After checking the room, he was still a little worried about Director Tang Fei's current situation.

After getting into trouble, you should greet the other party anyway.

is basically a subordinate relationship with Director Tang Fei, which can be regarded as a certain friendship, but it is far from the sister-brother relationship with Director Xueyan.

Just have a good excuse to call.

He was about to go to the emergency operating room to start his day's work. I can ask how the child who was diagnosed yesterday is doing.

The call came and it was quickly connected.

The explanation is okay.

"Director Tang, I'm sorry to disturb you so early!"

Zhou Can opened his mouth first.

"What's this, I've already gone to work in the hospital." She seems to be in a good mood.

Zhou Can strengthened his courage and asked tentatively, "I created a conflict in your family yesterday, I'm sorry!" If there is anything that needs my cooperation to clarify the misunderstanding, please do not hesitate to ask. ”

"Haha, I didn't expect it to be careless yesterday and overturn. I am the one who should apologize. Fortunately, after explaining it to my family, he didn't make any more trouble, and he got up very early this morning to make breakfast for me! ”

She also laughed when she mentioned yesterday's events.

Zhou Can also specially reminded her not to close the door, so as not to cause misunderstanding. As a result, she was so busy with work that she forgot her wedding anniversary. Her husband came to the hospital with a gift to look for her, and happened to find that she and Zhou Can had been in the office behind closed doors for a long time.

"It's okay. Has the child been tested? ”

Zhou Can was also slightly relieved when he heard that it was okay.

"Yesterday, many departments were already off work, and there was no way to arrange it. But I talked to the family and they agreed to do those tests. I should be able to do it this morning. ”

It was close to eight o'clock in the evening when Zhou Can came out of her office.

Most of the hospital's laboratory staff are off duty. Capsule endoscopy department, as long as it is not a special case, generally needs to make an appointment in advance.

"Doctor Zhou, Doctor Zhou, there is a rescue patient over there, and his face is purple!"

Some nurses are looking for a senior doctor to direct the rescue, but it is not yet at the point of handover. The doctor on duty is the strongest at the attending level.

She saw that Zhou Can was talking on the phone by the window at the end of the corridor, and quickly asked him for help.

"Okay, I'll be right over!"

After Zhou Can finished speaking, he explained to Director Tang Fei on the other end of the phone, "Director Tang, first of all, there are patients on my side who need to be rescued." ”

"You're busy!"

The two ended the call.

Yesterday's misunderstanding did not cause much trouble to her marriage, and Zhou Can was relieved.

Running with the nurse towards the emergency hall, he soon saw an older patient lying on a movable flat bed. The two family members nervously gathered around. Today is still Dr. Xie's night shift, and he has not yet taken over the shift.

He was on top of the triage table.

At this moment, the patient is in a coma, and Dr. Xie is working hard to give the patient cardiopulmonary resuscitation.

It's just that the patient's face is blue with a little grayish-white, which is a sign that there is a problem with blood oxygen exchange and that life is coming to an end.

Dr. Xie acted very professionally during the rescue, and the chest compression was just right, pressing 30 times, and giving the patient an artificial respiration.

For artificial respiration, Dr. Xie chose mouth-to-nose artificial respiration.

In this case, the patient's mouth is usually difficult to open, there is severe trauma, or it is in water, or the doctor's mouth is smaller than the patient's mouth.

In movies and TV series, there are often heroines drowning, and the male protagonist kisses the heroine's mouth to give her artificial respiration. That's really what the plot needs, and it's not professional at all.

The correct approach should be mouth-to-nose artificial respiration.

Also, when a female doctor or nurse encounters a patient who suddenly falls into a coma and needs to be resuscitated on the road, the woman's mouth is usually smaller than the man's. If they are psychologically strong enough, they may choose mouth-to-nose artificial respiration.

Because if a female doctor or nurse performs artificial respiration on a patient, the mouth is too small to completely seal the patient's mouth. When you blow up, the air escapes from the unblocked area and cannot enter the patient's lungs.

This condition is ineffective artificial respiration.

When blowing into the patient's mouth, do not pinch the patient's nose, this kind of unprofessional rescue is generally ordinary people. It's a common-sense error.

"The patient seems to have a bit of a problem with his airway."

Zhou Can has rich rescue experience, and it can be seen that when doing artificial respiration, the patient's chest cavity can see obvious ups and downs.

