Lu Cheng's impression in Professor Min's heart suddenly sank to the bottom.

Whether it is a medical student or a doctor, not knowing how to pretend to understand is the biggest taboo in medicine.

In the half month since Lu Cheng entered the department, he has a sincere learning attitude, a down-to-earth work, and is easy to ask.

Professor Min has always been labeled as diligent and studious, and Professor Min admires Lu Cheng's strong clinical thinking in such a short period of time under the guidance of him and Lin You.

Learning is oriented, and there is integration.

Especially yesterday, Lu Cheng was able to discover the cause of hip arthritis that Zhuo Yuan couldn't find in the subtleties, and he was able to explain it clearly through solid theoretical knowledge, which were all Lu Cheng's plus points.

But appreciation is appreciation, and it does not mean that Lu Chengcheng has really been recognized and can talk nonsense.

As the chief surgeon, how could Zhuo Yuan and Lin You not read the literature they had read?

However, in the literature, there is no accurate definite value for thrombocytopenia that can be tolerated before surgery.

Medicine is definitely not based on guesswork, you can't tell why, and even if you guess correctly, Professor Min will slap you in the face.

Although Professor Min's gaze and face turned cold, he did not immediately interrupt Lu Cheng's speech.

This is a teaching hospital, and as a professor in a teaching hospital, it is the most basic quality to benefit the audience. No one is a generalist, and in the broad and profound field of medicine, too much professional knowledge is required, and experts and professors from other departments are required.

Professor Min will not measure so small that he can't bear a little Lu Cheng's nonsense.

When Lin You heard Lu Cheng say this, his eyelids also jumped fiercely, he had been with Professor Min for four or five years, and he knew best what Professor Min hated the most in his heart.

Metaphysical diagnosis.

The definition of clinical medicine is to accurately describe the cause, development, prognosis and diagnosis of a patient's disease through clinical knowledge.

It's acceptable that I don't know, but I certainly can't accept gibberish.

As for the kind of mysterious doctor who can understand the diagnosis at a glance, no matter how high your level is and how high the final accuracy rate is, what any doctor wants to say to him is to give me out!

Metaphysical diagnosis, even if it maintains a 100% accuracy rate, but as long as there is one error, it will be a catastrophe.

But at present, Professor Min did not interrupt Lu Cheng's speech, he must have wanted Lu Cheng to continue, if Lu Cheng can't say why, then Lu Cheng's label will be a big question mark in the future.

Lin You couldn't help frowning.

Lu Cheng definitely doesn't seem to be a vain person, this kind of thing out of nothing, under normal circumstances, he will definitely not do it.

Could it be that he has beaten his knowledge framework too fragmented in these days, because his knowledge reserve is not enough, so he began to go astray?

Shi Ding and Chen Hui were only stunned for a moment, and then they shook their heads, and began to feel a little pitiful for Lu Cheng.

These things, that can come with an open mouth?

After all, Lu Cheng is still younger, and there are many mistakes, because of this mistake, if Lu Cheng wants to gain Professor Min's trust again, it will take at least half a year to be down-to-earth, and this time, compared to what Professor Min said some time ago, he can leave him some opportunities,

It should be at least half a year long.

And these hours of clinical infiltration are enough to make Lu Cheng grow a big circle.

The other graduate students and doctors present here, Zhuo Yuan, who has the most experience of this medical record, just shook his head slightly, and said secretly, junior brother, I remember that I told you the rules?

We, the graduate students, must do our part, what should be said and what should not be said, is it because we are not too detailed.

Lu Cheng's heart didn't think about it that much, although he could feel Professor Min's unkind gaze, he still didn't feel that he had done anything wrong.

First, my original intention is to watch from the sidelines and not to force it. The speech was requested by the professor.

Second, even if what I say next is wrong, there is a professor to correct it.

As a graduate student and a little doctor, it is their right to make mistakes and not know, if they can do it, then why do they need professors?

Third, Professor Min is not a man of words and cannot listen to any truth.

So, Lu Cheng continued: "The platelet level is above 30, which is my conclusion, not nonsense. Of course, nature is not reflected in all the current literature. ”

"However, teachers, I would like to talk about the reason why I came up with the figure of more than 30. If there is something wrong with the statement, please ask the teachers for guidance. Lu Cheng knew that he might have said something wrong, so he apologized first.

After all, if you say an accurate number for no reason, everyone will doubt it.

"Idiopathic thrombocytopenia is defined as an unexplained, perhaps immune-related, decrease in platelet levels that can cause bleeding throughout the body, most commonly bleeding gums. ”

"But one thing we need to pay attention to is that platelets have four basic functions. ”

"One, adhesion, two, agglutination, three, release, four, contraction. ”

"When blood vessels are damaged, platelets will adhere to the damaged blood vessels or capillaries, and agglutinate, release various procoagulant factors, and finally contract to achieve hemostasis. ”

"But the truth is that platelets are only part of the blood clotting function for hemostasis. ”

"The coagulation system is mainly composed of coagulation factors related to the endogenous and exogenous coagulation system. ”

"The presence of these coagulation factors and thrombin to promote the formation of multimers of fibrin is the key to blood clotting and hemostasis in our body. ”

Lu Cheng paused a little when he said this, these are the basic common sense of medical physiology, and the next is his main explanation:

"We can find that patients with idiopathic thrombocytopenia have a normal coagulation system, so their exogenous and endogenous coagulation pathways are normal, which means that their clotting time and prothrombin formation time are normal. ”

"In addition, we can also find that there is literature to support that in patients with clotting factor deficiency, the normal level of platelets may not have a large effect on the patient's clotting time. ”

"In addition to that, we have to pay attention. ”

"In the postoperative operation of any joint replacement patient, in order to prevent thrombosis in both lower extremities, we will prophylactically anticoagulation, and the most commonly used in clinical practice is low molecular weight heparin. ”

"Again, we should note that even in normal patients, the use of low molecular weight heparin sodium can lead to the development of thrombocytopenia, and even if the probability of occurrence is small, it is real. ”

"In the patients we mentioned for thrombocytopenia, heparin sodium will also be used for prophylactic anticoagulation postoperatively to reduce complications. ”

"Through statistical methods, I came up with the following pattern. ”

"The incidence of thrombocytopenia-related complications after surgery in all patients with thrombocytopenia in the current literature is not much different from the complications caused by heparin sodium in normal people. ”

"And the current reported preoperative platelet level is 34, so we may be able to lower this preoperative level a little bit, but I only conservatively estimated it to 30. ”

When Lu Cheng finished speaking unhurriedly, he also noticed that the faces of everyone present became wonderful.