Lin Yi was not impatient.

The time spent in the emergency department is not short, what kind of patient has not been seen?

I've had a lot of trouble before, and although they will be taken away by the police in the end, that kind of person is crazy and dares to do anything.

Lin Yi said in a very calm tone:

"This gentleman, you are coming to see our doctor's age? Or are you here to heal? ”

"If you have to find an elderly doctor, there are many doctors in our hospital who are in their eighties and rehired, and I can introduce you to them."

"If you're here to heal, I can show you."

Seeing Lin Yi's calm and breezy demeanor, the middle-aged man's mood eased a little.

The nurse next to her also immediately cooperated: "Don't look young as Dr. Lin, we are the leader of the independent clinic in our emergency department. ”

"The level is very high, he is very famous in our whole hospital, and he has no problem treating you."

As soon as I heard that Lin Yi was in an independent clinic at such a young age, most of the middle-aged manhood disappeared.

He hesitated for a moment and said, "Why don't you give me a good look again and see what kind of illness I am, I am very skeptical of what the doctor said just now." ”

The man said, pulling out all his inspection reports.

Lin Yi turned on the viewing light, put the film on it, looked at it in detail for a while, and then carefully looked at the test results.

The man's illness is already clear in his heart.

"I already know about your condition, so what are you suspicious of?"

The man said: "I was spitting bloodshot, I was afraid that it was cancer, and after the examination, I said that there was nothing wrong with me, I didn't believe it." ”

Lin Yi looked at his inspection report for a while and nodded:

"Well, you do get sick!"

When the middle-aged man heard Lin Yi say that he was indeed sick, he immediately looked nervous, and even his hands trembled a little.

"Doctor, am I really sick?"

"Am I having lung cancer?"

"Am I not going to live long?"

"Am I still saved?"

A series of questions from the depths of his soul made Lin Yi speechless.

This is a fight with the patient who always thought he was sick during the previous live broadcast.

He really wanted to say, "It's hopeless, wait for death!" ”

But the work ethic didn't allow him to do that.

Even the nurse next to her forced a smile.

Although she is not a doctor, this middle-aged man has been diagnosed by Dr. Wang, and basically cannot go wrong.

If he doesn't have any major problems, there should be no serious problems.

But this man has to think about lung cancer, it's weird enough!

Who would have fantasized that they had cancer!

And Lin Yi's medical skill level is there, and his surgical ability and rich clinical experience in recent months are obvious to everyone in the emergency department.

But now listening to Lin Yi, this man is really sick, and she also wants to know what kind of illness this man is.

Therefore, the head nurse couldn't help but prick up her ears and wait for Lin Yi's next words.

Seeing that Lin Yi had not spoken, the middle-aged man became even more nervous.

The muscles seemed to tremble a little, and the lips trembled a little.

"Doctor, why don't you speak? Did I really get lung cancer? I have money, I'm not afraid to spend money, if you give me all those imported medicines, you will definitely cure me. ”

Lin Yi couldn't help but sigh secretly.

This man also looks like a rich man.

He was very curious, with the intelligence of a man, how could he make so much money?

"You're sick, but not lung cancer."

Lin Yi pointed to the part of his heart and continued: "You are sick here. ”

"Heart disease!"

"What?"

"Heart disease?!"

The middle-aged man's eyes widened suddenly, and his voice was raised: "You said that I am not lung cancer, I am heart disease?" Heart disease, how can I cough and vomit blood? Will you see a doctor? ”

The head nurse was also speechless.

Say you're not lung cancer, you're still in a hurry!

Don't you have to get lung cancer to be happy?

There are really any kind of people in this hospital, you can meet them, and there are even people who want to get lung cancer.

She had never seen this kind of thought in her life!

Lin Yihuan put his arm on the table, looked directly at the middle-aged man, and said slowly:

"You do have a little problem in your lungs. However, it's not lung cancer, it's just bronchitis.

It may be caused by a cold and cold a while ago. But bronchitis, which causes you to cough violently and triggers the rupture of capillaries in the lungs, is why it causes blood in the cough sputum, which is not lung cancer! ”

"You don't want to search the internet for some symptoms and suspect you have lung cancer.

I can tell you now that there is some bronchitis in your lungs, and there is no major problem. ”

"What Dr. Wang told you before was right, you only need to take some antibiotics orally now, as well as cough and phlegm medicines, and you will slowly recover."

