Sun Lien took out the examination report again, "The hemoglobin dropped from 11.8g/dl to 8.4g/dl in three days, and if his physical condition had deteriorated at this rate before, he would have died long ago." ”

"So you think it's because of the effects of antibiotics?" is not as convincing as the previous one. Xu Yourong was still a little skeptical.

After all, blood collection does not cause hemolysis, and he has not received other treatments. Sun Lien scratched his head, this judgment is indeed a little not rigorous. Perhaps it can be verified later by an IgG antibody test. However, the treatment methods and principles of drug-induced hemolysis are similar to those used to treat sickle cell disease. ”

Xu Yourong reluctantly accepted Sun Lien's reason, and she asked, "Then what should I do next?"

"I'm going to go to the laboratory department. Sun Lien replied with a smile, "In order to find out what type of hemolysis Rawls is, I asked Yuan Ping'an to take a sample, calculate the time, and there should be a result." ”

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The laboratory department issued an examination report and sent the blood smear to the pathology department for further examination. However, sending it to the pathology department is just a standard process to ensure that there are no errors. Under the microscope, the sickle-shaped red blood cells are so obvious that they are even less likely to be wrong...... As long as the doctors in the laboratory department are not blind, they will not even be able to see this.

Sun Lien breathed a sigh of relief with the inspection report. Fortunately, I didn't overturn this time. Seriously, if the patient has other diseases, and he hasn't been checked out for a while, then Major General Peng will transfer people to the hospital at that time, and he will have nothing to be ashamed of - Gui Peisheng's face is used to lose. But Director Liu, who recommended people to come to the hospital to see a doctor, is afraid that his face will be very gloomy. I was embarrassed for a few days, but if Liu Da excavator lost face, I would not have a good time in the future.

"I'll be over later, there's just a patient. Sun Lien took out his mobile phone and called Hu Jia while walking towards the rescue room, "His problem is a little troublesome, but don't worry, I've solved it." ”

"Then I'll order first. Hu Jia looked very happy on the phone, "I thought you wouldn't be able to come over at noon today." ”

"Not really. Sun Lien looked at no one nearby, so he was a little presumptuous, "Don't look at who we are! As Nurse Xiaohu's boyfriend, there must be two brushes!"

Hu Jia laughed on the other end of the phone for a long time before stopping, "Your stinky and shameless appearance now is really getting more and more like an emergency doctor." ”

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Rawls's diagnosis is still one step away, and IgG measurement will take some time, but since sickle cell disease has been diagnosed, the rest of the treatment should be handled by the haematology. Professor Lai's department is also interested in Rawls, after all, the vast majority of sickle cell disease patients are black or related to black people. A very small number of patients in China may develop incidental sickle cell disease. But after all, Asians are not a high-incidence group of this disease, which can reach up to 40% of blood diseases in East Africa, and the average incidence in China is so low that there are no statistics. The hematology department of the fourth hospital can encounter such a patient, at least three Chinese cores should not be able to run away - a case report, a treatment record, and a nursing content.

One patient, three papers. The enthusiasm of the hematologists is at an all-time high.