Chapter 400: Heterophilia
It was around three o'clock in the afternoon.
Liu Qingqing went to the operating room first, and Qian Jianghong's third operation was almost finished, so Liu Qingqing didn't wash his hands and stood aside to watch for a while.
Qian Jianghong said: "Sister Lin's surgery is done?" Pretty smooth, right? ”
"It's good." Liu Qingqing was a little listless, skipped the topic directly, and said, "There is a patient with gastrointestinal bleeding in the Department of Internal Medicine, who has already done a gastroscopy yesterday, but he is still bleeding, and the hemoglobin cannot be maintained. The family would like to ask you to take a look. ”
"Call us to the surgeon?"
"yes, he wants to go straight to surgery. However, I have seen hemoglobin and it is not suitable for surgery at this time. ”
Qian Jianghong thought for a while: "Does he have liver disease?" Have you ever done a B-ultrasound? Are there any abdominal tumors? ”
"I'm sure there is no liver disease, and as for the abdominal tumor, I don't know."
Qian Jianghong said: "Did they send a consultation form?" Internal medicine is really outrageous, in this case, you should consult the hematology department! Maybe it's hemophilia? ”
Qian Jianghong didn't have surgery anymore, and directly handed over the finishing work to Liu Shucheng and Huang Zhaoyun.
The two returned to the ward, and sure enough, the consultation list from the Department of Gastroenterology had been delivered, and the speed was really fast enough.
Well, it was sent by Yuan Yue personally, it seems that he is really in a hurry, behind the gold-rimmed glasses, the two glasses are covered with bloodshots, and he may not have slept all night.
"Dr. Liu, you're finally back! I've been waiting for you for a long time. Yuan Yue hurriedly stuffed the consultation sheet into Liu Qingqing's hand.
For a long time?
Liu Qingqing went from the health center to the operating room and called Qian Jianghong back to the ward, which would take no more than half an hour at most.
Yuan Yue was really anxious.
Qian Jianghong smiled, "It turns out that you know each other." ”
Acquaintances must take care of it, even if they can't take care of it, go to see the patient, and give the patient a psychological comfort.
Qian Jianghong took care of Liu Qingqing's face, "Then let's go." ”
The three of them took the elevator to the gastroenterology department.
Yuan Yue led the way in front and led the two to Yuan Yu's bed.
At this moment, Yuan Yu was lying on the bed sickly, his face was sallow, and his breathing was slightly short.
An oxygen tube is inserted in one nostril and a gastric tube is inserted in the other, and the drainage bulb connected to the gastric tube shows a soy sauce-like liquid.
The gastric juice is generally dark green and is now soy sauce-like, possibly with blood.
Yuan Yu was connected to an ECG monitor, and the blood pressure measured in the previous round was 9050mmHg and his heart rate was 110 beats.
Qian Jianghong asked, "Your sister's usual blood pressure is not so low, right?" ”
Yuan Yue replied: "In the past, community physical examinations were normal. ”
Yuan Yu added weakly: "There is no high blood pressure, usually 13070mmHg, the doctor said that it is not more than 140, it is normal." ”
The problem is that Yuan Yu's blood pressure is now on the verge of low blood pressure, indicating that the blood loss is serious.
Yuan Yu has a deep vein catheter in his arm and is currently receiving a blood transfusion.
Qian Jianghong asked, "Does your stomach hurt?" Where does it hurt? ”
Yuan Yu pointed to the position of the upper abdomen.
Qian Jianghong asked her to bend her legs and do abdominal palpation, but she didn't feel a swollen mass or anything like that, but there was tenderness in her upper abdomen.
My legs are slightly swollen, I don't know if it's related to the large amount of infusion in the past two days.
Yuan Yu's situation does not look optimistic.
Liu Qingqing said beside her: "Director Qian, I look at her like a parasite. ”
The parasite, which is about 1 cm long, constantly bites Yuan Yu's small intestine, causing repeated bleeding there, so it is no wonder that the bleeding still cannot be eradicated after the gastroscopy stops the bleeding.
