"Okay, it's good to answer like this, if you don't know, you can't say it clearly, and then everyone will be clear in their hearts." Lin Lin deliberately played with words.

"Another question, when Dr. Cai reported his medical history just now, he said that the child had convulsive seizures. I would like to know how the mental state of the child differs before and after the attack. ”

"Before the attack, my mental state was good, but after the attack, I became lethargic." After Cai Xiaofeng answered, he was secretly surprised in his heart: It turned out that Dean Lin could hear the report just now.

"Okay, thank you very much Dr. Cai for your report and answer, let's go see the patient." Lin Lin stood up, took the white coat handed to him by Yang Yan and put it on his body.

When I came to the child's bedside, the child's mother was playing with the child, and it seemed that the child was still in good spirits.

Lin Lin stood and observed for a while, and then asked Yang Yan for a stethoscope.

"Dean Lin, the child is very afraid of the stethoscope, he will cry when he sees it, and he will not let you approach him." Cai Xiaofeng reminded in time.

"Oh, then, don't have a stethoscope." After Lin Lin finished speaking, she took a step forward and came to the bedside.

"Look here, kids." Lin Lin said, using her fingers to pop out the sound of "popping", the sound was loud and crisp, and the child was quickly attracted.

"Come, learn from your uncle, and you'll be able to play well." Lin Lin bent down, stretched out her hand to the child, and slowly showed the child the movement of snapping her fingers.

Amazingly, the child also stretched out his tender little hand and learned. Although he couldn't make a sound, the child was happy and smiled a little.

"Come, give my uncle a hug." Lin Lin stretched out her hands to the child, and the child reacted quickly and also stretched out her hands to Lin Lin.

Lin Lin picked up the child, and then rubbed her chin under the child's neck a few times, and the child was amused and laughed.

Lin Lin took advantage of this moment to put her ear close to the child's chest and listened carefully. Front, side, back, Lin Lin listened to it all once. The doctors next to them were stunned: Is there such an auscultation?

Yang Yan's beautiful eyes were even more brilliant: "This guy has a lot of ideas." ”

After listening to the heart and lungs, Lin Lin gently placed the child on the bed.

"Is he in the best spirit at this time of the day?" Lin Lin asked the child's mother.

"Yes, the spirit is the best at this time, and in the afternoon and evening, the spirit is worse."

"How bad is it?"

"I just don't want to deal with people, and I look listless."

"Do you sleep all the time?"

"That won't be."

"How's it going?"

"Very little, always don't want to eat, can't feed anything."

"Okay, thank you. Director Yang, borrow your percussion hammer. ”

"Well, here you go." Yang Yan handed the percussion hammer to Lin Lin.

Lin Lin carefully and systematically underwent a neurological physical examination.

After Lin Lin put away the percussion hammer, she gently massaged the child's abdomen with her hand, but the child did not respond.

Lin Lin put her hand on the back of the child's back pillow, and with a little force, she bent her neck forward, and the child cried, and Lin Lin also felt the resistance of her neck.

Lin Lin teased the child again, and the child stopped crying. Lin Lin was still not at ease, so she reached out and lifted one of the child's lower limbs in a way that the knee joint was bent at 90 degrees, and then straightened the knee joint, and the child cried again.

The doctors present all knew what Lin Lin was doing, Cai Xiaofeng didn't dare to make a sound, and Qiu Bin's face was very complicated and ugly.

Yes, the tests that Lin Lin did, and the reaction of these tests on the children, were slapping them in the face.

"That's all for my checks, let's see what else you need to do?" Lin Lin was not arbitrary, he gave them a chance.

No one answered, indicating that no one did better and thought more than Lin Lin.

"Okay, let's go to the office and talk about it." Lin Lin said to Yang Yan.

"yes, okay." Yang Yan agreed and led everyone back to the doctor's office.

After everyone sat down, Lin Lin asked Yang Yan with a smile: "Director Yang, I'm going to sing a one-man show?" ”

"Yes, you have to sing this play." Yang Yan was happy in her heart and replied with a smile.

"Okay, let me tell me my thoughts on the diagnosis and treatment of this child, what is wrong, please wait for me to finish, and criticize and correct."

"The onset of the child was subacute, with fever, poor spirit and vomiting as the main symptoms, and after admission, the treatment according to the viral brain was not ideal, and there was a trend of aggravation recently."

"During my physical examination today, the patient's heart and lungs were clean on both sides, and no obvious wet and dry rales were heard. Of course, my auscultation is irregular and is a last resort. ”

"On neurological examination, the child's pyramidal signs were negative, but the meningeal irritation signs were positive, and they were very positive."

"I looked at the laboratory tests after I was admitted to the hospital, and there were actually still a lot of problems."

"First, several blood routines, white blood cells were mildly elevated, and neutrophils were also synchronously elevated."

"Second, the blood biochemical examination, albumin is low, and it is clear from the consultation just now that the child eats very little, which should be one of the reasons. I said one, of course there is two, this, I'll talk about it later. ”

"Third, the child's cerebrospinal fluid examination showed that the number of white blood cells reached 160, and the red blood cells were basically normal. The Pansa test of cerebrospinal fluid is two plus, the cerebrospinal fluid protein is 80 mg, and the cerebrospinal fluid is mildly reduced in sugar and chloride. ”

"Fourth, the child's EEG did not see epileptic discharges, only a small amount of slow waves in the background."

"Fifth, the electrolyte test of the child is low in potassium and sodium, which may be related to the patient's lack of food."

"Sixth, I calculated the amount of fluid intake of the child, and if the fluid loss caused by fever is included, the intake is far from enough."

"Judging from the response to the treatment, there is a few days of false improvement, which is what Dr. Cai just said, in the first few days of using hormones, the body temperature returned to normal, but soon, the body temperature rose again, and the condition began to worsen during this time. This is of great significance. ”

"Combined with the above characteristics, the positioning diagnosis of this child, I consider it to be meningeal damage, and the damage to the brain parenchyma is not obvious, and even if there is, it is very mild."

"Let me explain this. When Dr. Cai reported his medical history, he said that the child had obvious drowsiness. In fact, from the situation reported by Dr. Cai and the information in the medical records I have just seen, the child should not have obvious drowsiness, not even drowsiness. ”

"However, I haven't seen the patient, so I don't dare to jump to conclusions."

"Just now, I saw the child and asked the child's mother. Now, I can say with certainty that the patient's state of consciousness is far from the level of drowsiness. ”