There were five patients in total, one discharged, and four had accidents.

Senior Brother He was also shocked when he heard the news, and hurriedly saw the patient together, and then the three of them walked to the ward together.

The patients who had fever yesterday were 82 beds in Zhang Tianyang's tube, and 51 beds and 77 beds in Chen's tube.

59 beds did not return to the ward overnight.

In fact, the doctor on duty has given emergency treatment to the situation of several patients, but as a doctor in charge of the bed, he must always find out what causes the fever.

Bed 77 is an 82-year-old man, who looks very thin and his face is relatively gloomy.

According to the medical records written by the previous doctors, he has been having a fever for two months.

The old man had a little meaning that no one should enter, and when he saw the doctor come in, he only glanced at it, and continued to drink porridge by himself.

"Doctor. ”

There were two family members, a young man and an old lady, who were sitting next to the hospital bed, and turned their heads at this time, and they didn't mean to stand up.

The young man did not speak, but the old lady gave orders.

"Doctor, you can show us what happened to our old man, who fainted outside early this morning. ”

The three white coats frowned slightly, and did not answer immediately.

Senior Brother He stepped forward and did a set of physical examinations for the patient, and Zhang Tianyang also followed.

"How's that, what's in mind?"

After all, it was Senior Sister Chen's bed, and Senior Brother He asked Chen Shishi this sentence.

"The sensation is related to the fever, but I can't say for sure. ”

Chen Shishi shook her head, "I looked at the medical records, and this patient's fever lasted for two months, with a maximum temperature of 39.1 degrees Celsius. However, because patients always take Motrin on their own to cool down, we cannot observe the thermal type of fever. ”

Zhang Tianyang also shook his head secretly, secretly saying that it was a pity.

In fact, the law of fever can see many problems.

The duration of the fever, the temperature at which the fever is generated, whether the fever has a period and regularity, etc.

For example, long-term low-grade fever and night sweats in the afternoon should raise suspicion of tuberculosis.

Another example is relaxation fever, if the body temperature is often above 39 °C, the fluctuation range is large, and the temperature fluctuation range is more than 2 °C within 24 hours, but it is above the normal level, it is necessary to suspect whether there is a possibility of sepsis.

Unfortunately, this patient seems to be a little disobedient.

Zhang Tianyang glanced at the impatient family members next to him, and secretly kept a heart.

Senior Sister Chen flipped through the medical records and continued to state.

"Both of the infection indicators are normal, and no infection has been detected.

In the case of hematologic diseases, bone marrow biopsy did not report significant problems.

Swell...... In terms of cancer, several markers are high, but patients with liver cirrhosis will have high and no specificity.

As for his fainting this morning, I have no idea. ”

After Senior Sister Chen finished her statement, she said that she could not do anything.

"Incurable disease. ”

Senior Brother He sighed.

In fact, such situations are the norm in hospitals.

Not all diseases have a clear pathogenesis, and not all diseases eventually find an explanation.

What's more, as a well-known comprehensive tertiary hospital, Dongfang Hospital will receive many patients who cannot be diagnosed and treated by lower-level hospitals.

In this case, doctors need to rely on their rich clinical experience to "guess" what the patient's disease is.

And then try to find evidence to prove it.

So, sometimes, curing a disease is like solving a crime.

Senior Sister Chen shook her head helplessly, "The last doctor has been looking for a little half a month and hasn't figured out the cause, I just took over, and I can't figure out the cause." ”

I don't know what the disease is, so how can I guess that this syncope caused by the disease is caused?

"Senior sister, have you done PET-CT?"

Zhang Tianyang suddenly interjected, and Senior Sister Chen paused, "No." ”

"Unexplained fever does not rule out a hematologic disorder, nor does a normal bone marrow picture and biopsy rule out a hematologic disorder.

I think it's necessary to do PET. ”

When no useful evidence is found in other directions, PET-CT, or positron emission tomography, becomes the key to diagnosis.