"But you have to think about your own illness to the aspect of lung cancer, you are not a heart disease, what is it?"

Lin Yi explained in detail, and explained the reason why the middle-aged man coughed with blood very clearly.

Even the nurse on the side nodded secretly.

I feel that Lin Yi is serious and careful in seeing a doctor, and he is also very patient.

For such a strange patient, he is not in a hurry or impatient.

couldn't help but praise Lin Yi again and again.

Although Lin Yi explained in detail, the middle-aged man didn't buy it.

"I used to have a lot of colds, coughing and spitting, but I have never had blood in the sputum, why this time, cough with blood in the sputum after a cold?"

"And other people in my family also have colds and coughs, why don't they have a cough with blood? But I have it? ”

"And it is also said on the Internet that if you cough with blood in your sputum, you must be vigilant against lung cancer. I have blood in my phlegm, and you still say that I am just a small problem, just take some medicine, will you see a doctor? ”

"Or do you see that I have lung cancer, and you deliberately don't tell me about it, and ask me to call my family members?"

"You are irresponsible to the patient, you little young doctor is really unreliable!"

The real cause of this man was indeed bronchitis, which was a rupture of capillaries and bleeding.

And the cough with blood in the phlegm is not a big problem, and it will slowly heal after a few days of taking some medicine.

But this person, who doesn't know where to see blood in the sputum, thinks about lung cancer.

Therefore, he stubbornly believed that he was lung cancer, and thought that the doctor lied to him.

For this kind of paranoid and stubborn patient, it is impossible for Lin Yi to patiently explain to him all the time.

Even if you explain it to him, he won't believe it, he would rather believe what he sees and hears than the doctor.

And there are not a few such patients.

Lin Yi said solemnly again: "According to all your current examination results, you are just tracheitis, not lung cancer at all." If you don't believe me, you can choose to go to another hospital. ”

The middle-aged man stood up suddenly, his voice raising again.

"If you can't see the problem, let me go to other hospitals to see, your central hospital is at this level?"

"What a quack! Wasted my morning time. ”

After the middle-aged man finished speaking, he snatched the door and left.

Looking at the middle-aged man who hurriedly went out, the head nurse was stunned.

"Director Lin, why is this person like this? You tell him that there is nothing wrong with it, but you don't believe it, and you have to believe that you have lung cancer, it's really strange! ”

"I've made it clear to him what needs to be said. If you don't believe it, you can't help it. Since he is not short of money, let him toss as he wants. ”

The middle-aged man got out of the emergency department and did not go to other departments to register, but scolded all the way to the parking lot.

He came to the front of the overbearing, opened the door, and got into the cab.

He took out a stick, stuffed it into his mouth, took out a lighter, and prepared to light it.

After thinking about it, he was still coughing and bleeding, so he stuffed Huazi back again.

"Hmph, this hospital is full of quacks, I saw a few doctors, and they all said that I don't have any major problems. Damn, as soon as I coughed up phlegm, it got blood, and I said I was fine.

The cough is bloody, is this okay? ”

"No, the level of this hospital is not good, and neither are the doctors, I have to go to a big hospital tomorrow for an examination."

The middle-aged man muttered while lighting the fire, kicked the accelerator, and walked away.

My house had just been demolished, and I got 20 million before I bought a big bully and married a little wife in her twenties.

You can't get lung cancer!

Not long after Lin Yi sent him away, another attending doctor from the emergency department came over and said that there was a patient who wanted Lin Yi to see.

Lin Yao took the medical record and looked at it.

He complained of bloody stool for more than a month, and was admitted to the hospital after a week of worsening with perianal foreign body sensation.

At the time of admission, all vital signs and examinations were normal, and the diagnosis of admission was mixed hemorrhoids, so suture surgery was performed.

But on the third day, he started to have bloody stools again, and the amount of blood was about 50 milliliters.

I did a simple hemostatic bandage.

Three days later, he bleed again, and the amount of bleeding was 200 ml, and the sigmoid colon vascular malformation rupture and bleeding were detected.

Surgery removes the malformed blood vessels and then sutures them.

In less than six hours, the wound was bleeding again.

Intestinal resection and intervention were performed to stop the bleeding.

Three surgeries before and after.

The amount of bleeding is also greater and heavier each time.

