"Guillain-Barré syndrome?" Hearing Xu Ze's words, Director Qu was stunned for a moment, a glimmer of light flashed in his eyes under the black-framed glasses, and he glanced at Xu Ze fixedly, but said with some surprise: "You also know about this disease?" ”

Seeing Director Qu ask like this, Xu Ze was overjoyed, and secretly said that Director Qu knew that he didn't need to bother to talk about it.

He nodded lightly at the moment, then handed over the medical record in his hand and said to Director Qu: "Director, look at this patient..."

Seeing that the medical record handed over by Xu Ze was the patient who had seen the fatigue chaint he had seen, Director Qu couldn't help but be stunned, and after taking a deep look at Xu Ze, he finally took the medical record and looked at it.

Director Qu looked very carefully, turned over page by page, and thought for a long time, he also went to see this patient today, but there were too many patients at that time, and he did some examinations, and then after listening to Qian Xuebin's report, he agreed to his diagnosis, but he didn't take this disease into account at that time.

However, according to the information I saw last time, in retrospect, some of the symptoms are very similar, and it seems that the diagnosis of myasthenia gravis is more appropriate than this neurogenic surname.

Director Qu thought for a long time before he looked up at Xu Ze and said slowly, "Have you also read the latest information?" ”

Xu Ze nodded, then looked at Director Qu and said, "Director, I have just conducted a detailed examination and physical examination of the patient, which is slightly more detailed than the medical history recorded by Dr. Qian, the patient had a history of infection two weeks before the onset of the disease, and a history of limb and neck pain before the onset of the disease!" ”

Hearing Xu Ze's explanation, Director Qu's eyes gradually brightened, and he motioned for Xu Ze to continue.

"On physical examination, in addition to the decrease and loss of limb muscle strength and the loss of tendon reflexes, I also found that the patient had superficial sensory impairment of the lower limbs, although it was only mild, but it did exist..."

Xu Ze paused slightly, saw that Director Qu was looking at him, listening carefully, and continued: "Through some of the current medical treatments carried out by Dr. Qian, the patient's effect is not certain, and it only temporarily prevents the further aggravation of the condition, and does not achieve tangible results, indicating that the diagnosis of neurogenic muscle weakness is still questionable. ”

"So according to the current medical history and physical examination analysis, the possibility of Guillain-Barré syndrome is extremely great...", Xu Ze looked at Director Qu fixedly, waiting for his reaction.

After listening to Xu Ze's analysis, Director Qu nodded slowly, looked at Xu Ze approvingly, and said, "Yes, you are only at this age, but you can have such a wide range of knowledge, and you can be so careful, it's very good..."

"Yes, but we must be careful in the diagnosis of this disease, after all, it is a newly discovered disease, and there are not many reports on this in China..." Let's check it out again! ”

Seeing that Director Qu did not object to his opinion, nor did he easily agree, but insisted on checking and confirming it together again, Xu Ze couldn't help but nod secretly, this is the caution that a medical expert with advanced professional qualities should have. The two of them did not hesitate at the moment, and went directly to the ward.

After watching Director Qu and his new disciples chat for a while, they went out together, Zhang Qi next to him looked up in surprise, and then continued to write a record of his illness.

The two pushed open the door of the ward and walked to the bed of the patient with fatigue, the family members and patients next to him had seen Director Qu this morning, and knew that he was the professor of the attached one and the director here.

At this time, when I saw Director Qu coming in, the family was originally feeding the patient porridge, so he quickly stood up happily and said, "Director Qu, hello!" ”

Director Qu smiled and nodded, and then said to the patient: "There were too many patients this morning, and things were too busy, so I didn't give you a detailed examination... Now Dr. Xu and I will give you a closer examination! ”

"Ahh Good, good... I'm sorry for you and Dr. Xu! The patient looked at Director Qu and Xu Ze beside him, and quickly thanked him excitedly and politely.

Director Qu smiled and asked about the medical history again, and listened to Director Qu's inquiry, but the patient was curious, how did Director Qu like the first Doctor Xiao Xu, like asking some inexplicable irrelevant things.

Hearing what he asked, Director Qu nodded, and then conducted a careful physical examination, and the final result was indeed as Xu Ze said, in addition to the loss of muscle strength and tendon reflexes in the lower limbs, the patient also had a slight superficial sensory impairment in the lower limbs.

After the examination, Director Qu nodded at Xu Ze, and then the two of them left the ward.

Director Qu looked at Qian Xuebin's medical records, couldn't help frowning and shaking his head, secretly saying why didn't Qian Xuebin ask about his condition carefully, if he asked carefully, he wouldn't have almost missed this disease today.

At the moment, I couldn't help but look at Xu Zedao happily: "According to this situation, it is indeed very similar to Guillain-Barré syndrome, but there is no official information in China yet, and our diagnosis is still not definitive..."

Xu Ze chuckled and said, "Director, Guillain-Barré syndrome has a characteristic thing, that is, the separation of protein cells in cerebrospinal fluid... We just need to do a lumbar puncture and extract some cerebrospinal fluid for testing, and it should be fine..."

