The fat man took a large handful of test sheets and returned to the consultation room.

"In the acute stage of gout, I will first give you the medicine to see if it can stop the pain, if not, I will come and see," the doctor explained coldly.

"Doctor, is the girl who brought me here also from your hospital?" The fat man asked curiously.

"Dr. Li Haishan from the gynecology department!"

"You go get the medicine! There are outpatients in the back," the doctor urged.

The fat man endured the pain in his feet and limped to take the medicine. Probenecid...... Ibuprofen extended-release capsules.

The fat man found a water dispenser in the outpatient hall, got a cup and took a glass of water, and drank both medicines according to the instructions.

Sitting on the chair in the outpatient hall, he felt that the biggest thing in life was life and death, looking at the bustling patients, the confusion in his heart began to break the ice, he took out his mobile phone and recorded his improvement of the work plan in the mobile phone sticky notes, he had entered the working state, he had been scribbling and painting for several hours, he had forgotten where he was.

Hai Shan, who was about to go to the cafeteria to eat, saw the fat man she brought sitting on the chair stupidly, and she didn't know what she was thinking? Hai Shan didn't have a good anger and went up and pushed him: "Fatty, why don't you leave, you are still in the outpatient clinic and want to do it?" ”

The fat man was pushed by her, and only then did he turn back from his thoughts at work, why he was still in the hospital, and he didn't know it! Li Haishan, who looked at her and pushed her, remembered the scene in the morning, "Doctor Li, I'll invite you to dinner at noon, and you can popularize a little gout knowledge for me."

"There is no space" Hai Shan annoyed him in her heart, why is it so annoying, you can meet fat men wherever you go.

"Why are you doctors so cold to your patients?"

Shan went straight to the point and said, "Don't you know? The more enthusiastic the doctor, the better and more cordial he is to you, it means that there is a big problem with your body, and the doctor has finished saying a sentence or two, which means that you have no big problem, and he is cold to you, isn't it good? ”

When the fat man heard this, he took out the two medicines prescribed by the surgeon and handed them to Haishan.

Probenecid inhibits urate reabsorption in the proximal renal tubules, thereby increasing uric acid excretion and decreasing uric acid levels. It is necessary to drink plenty of fluids to avoid causing stones. Anti-inflammatory and analgesic drugs: ibuprofen extended-release capsules. It can inhibit the synthesis of prostaglandins, has analgesic, anti-inflammatory, and antipyretic effects, and is best used for no more than five days. Hai Shan said the principle of the two medicines in one breath, and the fat man looked at Hai Shan and admired in his heart, the little girl is still quite good, and her professional knowledge is really harmful.

"How did I cause this disease, how can I prevent it! It's going to hurt me today," the fat man still had lingering palpitations about the pain in the morning.

"Bad habits! Drinking, especially drinking beer and skewers, let's talk about beer bars first, the alcohol that enters the body is metabolized in the liver tissue and then ingests a large amount of water, plus the meat, animal offal, and seafood you eat make uric acid, which is close to saturation, accelerates the formation of crystals, resulting in an overreaction of the body's immune system, which causes inflammation, so the joints swell."

"Isn't that why you can't drink beer and skewer in the future?"

"That's right! Quit alcohol and sugar, exercise more, and drink more water."

The fat man smiled and looked at Haishan, "Doctor, we don't know each other, for the sake of my cat, add a WeChat, if I have any minor illnesses and disasters in the future, I can also consult you, if you like my cat, I can also bring it out for you to play"

Hai Shan still likes his white and black cat, took out her mobile phone, and the two of them added WeChat to each other.

"I'll bring the cat out tomorrow morning after I'm fed and give you a little fun."

Hysan's phone rang. Li Xizi urged her to eat Chinese food with her again. Haishan said goodbye to the fat man! When she had time, she asked him to play with cats.

The world is the biggest eater, and now Li Haishan is going to the cafeteria to eat Chinese food.

The cafeteria was crowded with doctors and nurses, and when Li Xizi saw Hai Shan enter the cafeteria, he quickly stood up and waved his hand vigorously, "Come here...... Come here," Hassana ran over in small steps.

"The food for you, what are you grinding today, you didn't have surgery this morning, and the food is going to be cold"

"Thank you! Delayed by a little thing, I returned the cat to its owner, and it happened that he had a gout attack, and I took him to the surgical clinic to see him, and I met him again after work, I feel it! This person was a little stupid, sitting alone on the outpatient chair in a daze, so he chatted a few more words"

"Day by day, you have a lot to do" Li Xizi made her eventful expression.

Complete the inpatient assessment form for newly admitted patients...... Inpatient Condition Notification ...... Consent to treatment regimen...... Record of the first course of illness.

Today's class was free, and Haishan took out a white rabbit toffee and ate it. "Dr. Lai, go to the director's office" A nurse ran into the doctor's office to inform him.

"Director Qin, what are you looking for me?"

Director Qin told Hai Shan: "Professor Lin of the Department of Surgery asked you to go to the surgery for support, and the emergency department said that a female patient with a tracheal foreign body was about to be sent over, so you immediately went to report to Professor Lin." ”

"Okay, I know, I'll go right away" Li Haishan thought that she could be idle for a day today, but she didn't expect to receive a task.