Lin Yi flipped through the medical records and doctor's orders.

But after looking around, I didn't find any suspicious problems.

All doctor's orders and records are treated according to bleeding, so what's the problem?

Lin Yi frowned, he also felt a little strange.

Then, Lin Yi looked through all the examination lists of the patient, including B-ultrasound, blood routine, CT and imaging results.

After looking around, there was nothing unusual.

It is equivalent to saying that the patient was only found to have hemorrhoids when he came to the hospital.

Although the blood was bloody for more than a month, the family did not even have anemia.

I still came to the hospital to cut hemorrhoids, and after bleeding and three surgeries, it caused anemia, and the hemoglobin was as low as 98g/L.

Previously, the hemoglobin was always above 110.

Yas.

What's wrong with this medical record?

Not to mention, it really aroused Lin Yi's curiosity.

Lin Yi simply sat on the chair and looked at the medical record again.

While watching, Lin Yi's mind combined the patient's physical condition.

The patient had no other injuries to his body, except for a few bleeding spots in the intestines.

I didn't have any heart disease, tumors or anything.

"The blood routine white blood cells and eosinophils are not high, and it is normal to check the four coagulation items three times.

Infectious diseases such as HIV, syphilis, and hepatitis B are also absent.

It's weird, this guy is really weird......"

Lin Yi muttered to himself.

Suddenly, Lin Yi set his eyes on the four items of blood coagulation.

The knowledge points in my mind are also tumbling rapidly, trying to find the most correct point!

The four items of coagulation are mandatory for every patient admitted to the hospital.

These include prothrombin time, thrombin time, fibrinogen quantification, and activated partial thromboplastin time.

These indicators are a combination of clotting factors in this patient.

Generally speaking, as long as the test result is normal, it means that the person does not have a blood clotting disorder.

It is possible to go to the operating room, and there will be no heavy bleeding during the operation.

But this patient had inexplicable bleeding after surgery??

Lin Yikan recorded that on the day of admission, on the fourth day and this morning, he urgently checked three coagulation items and four items.

There should be no problem with the results of the examination, and it has been checked three times.

Anticoagulants were also used in the doctor's order, but none of them worked for the patient......

So what the hell is going on??

Lin Yi frowned and thought about it repeatedly......

Suddenly!

Lin Yi's eyes lit up!

That's right!

And genes!

This patient didn't check the coagulation gene!!

All patients must be admitted to the hospital must check the four items of blood clotting, but this is the general public!

Ordinary people can basically find out how his coagulation function is, whether he has coagulation disorders, etc.

But this is only for the average patient!

There is also an extremely rare possibility that the patient may have a disease that cannot be detected by the four items of blood clotting!

It's called hemophilia!

It is an X-linked recessive hereditary hemorrhage!

It is caused by a deletion of the coagulation factor VII gene (hemophilia A) or a deletion of the coagulation factor IX (hemophilia B) gene in the patient.

This disease can only be detected by genetic testing!

Deficiency of VII is called hemophilia A, and deficiency of IX is called hemophilia B.

This disease is not easy to detect because it is rare, and the four items of routine coagulation on admission to the hospital are the majority of the screening.

As long as this result is correct, it means that the patient does not have coagulopathy.

But this patient is a rare hemophilia.

That's why I've been treated for so long, and so many anticoagulants have been inflated.

Because the medicine didn't lose to the idea.

Hemophilia A is deficient in the VII gene, and if the bleeding is stopped, the only way to stop bleeding is to transfuse blood containing more VII gene to treat bleeding.

Hemophilia B lacks the IX gene, and the treatment is the same as that of hemophilia A.

Such patients can only stop bleeding if they lack something and what they lose.

Other conditions are certainly untreatable.

Thinking of this, Lin Yi suddenly brightened.

That's definitely the reason!

Your own speculation should not be false!

Just then, there was a burst of expletives outside the office.

"The patient's father is here."

The attending doctor couldn't help but frown.

"Bleeding again? What the hell is your hospital going to do? My son has had three surgeries with you, and his health is getting worse and worse, isn't it?! ”

Then, a middle-aged man walked into the consultation room.

The attending doctor lowered his head slightly, and the scolding from his family really made him uncomfortable.

But at the moment, as a doctor, he can only suffer:

"Don't get excited, didn't I ask this Dr. Lin to show your son."