"Protein cell isolation?" Director Qu frowned and recalled the information he saw, there seemed to be this statement on it, and he didn't remember it very clearly, but it seemed that what he said above was not very certain, and he couldn't help but look at Xu Ze and said, "Xu Ze, are you sure?" ”

"I remember that the treatment of Guillain-Barré syndrome and this neurogenic surname muscle weakness was almost completely different... Be cautious about this! Director Qu looked at Xu Ze and said seriously.

Xu Ze smiled and nodded, he was completely sure that what he just said was right, because this had been proven in future medical technology.

"That's good... Let's go for a waist piercing now... Don't delay any longer, you must get this disease diagnosed as soon as possible! Director Qu resolutely stood up and said.

Seeing that Director Qu was so anxious, Xu Ze couldn't help but be stunned: "Don't we have to wait for Doctor Qian?" ”

"Now I don't have to wait... He should be ready for lunch now, he won't come to take over at noon, let's hurry up and do it first, and make a diagnosis as soon as possible..."Director Qu said categorically.

Seeing Director Qu's affirmation, Xu Ze no longer hesitated, nodded, and then said, "Then I'll prepare the utensils!" ”

Although Xu Ze was not too familiar with the emergency department, with the help of the little nurse Hu Xia, he quickly prepared all the utensils for the waist piercing.

Director Qu personally went to call the patient's family to come over and told him about the newly discovered situation and the necessary surname for this lumbar puncture examination.

The family members heard Director Qu's words, and remembered that Dr. Xiao Xu came to check first, and then asked about the situation, and then Director Qu came to ask again, and then thought about this problem, but they couldn't help but be secretly grateful to Xu Ze, if it wasn't for Dr. Xiao Xu to find out the problem and tell Director Qu very responsibly, I'm afraid that I can't find this possible reason.

At that moment, I hurriedly signed the consent form for waist wear, and asked Director Qu to be more careful. Xu Ze, who was waiting, came in with the utensils he wore on his waist, and the family members saw Xu Ze very enthusiastically, which made Xu Ze a little unaccustomed to it.

Seeing that Xu Ze was ready, Director Qu took Xu Ze, and the two of them went straight to the ward with their things.

At this time, the patient had already learned about the situation from the family, and he was going to do such an examination, but his eyes when he looked at Xu Ze were very different from the first one, and his eyes were full of gratitude.

Director Qu pushed his glasses and watched Xu Ze skillfully position the patient in a side-lying position with his knees hugged, and then he was curious again, and said secretly: "Could it be that Xu Ze can actually do a lumbar puncture?" It can't be, right? It is not possible to do this lumbar puncture in the clinic! ”

However, out of an inexplicable confidence in Xu Ze's surprise to him today, after Xu Ze prepared for himself, he looked at Xu Ze and said tentatively: "Xu Ze, will you do it?" ”

Hearing Director Qu's question, Xu Ze was stunned for a moment, but replied honestly: "Yes..."

"Yes?" Director Qu's eyes flashed with a strange light, and a hint of surprise flashed, and he smiled immediately: "Okay... Then you do it! ”

"Oh... Good! Listening to his own hands, Xu Ze was still very excited about being able to actually perform a lumbar puncture with his own hands, after all, he had only carried out simulated drills in the void space before, although these simulated drills were almost the same as the real ones, but when he really did it, he was still extremely excited.

Lumbar puncture is also a small operation with great difficulty, and many doctors rarely succeed in the first or second time, but Xu Ze is still quite confident in himself.

At that moment, in order to make a successful puncture, Xu Ze adjusted the patient's position again, so that the patient's back was perpendicular to the bed, the head was bent forward and chest, and the hands and knees were close to the abdomen, so that the trunk was arched, so that the patient's spine protruded as much as possible to increase the width of the intervertebral space and facilitate needle insertion.

Then he began to select the position of the puncture, he stretched out his hands, and determined the puncture point at the intersection of the posterior superior iliac spine line of the pelvis and the posterior midline of the spine, which is the position of the spinous process space of the 3rd ~ 4th lumbar vertebrae, and it is also the best position for puncture.

Then take out the complexed iodine cotton swab, routinely disinfect the skin at the puncture point, then wear sterile gloves, open the sterile lumbar puncture bag, and spread a disinfectant towel for the patient... Director Qu looked at Xu Ze's movements with satisfaction, Xu Ze did these procedures extremely skillfully, completely in line with the procedures of aseptic operation, and did not make a single mistake, just like a veteran.

This made Director Qu secretly amazed, Xu Ze really surprised him too much today, I really don't know where he learned this? How can a junior know this?

At this time, seeing that Xu Ze had already laid out the disinfectant towel and picked up the syringe, Director Qu suppressed his surprise, took out a 2% lidocaine from the plate, opened it, and came to Xu Ze, waiting for Xu Ze to draw the medicine and fulfill his duties as an assistant.

And Zhang Qi, who had been in the office at this time, also followed curiously at this time, and at this time he saw that Director Qu was actually working as an assistant for Xu Ze, and he couldn't help but be taken aback, Director Qu was an assistant to others, and this person was still a novice who had just arrived, if he said it, who could believe it?