Chapter 18 Patients with uterine bleeding

Xia Wei came to the office, filled in the medical records, and was writing, when she suddenly heard a group of noisy voices coming this way. She immediately put down her work, went to the corridor, greeted the crowd and asked, "What's the situation?" ”

A woman in the crowd said, "Is the obstetrician and gynecologist there?" ”

"Yes, I'm just, tell me what's going on?" Xia Wei led the crowd to the obstetrics and gynecology office.

The woman pointed to the woman in the recliner and said, "It's my second sister who had an abortion in the family planning office, first she was fine, but she suddenly bleed today, help us see what's going on." ”

"Oh, that's the case, quickly carry the second sister into the examination room, I'll take a look." How many days have you been doing abortion? ”

"Today is the third day, and the first two days were fine."

Xia Wei placed the patient on the examination table and instructed the family, "Help her take off one of her trouser legs." Then he brought disinfectant supplies, put on sterile gloves, and asked the patient: "Second sister, don't be nervous, is there anything uncomfortable now?" ”

"I just feel like I'm bleeding underneath, and there's nothing uncomfortable, I just don't dare to move." The second sister lay nervously on the examination table. took off her trouser legs, only to see blood flowing down her buttocks, Xia Wei immediately disinfected her vulva and opened it with a speculum, only to see a large number of blood clots blocked, so she picked up the oval forceps and took out the blood clot in **, exposing the **neck, only to see that there was also a blood clot blockage at the neck opening, and gently pulled out the blood clot in the cervical opening, and the blood continued to flow out. Xia Wei explained to the family and the patient: "Second sister, I will perform uterine evacuation surgery for you immediately, otherwise the bleeding will not stop." He immediately got up and took off his gloves and prepared the items for clearing the palace. He instructed the family members again: "Go to the ward and ask the nurse to come and help measure blood pressure." ”

After a while, Xiao Zhu, the nurse on duty, brought a blood pressure monitor, measured his blood pressure and said, "It's okay, the blood pressure is normal." ”

Xia Wei explained again: "Let's hang the balance liquid on her first, I will perform uterine clearing surgery on her." ”

"Okay." Xiao Zhu turned and left.

Xia Wei opened the abortion surgery bag, disinfected, laid a sterile towel, put on the vaginal dilator and cervical forceps, and then used the probe to probe the depth of the uterine cavity, she used the probe to probe the depth of the left uterine cavity was normal, but when the probe probed to the right uterine cavity, she found that the probe could not pass, Xia Wei thought, the width of the uterine cavity should not be so narrow, she retreated the probe to the inner cervix, and then probed to the right side, the probe entered into the depth without obstruction, she slowly continued to enter the probe forward, and suddenly there was a bottom, and the depth of the uterine cavity was measured to reach eleven centimeters. At this time, Xia Wei made a judgment: the second sister is a double **, she only had an abortion operation on one side, and the other side is still pregnant. Xia Wei explained to her family: "The second sister is a double **, the left uterine cavity is of normal size, and the right side needs to be suction again, I will give her uterine suction first." ”

"Okay, I'm sorry for you."

"It doesn't matter, it's important to stop the bleeding." Xia Wei spoke, picked up the straw and began to attract. Xia Wei felt that there was a large piece of soft sponge-like tissue in the cavity that could not be sucked out, so she immediately took out the straw, replaced it with edentous forceps, entered the uterine cavity, clamped it with soft tissue, exited the uterine cavity, and then picked up the straw again to suck the remaining tissue in the uterine cavity. At this time, the amount of bleeding was significantly reduced, and Xia Wei breathed a sigh of relief and said, "Okay, the bleeding has stopped." However, it is still necessary to be hospitalized for observation and given anti-inflammatory treatment. ”

The second sister immediately came to her senses and said, "Thank you, you scared me to death, I was at home just now, and suddenly there was blood flowing out of my seat, I was so scared that I sat there and didn't dare to move, and my mother immediately called someone to carry me on a deck chair." ”

Xia Wei smiled and said, "Now you are in good spirits, when you first came, your expression looked strange and scary." ”

The second sister also smiled: "How can I be a double **?" ”

