PS: Second watch, continue to Carvin, there are two more watches today, damn it! Kneel down and beg for a monthly pass, a recommended ticket!

Don't look at Huanggu County Hospital is only a county-level second-class hospital, not a big hospital, but Huanggu County has a large population, with such a large population base, naturally there are many patients who come to see a doctor every day, except for the obstetrics and gynecology department, which is deserted, there are many other outpatients.

Su Hongwen sat in the outpatient clinic boredly flipping through a book of obstetrics and gynecology surgery, he had read this book many times, and now he could almost memorize it backwards, Su Hongwen really didn't want to live such a boring day, now he wanted to quickly complete the branch tasks of obstetrics and gynecology, and then move to other departments.

Just as Su Hongwen was flipping through the book with some irritability, the door opened, and a woman in her thirties led a little girl of seven or eight years old.

The woman's face was a little embarrassed at first when she saw that it was a male doctor who was sitting in the consultation, but then she gritted her teeth and led her daughter over, put the registration ticket on the table first, and opened her mouth several times to say something, but she couldn't say the words when she came to her mouth.

Seeing the woman's embarrassed expression, Su Hongwen smiled bitterly, it seems that the male doctor in obstetrics and gynecology is really not good, many female patients are like this, and they are embarrassed to say their own condition, but this patient is not bad, and he didn't turn around and leave as soon as he saw himself like other patients.

"Sit, what's uncomfortable?" Su Hongwen said softly.

"That, that ......" the woman didn't say a complete sentence for a long time.

"If you feel uncomfortable, say it slowly, don't feel embarrassed, I'm a doctor. You don't have to care about my gender, just treat me like a woman. Su Hongwen saw that she couldn't say it, so he had to comfort her first, and guided her to tell her about her condition, in order to let the patient tell him about his condition, he even said that he was a woman.

The woman thought for a moment and gritted her teeth and said, "It's not that I'm uncomfortable, it's my daughter, she, she ......" The woman couldn't say it again.

"What's wrong with the kid?" Su Hongwen didn't feel that this was a gynecology, so it was not appropriate for a woman to bring a child to see a doctor, and the little girl might also suffer from gynecological diseases.

The woman frowned and struggled for a long time and said, "She, his chest has developed." It's a good thing. ”

Su Hongwen frowned when he heard this. Turning his head to look at the little girl, the child was seven or eight years old, with a pair of big eyes on his white face, and two pigtails were very cute. It's still a little cold. The little girl was dressed a little too much. Therefore, Su Hongwen could not see the development of her breasts clearly, but from the woman's words, Su Hongwen could infer that the child was suffering from precocious puberty.

"Take off the child's clothes and I'll take a look." Su Hongwen didn't expect to encounter such a rare disease today.

"This?" The woman began to be embarrassed again.

"Don't be burdened, as I said. I am a doctor, in the eyes of the doctor, the patient is not gendered, and the child is likely to have precocious puberty, although this disease is not fatal, but the child can not grow taller, if not treated in time, she will grow up to 1.5 meters, you don't want to delay the child's condition, just let her grow so tall, right? "Su Hongwen is telling the truth.

To put it bluntly, the disease of precocious puberty is that the abnormal hormone secretion in the body causes the patient to enter puberty early, and the linear growth of the patient's body accelerates, but due to the rapid development of height and premature epiphysis, it will eventually lead to short stature, 50% of patients are less than 152cm in height, and even affect intellectual development in severe cases, but it is relatively rare.

Hearing Su Hongwen's words, the woman gritted her teeth and took off the child's shirt, Su Hongwen looked at it, the child's chest had indeed developed, and the woman meant that the child had menstruation, and the diagnosis of precocious puberty was confirmed, but now Su Hongwen wanted to figure out the reason.

In fact, the disease of precocious puberty should belong to pediatrics, it is a disease of the endocrine system, but the woman saw that her daughter came to menstruation, and she didn't understand it and brought it to the gynecology, but it is not wrong to say that this disease belongs to gynecology, precocious puberty is one of the female reproductive endocrine diseases, so there is nothing wrong with seeing gynecology or pediatrics, of course, there will be special pediatric endocrinology departments in large hospitals, but county-level hospitals do not, so Su Hongwen is not a patient who robs pediatrics.

Asked the woman to dress the child, Su Hongwen asked the child's name and age, the child's name is Fan Qingqing, just eight years old, which also applies for the diagnosis of precocious puberty.

Precocious puberty refers to abnormal conditions in which girls develop secondary sexual characteristics before the age of 8 and boys before the age of 9.

Now what Su Hongwen has to do is to figure out the cause, he explained to Qingqing's mother Zhang Yafang while opening the examination list: "The cause of the disease that causes precocious puberty may be caused by organic lesions of the central nervous system, it may be a tumor or a cyst, so it is necessary to take a head CT, does the child have any other symptoms recently, such as nausea, vomiting, and headache?" ”

Zhang Yafang heard Su Hongwen say this, her face was full of nervousness, and she quickly shook her head and said, "Then no, the doctor can't really be a tumor, right?" "People talk about tumors, because in their eyes, tumors are equal to cancer.