"Oh?" Qian Jianghong grabbed the patient's hand and looked at it.
Yuan Yu's fingers are slender, clean, and well-maintained.
Qian Jianghong asked, "What does your sister do?" ”
Yuan Yue said: "She is a teacher, a Chinese teacher, and has been rated as an excellent teacher!" ”
If you are not a farmer, you should not have the opportunity to come into contact with the soil and be infected with parasites.
At this time,
Director Jin Zhen of the Department of Gastroenterology also came and greeted Qian Jianghong warmly: "Director Qian, right?" Fortunately, we also suspected parasites before, and did a test for eggs, but no eggs were found. ”
"Oh, yes." Qian Jianghong responded for some reason, and decided to return to the nurse's station to look at the patient's medical records.
Liu Qingqing was still beside Yuan Yu's bedside, strange, she obviously saw some wriggling nematodes on the upper end of Yuan Yu's small intestine, how could she not find the eggs.
"Has your sister been to the countryside lately?"
"I haven't been to the countryside before, but there is a farmhouse in the suburbs where rice is grown, and their school organized students to experience it, is that counted?"
"Uh------" Such an important situation, Yuan Yue didn't say it just now.
In this way, it is very likely that Yuan Yu was infected with nematodes when he was experiencing the farmhouse.
However, in addition to the nematodes in the small intestine, Liu Qingqing found that Yuan Yu's lungs also had many bleeding spots, so why?
Yuan Yu seemed to be a little bored, holding up a hand and biting the sleeve of his clothes.
At first, Liu Qingqing thought that she was in too much pain, so she could hold back the pain by biting something, but when she looked closely, she found that there was a gap in her sleeve.
"Hey, your sleeves are torn, do you want to ask the nurse to change your clothes?" Liu Qingqing asked.
"En------ don't need to -------" Yuan Yu was suddenly a little cramped, like a student who had made a mistake, and lowered his head.
Liu Qingqing was shocked, "You won't eat it, will you?" ”
"Ah------- uh-------" Yuan Yu was speechless.
Yuan Yue also looked at his sister in a daze, "Sister, why did you ------- you ------- this sleeve was bitten by you?" ”
Yuan Yu's face swelled, "I don't know why, I suddenly think it's delicious." ”
"Ahh Yuan Yue grew up and couldn't close his mouth anymore, "Sister, you ------- you--------" His elegant squinting eyes stared at Lao Yuan for a moment, probably thinking that his sister had a neuropathy.
And Yuan Yu lowered his head, didn't say a word, and was still biting his sleeves, and the cuffs were already wet with saliva.
"Koyanagi!" Qian Jianghong called Liu Qingqing at the door. UU reads books
Liu Qingqing came to the nurse's station with a cigarette, "Director Qian, the patient was just eating his sleeves." ”
"Huh?" Jin Zhen said, "Iron deficiency anemia. ”
Iron deficiency anemia can cause some patients to have abnormal manifestations such as eating raw rice, soil, cinders, rags, etc., which is called "heterophilia".
"She also has problems with her lungs." Liu Qingqing said.
Jin Zhen said: "Yes, the respiratory department has been invited to come for consultation. ”
Liu Qingqing said: "I still think she is a parasite. ”
Jin Zhen said: "The eggs have been checked, but they have not been found." ”
Liu Qingqing didn't give up: "Do you want to check it again?" ”
Jin Zhen looked at Liu Qingqing, saw that she was very young, and knew that she came with Qian Jianghong, "There is no need for that, and repeated examinations may cause patients to complain." ”
Qian Jianghong said: "Haven't you considered hemophilia?" ”
Hemophilia is a bleeding disorder in which there is an inherited coagulopathy, and its common features are impaired active thromboplastin production, prolonged clotting time, and a lifelong tendency to bleed after mild trauma.
In the case of hemophilia, then a slight ulcer in the small intestine can also cause recurrent bleeding.
Jin Zhen said: "Yes, I also invited the hematology department to come for a consultation." ”
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