"Yes, junior brother. ”

Senior Brother He raised his eyebrows, "I think the same way, I doubt the possibility of blood system diseases, and it will be more likely to be diagnosed if I can do PET." ”

"What do you mean?"

The family couldn't sit still, and the old lady stood up suddenly, "Why do you have to do another examination?"

"I've been in your hospital for half a month, and I've done so many tests, why do I have to do it?"

The old lady opened her arms, exaggerated metaphors, the facial features on her face were wrinkled together, and suddenly stared at Chen Shishi and began to question.

"Hey, you're our old man's doctor, aren't you? What's going on?

After all, Senior Sister Chen is an old fritter who has been mixed in the clinic for several years, and she is not false at all, and explained to her family, "The purpose of the examination is to find out the cause, and the cause is not clear how to treat the disease?"

"Do a check, do a check, I think you're cheating money!"

The old lady didn't seem to be a good person, and seemed to have been accumulating anger for half a month.

Seeing the conflict, Senior Brother He came over with a "vicissitudes" and "reliable" face.

"If you have something to say, what about this patient, the situation is more complicated, these tests are necessary, and this PET-CT is ......"

"Don't fool me!"

The old lady directly and rudely interrupted Senior Brother He's words, "Don't think I don't understand anything, I've checked, this PET-CT is the most expensive test, you just want to cheat us out of our money!"

The old man in bed 77 also snorted coldly, expressing his approval of the old lady.

The atmosphere was frozen there all at once.

The patient is an old man, the family is an old lady, and both of them are very old, so it is not easy to talk to them.

Don't accidentally get angry and add to the trouble. 、

The only young man, who hid to the side and played with his mobile phone without saying a word, looked like he didn't care about himself, and he didn't look reliable.

Zhang Tianyang sighed silently.

"Old lady, do you know, in fact, you are not afraid of not understanding anything, but only a little bit. ”

The old lady just wanted to continue the seizure, but Zhang Tianyang opened her mouth and blocked her back.

"Old lady, do you know what the full name of PET-CT is?"

The family opened their mouths, "I, how do I know! I don't need to know! I know you are going to cheat us out of our money!"

Zhang Tianyang silently felt the effect of "reliable +2" and opened his mouth to explain.

"The Chinese name of PET is positron emission tomography, and CT is full of electronic computed X-ray tomography technology.

PET-CT is a combination of these two technologies and done with the same machine.

Compared with other tests, it can be diagnosed early, safely, accurately, and quickly. ”

A bunch of proper nouns calmed the old lady, but the patient remained stubborn.

"I don't understand these things of yours, I know, I used to be in other hospitals, and they didn't let me do this!"

Zhang Tianyang smiled, "Did those hospitals diagnose your illness?"

“......”

Patients and their families were speechless for a while.

"PET-CT is not something that can be done in any hospital, and now it is the case that all the other tests have been done, but there is no evidence that can explain that you have a fever all the time.

As a doctor, to advise you from a professional point of view, this examination still needs to be done. ”

Senior Brother He nodded silently beside him.

The Department of Hematology of East Hoka Hospital regards PET-CT as a mandatory item for admission, in order to clarify the diagnosis and ensure that there is no missed diagnosis or misdiagnosis.

No other tests have been able to detect it, and there are many patients who have been diagnosed through this test.

The patient and family fell silent, and Zhang Tianyang's tone slowed.

"Moreover, I also read your information just now, so there should be no shortage of money at home, right? ”

The old lady finally relented, but still muttered quietly.

"Yes, there is no shortage of money, my son is good to us...... Yes, you can ......"

"We suggested it, but the final decision is still in your hands, and you really don't want to do it, you can sign it, not reluctantly. ”

Senior Brother He made a final summary, and the old man and old lady said that they would consider it.

"Alright, it's solved for now, let's go check the next one. ”

Senior Sister Chen breathed a sigh of relief and turned around to leave.

"It probably didn't work out. ”

Zhang Tianyang sighed silently and walked to the young man who had been silent.

"Can you show me your phone?

In hospitals, recording is generally not allowed. ”