"This probability is relatively low, you can rest assured, even if it is a tumor, it is rarely malignant, it is generally benign, it can be completely cured, and it will not have any impact on the child." Speaking of this, Su Hongwen said: "I have to do a B-ultrasound, I have to look at the development of the child's uterus and ovaries." ”

"Okay, okay, we'll do it, you can just drive." Zhang Yafang, who is a mother, can spend as much as she wants to cure her child's illness, this is a mother, a great mother.

Su Hongwen said so much to explain to the patient's family, because Qingqing has to do a lot of auxiliary examinations, including head CT, B-ultrasound, wrist X-ray (examination of poor bone age), these are imaging examinations, as well as hormone examinations, such as plasma reproductive hormone measurement to see if it is central precocious puberty, TSH, T3, T4 to check whether thyroid function is due to abnormalities to promote Qingqing's early development, and the most important GnRH provocation test to see if Qingqing is idiopathic precocious puberty.

The price of these auxiliary examinations is not low, in order not to let the patient's family misunderstand that he deliberately opened more checklists, Su Hongwen had to explain in detail.

When Su Hongwen finished these auxiliary examinations, Zhang Yafang suddenly said: "Doctor, my daughter broke her head half a month ago, and she did a head CT at that time, do you think the CT can still be used?" Zhang Yafang's family is not too wealthy, and she was too worried about her daughter's condition just now, so Su Hongwen said that when she opened the CT scan, she didn't expect that there would be a CT film at home, which would calm down and think that if the CT can be used, it can save nearly 200 yuan.

Su Hongwen thought for a while and said: "Let's still do it, just compare it with the previous one, some patients' brain lesions will progress in half a month." ”

"Okay, then I'll take her for a check-up." Zhang Yafang felt that it made sense when she heard Su Hongwen say this, for the sake of her daughter's health, spend two hundred more.

One morning, Su Hongwen didn't have any patients, he had been waiting for Zhang Yafang to come to him with the checklist after the examination, but he didn't see her when he got off work, it seems that Zhang Yafang didn't trust himself because he was young, and he probably went to find other doctors, thinking of this, Su Hongwen was a little disappointed, sighed and closed the door and went home for dinner.

At two o'clock in the afternoon, Su Hongwen just opened the door, Zhang Yafang and a man came with Qingqing, the man is Qingqing's father is called Fan Long, in the morning, Zhang Yafang took her daughter to check and see that there was still some time before the results came out, so she took her daughter home to get the CT film, and when she came back and ran up and down to get her daughter's examination results, it was already past 12 o'clock, and Su Hongwen had already left when she came to the clinic.

There was no way Zhang Yafang had to come in the afternoon, Fan Long heard that his daughter had this disease, so he still had the heart to go to work, so he came with him in the afternoon.

Fan Long frowned as soon as he saw Su Hongwen sitting in the outpatient clinic, he looked at Su Hongwen too young like everyone else, and he couldn't believe it, but in front of Su Hongwen, Fan Long didn't say anything, he went out of the clinic directly, took out the phone to find someone, he wanted to find an older doctor to take a good look at his daughter.

Su Hongwen took the auxiliary checklist handed by Zhang Yafang and looked at it carefully, and when he finished watching the two CT scans, he frowned together, and thought for a while: "Judging from the examination results, Qingqing is precocious puberty caused by hypothalamic hamartoma, and she has to undergo surgery to remove the hamartoma." ”

"What? I still have to do surgery, what kind of tumor is the doctor, is it cancer? Zhang Yafang's heart was in her throat at this time, she was afraid that her daughter would have some terminal illness.

"Don't be nervous, it's not cancer, and surgery won't have any effect on Qingqing." Su Hongwen explained.

At this moment, He Jiali's mocking voice suddenly came: "Doctor Su, don't you know that patients with precocious puberty due to hypothalamic hamartoma do not need to undergo surgery immediately, but take medication first?" ”

Fan Longgang called to find someone, and it happened that his friend helped him contact He Jiali, He Jiali came a little later in the afternoon, and after receiving the call, he didn't go to the ward and went directly to the outpatient clinic, just hearing what Su Hongwen said to Zhang Yafang just now.

He Jiali is right, it is true that patients with precocious puberty due to hypothalamic hamartoma do not need immediate surgery, but take drug treatment first, and only consider surgery when drug treatment is ineffective, and the probability of drug treatment ineffectiveness is quite small, 90% of patients can be cured after taking drugs.

"But ......" Su Hongwen was about to say the reason why he asked the patient to have surgery, but He Jiali interrupted him and said: "Don't be, it's young in the end, you don't have to read more books, young people should be diligent and studious, don't let the patient do surgery at every turn, you are a doctor, you have to be responsible for the patient, okay, I will take over this patient." (To be continued......)