In the emergency room doctor's office, Professor Lin and the village doctor were having a telephone conversation, and the village doctor told Professor Lin that the family said that the foreign body in the patient's trachea was peanuts.

Professor Lin instructed the village doctor to "give the patient a flat position, give psychological support as much as possible, and comfort the patient"

A nurse in her forties said to Professor Lin with a blue bar on her hat, "Professor, do you need to start the multidisciplinary care (MDT) model?" ”

Professor Lin responded, "Immediately start the multidisciplinary diagnosis and treatment (MDT) model, open a "green channel", and notify the departments of internal medicine, thoracic surgery, anesthesiology, otolaryngology, and collaborative diagnosis and treatment.

The head nurse ran to the emergency department and the head nurse informed them one by one.

"Internal Medicine, bring a doctor to the emergency doctor's office"

"Department of anesthesiology, please prepare an operating room, there may be an emergency room to use, and Professor Lin of the Department of Surgery informs you that an anesthesiologist is needed to coordinate diagnosis and treatment."

"Thoracic surgery? Is the director in the department? Please come to the emergency department immediately for medical cooperation."

Is the otolaryngology doctor there? Please consult the emergency department »

"Head nurse, the female patient has arrived at the hospital," a group of doctors in white coats, led by Professor Lin, stood in the passage waiting for the arrival of the patient.

A contest of life and death, a war for life at the hands of the Grim Reaper is about to begin, it is not a battle, but it is more fierce than a battle.

A CT scan, clamped onto a development screen.

The director of the imaging department pointed to the CT film: "There is a round foreign body in the narrow part of the trifurcation where the main trachea and bronchi meet, and the airway is almost blocked"

Professor Lin asked for the advice of the experts and doctors who entered the imaging department together.

"The risk is very high, the airway is almost completely blocked, open the thoracotomy and trachea, I'm afraid it's too late, maybe before the thoracotomy is opened, the person dies," said the director of thoracic surgery.

"If you transfer to a provincial hospital, I am afraid that on the way, the patient will be suffocated by a foreign body, and the patient will stop breathing and die," the internist said.

"The safest method, bronchoscopic foreign body removal, the operation is also very difficult, peanuts have two petals, if the peanut skin is broken, the peanuts will be broken under the action of forceps, it is very difficult," the imaging expert said his opinion.

"Dr. Lai, what do you think?" Professor Lin named Haishan.

Haishan, who was named, was a little excited in her heart, with so many experts, she could still say her views as a little doctor, and she was happy...... Can she summarize before speaking?

Professor Lin nodded again, indicating that she should speak boldly.

"Teachers, experts, I think luck is very important, if you are lucky, you can grab the peanuts with a single stroke" Hai Shan finished speaking, and made a gesture of grasping something.

Newborn calves are not afraid of tigers, young is good, and Professor Lin still likes the vigor and courage of young doctors.

After the consultation, we came up with four treatment plans

1. Immediately transfer to a provincial hospital

2. Bronchoscopic foreign body removal

3. Thoracotomy tracheal foreign body removal

Fourth, the Heimlich maneuver of first aid, try to take foreign bodies

The director of thoracic surgery should talk to the family immediately, and every treatment plan should be clearly discussed and explained to the family. Sign the notification of illness, the consent form for surgery, and prepare the operating room of each department. Professor Lin gave the order.

"Doctor, help my mom"

The chief of thoracic surgery patted the family on the shoulder and told him that there were four treatment options for him to choose from

The first plan: send to the provincial hospital, the advantage of the provincial hospital is the high level of medical care, the disadvantage of transfer: the bump of the patient during the transfer may make the foreign body rotate and displace, and the airway may be blocked at any time, which may directly lead to his death.

"Oops, I can't send my mother to a provincial hospital, I'm afraid she'll die on the way" The family disagreed with the first plan.

The second option: bronchoscopic foreign body removal

By taking a foreign body under bronchoscopy, advantages: less trauma. Disadvantages: high requirements for anesthesia, there may be anesthesia accidents during the operation or peanuts are broken when the peanuts are clamped by the forceps, and it is very difficult and the risk is extremely high to remove the foreign body completely. However, at present, the preferred option for multidisciplinary joint consultation.

"Doctor, is there a better way?" The family members asked again with sad faces.

"There are two more options"

The third option: thoracotomy and tracheal foreign body removal

If bronchoscopic removal of the foreign body fails, thoracotomy can only be performed, or it is possible that the patient dies of suffocation due to lack of time.

Thoracotomy will also cause great trauma to the patient, and the trachea is not easy to heal completely after surgery, which may form tracheal stenosis, affect respiratory function, and reduce the quality of life.

"There's another plan?"

The fourth option is: the Heimlich maneuver, which tries to take a foreign body, and the probability of failure is very high.

The family squatted on the ground with their heads in their hands, and quickly stood up, and he chose the plan of the doctors' consultation.

"Okay, sign the surgery consent form immediately, you can rest assured, our doctor will do his best, and Professor Lin of our hospital will personally perform this operation."