"Yes, you are not only double**, but also two ** are pregnant, the Family Planning Office only made you an embryo sac with a **cavity, and there is a gestational embryo sac in the right uterine cavity, so it's okay for you to do it." Xia Wei poured out the tissue sucked out of the suction bottle, sifted it, poured it into the curved plate, and checked. Only the intact embryo sac and some endometrial tissue are seen. He turned around and explained to his family: "Now it's okay, the embryonic tissue is very intact and there will be no more bleeding." ”

The family members came to the front to check and said: "Doctor Xia, you are really good at medical skills, the second sister is a double **, I never knew it before, no one found out, and the doctor who went to the county family planning office to do an abortion that day did not find it, if you didn't find out, so the bleeding will kill you." ”

"Gao Ming can't talk about belching, as long as you are careful, you can still find it. The doctor at the Family Planning Office probably didn't expect her to be a double ** and ignored it. This pair of ** is also rare, and many doctors have never seen it. Xia Wei continued to work and explained.

"I see, I'm glad you found out."

"Yes, the second sister has to remember that you are a double **, and you will have to go on both sides of the ring in the future." Xia Wei explained.

"Oh, it's going to be so much trouble."

"Yes, otherwise you will have to suffer." Xia Wei packed up her belongings and continued to explain: "Second sister, get up and go to the ward to rest, I will immediately ask the nurse to do a skin test for you, and you need to use some anti-inflammatory drugs." ”

"Okay." The second sister got up and put on her pants, and her family helped her into the ward to rest.

At this time, Xia Wei received a call from an old patient, who told her on the phone that she was working in the city, and had been bleeding after menstruation last month, and it was almost a month, and it was not clean until now, and she had seen it in the hospital in the city, and the tests that should have been done were done, and there was no problem with the laboratory examination, but she had mild neck erosion, and she was given infusion treatment for many days, and she had spent thousands of yuan, and now she was bleeding, and she had no money to see a doctor, so she was going to come back and ask Xia Wei to help her.

When Xia Wei learned of this situation, she immediately agreed to the patient's request and asked her to bring all the medical records and examination reports.

The next day, the patient came to Xia Wei's office as scheduled, she looked at all the medical records and various laboratory reports, the only positive sign was mild cervical erosion, given hemostatic agents and antibiotic infusion treatment, after reading these, Xia Wei gave the patient a gynecological examination, found that the patient ** and the cervical opening had a small amount of bright red blood, so she wiped the blood with a dry cotton ball, waited for a few seconds, she found that there was a small amount of bright red blood oozing out of the erosion area of the cervical ostium, and there was no blood outflow in the uterine orifice, She basically concluded that the bleeding was on the erosion surface of the internal cervical orifice, and the cause of the bleeding was already clear, so she immediately gave ** internal disinfection, gave the internal cervical orifice to apply traditional Chinese medicine hemostatic powder, pressed the wound with dry gauze, and instructed the patient to come to the hospital every day to give cervical medicine.

The patient came as promised, Xia Wei took out the gauze at the inner opening of the cervix, and saw that there was a small amount of bright red blood on the gauze, and the bleeding from the erosive surface of the cervix had been significantly reduced. insisted on taking medicine on the cervix for a week, and prescribed some Chinese medicine effervescent tablets to the patient to continue the treatment of cervicitis. The patient spent more than 100 yuan in total. On the day of the patient's departure, he held Xia Wei's hand and said, "Doctor Xia, you really deserve to be a good doctor with a sense of responsibility!" I am drugged every day, so I can't thank you enough. ”

"No thanks, you can work with peace of mind, if you feel uncomfortable, you can call me, and I will try to help you if I can." It's not easy for you to work outside. ”

Xia Wei watched the patient's departure, her heart was uneasy, she was thinking, just such a simple cervical inflammation and bleeding, let the patient toss for so long, spent so much money, the result still did not achieve the effect of treatment, it is really sad. From this point of view, it is not only a matter of responsibility, but also may hide a more little-known bad tendency, they put the safety of patients at risk, which is really too undeserved, and also lacks professional ethics.

She wrote in her notebook: As a doctor, you must adhere to professional ethics and not be blinded by money.