Sodium valproate is a broad-spectrum antiepileptic drug that does not contain nitrogen.

There are different degrees of antagonistic effects on convulsions caused by various methods. It is effective for all types of human epilepsy, such as petit mal seizures, myoclonic epilepsy, localized seizures, grand mal seizures, and mixed epilepsy.

In addition to anti-epileptic use, valproate sodium can also be used to treat febrile seizures, movement disorders, chorea, porphyria, schizophrenia, pain caused by herpes zoster, adrenal disorders, and prevent alcohol withdrawal syndrome, among others.

It can be said that it is very versatile.

In addition, there is another thing that is rarely mentioned by ordinary people, that is, it is also effective for mental illness caused by epilepsy, which is commonly known as "neuropathy......

If Chen Qi is going to use sodium valproate, if Yu Sisi is indeed suffering from epileptic abdominal pain, it will definitely have an effect.

But this medicine is not only not good to say, the key is that there are many side effects.

For example, the effect on liver and kidney function can easily lead to thrombocytopenia causing purpura, bleeding and prolonged bleeding time, and hearing loss and reversible hearing damage in adolescents.

However, when a doctor sees a doctor, he can only choose the lesser of the two powers, and choose the greater of the two powers, depending on whether the benefits are greater or the damage is greater.

Nothing can be perfect, and there is nothing wrong with being a medicine that is poisonous.

A doctor at Xijing Hospital disagreed:

"Dean Chen, now the diagnosis is not clear, and no evidence has been found in the relevant examinations, so if sodium valproate is applied directly, there will be certain side effects at that time, and it is difficult for parents to explain here."

He was kind enough to remind him, after all, this was a 16-year-old girl in the flower season, and everyone wanted to cure her illness at the lowest cost.

Chen Qi patiently explained:

"The little girl's clinical symptoms, medical history, and genetic history are more consistent with abdominal pain caused by epilepsy, and we should still try it, if it really doesn't work, the damage to the human body with a drug is also controllable.

If the abdominal pain can be relieved with anti-epileptic drugs, then we can be sure that it is caused by epilepsy, which is called diagnostic treatment, and it is also in line with the diagnosis and treatment standards, otherwise what should we do? Not finding out the cause is always a time bomb. ”

The unknown is the scariest.

There is a famous saying in Chinese traditional Chinese medicine: the upper medicine is not sick, the Chinese medicine is sick, and the lower medicine is sick.

For diseases, early prevention, early detection, and early treatment can avoid the worst results.

Professor Tong made a final move:

"Our gastroenterologists are too limited in their vision and only focus on the gastrointestinal tract, which is a disadvantage and the reason why we can't find the cause. Today, we are here to learn from our counterparts in Vietnam, so let's listen to Dean Chen now. ”

There are many doctors at Xijing Hospital who are angry that they originally wanted to see the awesomeness of endoscopic surgery, but not to see anything else.

But these doctors forgot that this patient was a new diagnosis, and it was their inability to diagnose that led to the patient's trip to Haidong.

Chen Qi doesn't care what others think, he is a doctor, and doctors are to treat people, and they are not actors who specialize in performing endoscopic surgery for others.

The doctor's order was quickly issued, and the head nurse personally took the sodium valproate injection.

Then everyone was waiting for the results of the drug test, waiting for Yu Sisi's abdominal pain to happen again, after all, there was no time pattern for this abdominal pain, so they could only wait.

This time it was a face-saving thing, and just before noon, the girl's abdominal pain reappeared.

The head nurse hung up a bag of sodium valproate needles as quickly as possible, and all the doctors, including Chen Qi and Professor Tong, ran to the hospital bed as fast as they could.

Everybody wants to see how it works?

The doctors of Xijing Hospital want to see how much real ability this "double director" can say?

The doctors of the Vietnamese and Chinese hospitals have no brains to trust the president, and feel that the director is 100% accurate, and now they are waiting for the mystery to be revealed for the doctors from other places to see.

The most nervous and entangled are Yu Sisi's parents, because whether the result is effective or ineffective, it is bad news for their family.

If sodium valproate has no effect, it means that the cause has not been detected, then not only is it a trip for thousands of miles, but my daughter's condition is always a heart disease, and I don't know when it will explode.

But if sodium valproate has an effect, this is also a disguised diagnosis of the existence of "epilepsy", and the news is even worse.

Sheep is crazy, for an unmarried, flowery little girl, it is too cruel to do so, and a lifetime of happiness will be ruined.

Who wants to marry a sheep in the future? What's more, the disease is hereditary.

In this way, the three parties have their own thoughts, and they are all waiting for the patient's reaction after taking the drug.

The sodium valproate injection slowly dripped into the patient's body through the infusion tube, and Dr. Ma Xiaona was by the patient's side throughout the whole process, doing physical examinations from time to time and asking questions.

After about 15 minutes, Yu Sisi, who was still shrunk into a ball of pain just now, slowly stretched out her body, and saw that she was still a little surprised:

"Doctor Ma, my stomach doesn't seem to hurt so much."

Ma Xiaona quickly pressed her stomach, then raised her head and said to Chen Qi: "The abdominal wall is no longer tense, and there is no obvious tenderness and rebound pain, sodium valproate seems to have taken effect." ”

When the girl's mother heard this, she covered her face with her hands and cried bitterly.

The girl's father also squatted on the ground and slammed the ground hard, his face full of pain and despair.

The doctors of the two hospitals, you look at me, I look at you, no one said a word, and all quietly exited the ward, and the answer is already obvious.

What I thought about was epileptic abdominal pain.

Chen Qi gently touched the little patient's head, and he didn't know whether to congratulate or comfort her to be strong, but he always had to give this little girl or her family a glimmer of hope.

"Now that the cause of your stomach ache has been identified, it's good news and bad news. But you don't have any burden, as long as you take medicine on time in the future, your abdominal pain will not occur again, and there will be no other bad symptoms coming out, understand? ”

A 16-year-old girl is not a fool, and when she sees her parents' reactions, she knows that "epilepsy" is definitely not a good thing.

But girls in the flowering and rainy seasons are always easy to fool and are much more optimistic:

"Okay, I listen to you, I will definitely take the medicine on time in the future!"

People's joys and sorrows are not connected, and Yu Sisi's family felt that the sky had fallen and fell into endless despair.

When Chen Qi walked into the gastroenterology office, there was a round of applause.

Professor Tong kept nodding:

"Yes, yes, Xiao Chen, you are really an all-round doctor, such a rare disease can be diagnosed, you look at our Xijing Hospital, I can't find it out after half a month, I'm ashamed."

Chen Qi thought to himself that the level of your Xijing Hospital is indeed not good, since there is no positive performance in the gastrointestinal examination, other causes should be considered.

In the final analysis, this is one of the disadvantages of specialization, specialists only focus on their own specialized diseases, and do not have the thinking and pattern of general practice.

Of course, Chen Qi can't say that:

"I was also lucky, when I first met the patient's mother at the train station, I noticed that the corners of her mouth were twitching from time to time, not very often, but I could still see something strange, and I saw it a few times later.

So I thought, is this a petit mal seizure? With this question, and then follow this line of thought, for example, will epilepsy be passed on to her daughter, that is, Yu Sisi, will epilepsy cause abdominal pain?

I remember when I asked my child's mother if she had any history of epilepsy, many doctors, including Professor Tong, suddenly realized that we all wanted to go together. I didn't diagnose it before, but I said that you were unlucky and didn't see the corners of the child's mother's mouth twitch. ”

Chen Qi's words were beautiful, and the embarrassment of many doctors in Xijing Hospital was eliminated at once.

Many doctors thought to themselves: yes, if I realized that the girl had epilepsy, I could guess that it was epileptic abdominal pain.

Although this disease is rare, doctors in grassroots hospitals may not have seen it or studied it, but the doctors at Xijing Hospital must have studied it.

Professor Tong waved his hand:

"Let's see a doctor is the same as a sports competition, winning is winning, losing is losing, and if you can't lose, blame the weather, blame the referee, blame luck, isn't it?"

Director Liang Wenwen was a little regretful:

"It's a pity, I thought Yu Sisi was suffering from some kind of gastrointestinal disease, and I wanted to see Dean Chen's endoscopic surgery."

Chen Qi also smiled: "It's not easy to see endoscopic surgery, we have a lot of patients in this area now......"

Before he finished speaking, he saw Yi Zewen, the head of the emergency department, running in in a hurry, and was shocked when he saw so many people:

"Ah, Dean, you're in a meeting, I'm sorry to disturb you."

Chen Qi knew that his henchman was fine, and he would not come to bother, and knew that there must be something else, so he asked:

"What's wrong? Something going on in the emergency department? ”

"There is something to do, in the morning we received a patient with abdominal pain, the examination was also done, and the antispasmodic painkillers were also used, but it has not worked, the patient's abdominal pain is getting worse and worse, this is not to ask your old man to go out to help see."

Chen Qi scolded with a smile:

"Fuck off, return the old man. Professor Tong, Director Liang, Director Zhou, and all of you, I'm sorry, I have an acute abdomen, and I have to miss it first. ”

Professor Tong listened with a serious face: "We're fine, you can go quickly." ”

Doctors have a natural sensitivity to emergency patients, and basically they will leave everything at hand and rush away, as a doctor at Xijing Hospital, of course, understands.

Seeing Chen Qi running away, the doctors at Xijing Hospital were idle.

Director Liang looked at Professor Tong: "Teacher Tong, how many scenic spots will we go to in Vietnam next?" ”

Many doctors in the back have bright eyes, and in addition to studying, the bigger purpose of them is to travel at public expense.

Professor Tong smiled:

"Why, you want to play the second day after you came? Let's finish the main work first, this is not another emergency patient with abdominal pain, it just happens to be our professional counterpart, so let's also go and see the excitement.

Compare it in your hearts, what is the difference between us and the diagnosis and treatment ideas of the Vietnamese Hospital, and then think about it, who has a higher level and underestimated the heroes of the world, which has caused you to be so immodest now. ”

Professor Tong is an old champion, and everyone dare not speak up when he criticizes him like this.

The old man brought his group of disciples and grandchildren over, originally to "crack down" on them, and of course he would not miss any opportunity.

Chen Qi followed Yi Zewen and ran quickly towards the emergency department:

"Lao Yi, what is the approximate situation of this patient?"

Yi Zewen hurriedly reported quickly: "The patient is the old Cui of the Post and Telecommunications Bureau opposite our hospital, Cui Tongzhi, this matter has to start from the morning......"

Cui Tongzhi, 45 years old this year, is a section chief of the Post and Telecommunications Bureau, and he is fat and round.

Usually he is kind, and it is very refreshing for someone to do something, so he is very popular, and he knows many employees in the people's hospital.

In 1989, the postal and telecommunications departments had not yet separated, and the telegraph business was also very hot, so the work of the post office was idle, the salary was still high, and it was convenient to make a phone call and send a telegram, which was a good job that everyone envied.

Cui Tongzhi went to the emergency department to see a doctor in the morning.

When he came, he was bent over, his hands on his stomach, his face was a little pale, and his fat and round face was covered with beads of sweat.

Obviously it hurts a lot.

It just so happened that Yi Zewen hadn't gotten off work on the night shift last night, so Cui Tongzhi came directly to the door.

"Director Yi, come on, my stomach hurts so much, you hurry up and help me stop the pain. Ouch hey~~~"

"Yo, isn't this the section chief of Cui University? My stomach hurts, I must have gone to some of the restaurants last night to eat and drink, right? Oh, come, lie down here, I'll check it for you, when did it start to hurt? ”

Yi Zewen joked and began to check, and Cui Tongzhi also replied honestly:

"I started to have a dull pain in the morning, and it got worse and worse 20 minutes ago, and I couldn't stand it anymore so I came to the emergency department of your hospital."

"Which hurts the most?"

Yi Zewen asked, and his brain quickly began to analyze the spectrum of the disease.

There are dozens or hundreds of causes of abdominal pain, and abdominal pain in different parts, the duration of the pain, the nature of the pain, etc., may be the key to a successful diagnosis, and no clues can be missed.

"Here, it hurts the most!"

Cui Tongzhi pointed to his navel and said that the middle of his stomach hurt the most, and when he said it, he couldn't help but want to curl up his body, as if this would relieve the pain.

Such a strong middle-aged man, at this moment, is in pain like a little girl, and it is estimated that the pain is really not light.

Yi Zewen pressed his stomach around, focusing on the area around the navel.

But the strange thing is that the patient clearly said that the abdominal pain was severe, but when pressing, he did not show a significant pain response, and the abdominal muscles did not show a tonic contraction.

The auscultation bowel sounds were a little more active, and there was nothing else, which made Yi Zewen scratch his head a little, but he didn't care.

"Check it out, you get out of bed first, do you remember what you ate last night?"

"Last night, I ate at home, it was ordinary home-cooked food, and I really didn't go out to eat and drink."

"And what about this morning?"

"In the morning, I ate two bowls of small wontons and two drawers of xiaolongbao at Dayun Qiaotou, which I used to eat often, and there was no problem."

It seems that there is no problem with the diet, but what kind of trouble is this?

(End of chapter)