It means that the air blown in reaches the lungs.

Helped the patient complete the dilation of the lungs.

As we all know, the breathing of the lungs is done through the relaxation and contraction of the alveoli. Intuitively, it can be understood as inhaling when the left and right lungs are inflated like balloons. The contraction becomes smaller and is exhausting.

When the mouse is dissected, the changes in the lungs can be seen very clearly.

As for the general teacher, don't even think about it.

The remains used for medical research are all human beings whose lives have ended, and only the little devils are so cruel and anti-human when they use living people for medical research.

Zhou Can stepped forward, tried to raise the patient's head at a greater angle, put his hand against the patient's chin, and lifted it up.

This is the most commonly used method of raising the head and cheeks.

The patient's teeth are clenched and the mouth is tightly closed.

He pinched the patient's mouth slightly harder, revealing a two- or three-centimeter-wide thread, and then observed the inside of the mouth.

"It turned out that the base of his tongue fell back and blocked the airway!"

At first, I thought it was because the food got stuck in the trachea and caused suffocation.

This condition often occurs when the patient is delirious, and the pharyngeal muscles relax, causing the base of the tongue to fall backwards, thereby blocking the airway.

The human tongue and epiglottis are connected to the lower jaw, and at this time, just like Zhou Can, pushing the lower jaw upwards can force the tongue and epiglottis to lift away, so as to move away from the posterior pharyngeal wall, and the patient's airway can be restored.

After Zhou Can's help, the patient's airway was restored to smoothness, and the cyanosis on his face disappeared little by little, gradually returning to normal.

"How did he get unconscious?"

The patient is now completely unconscious.

This is also the main cause of the base of the tongue falling backward and blocking the airway.

"My dad has always had high blood pressure and loves to drink. The doctor told him not to drink, and we were very careful not to let him drink. He went out early this morning, bought a bottle of wine outside and drank some. It didn't take long for him to have slurred speech and his body was unable to stand firmly. We're going to get people here. On the road, the person was still awake and could still speak, but he fell into a coma directly behind. ”

The family members are a middle-aged couple in their forties.

It should be the son who answered.

The daughter-in-law stood next to her and did not speak, but looked anxiously at the unconscious patient.

"Teacher Lu, have you measured his blood pressure?"

Try not to drink alcohol for high blood pressure, because no one knows what the result will be if you take a sip of alcohol.

Especially in this elderly person, the consequences are often severe.

"Systolic blood pressure 180, diastolic blood pressure 120."

Nurse Lu is an experienced veteran nurse in the emergency department, and she often has a strong professional prediction when rescuing patients.

What kind of patient needs to find a senior doctor to come and support, she can handle it just right.

"Hurry up and check the cardiovascular and cerebrovascular systems! I think he's doing badly. ”

Zhou Can deduced from some of the patient's symptoms that it was likely to be a cerebral hemorrhage or something like that.

High blood pressure must be well controlled, once a cerebral hemorrhage occurs, the probability of stroke is extremely high. And it is particularly dangerous, and the prognosis is often very poor. It's good to end up with a hemiplegia.

……

He went into the operating room for surgery, and he didn't care about the outside world.

When he came out to eat at noon, he heard that the patient had a ruptured cerebral blood vessel and an intracranial hemorrhage. Now the person has been transferred to neurosurgery.

The neurosurgery department of Tuya Hospital actually includes brain surgery.

In some hospitals, there will be a specialized brain surgery.

Many ordinary patients think that the outside of the brain belongs to the outside of the brain, which is completely reversed. Neurosurgery covers a much wider field than the outside of the brain.

Human nerves are found in all parts of the human body.

The most studied outside the gods are the nerves of the head and the nerves of the spine.

The head can be thought of as the nerve center, and the spinal nerves are the main road to the body.

Some children suffer spinal injuries in the process of dancing, or falling from a height, or accidentally falling. Then it is directly paralyzed, and often the most common is paralysis of the lower limbs.

This is because the nerves in the spine are compressed and damaged.

When practicing dance, the child's endurance is limited, and if the child expresses a lot of pain when pressing the leg or lower the waist, then it must not be forced. It needs to be gradual, little by little, to gradually increase the difficulty of the movements.

Some dance teachers always feel that they are very professional and that it is okay to teach so many children, so they are the same rough for every child.

They pursued a strict teacher and a high apprentice.

As long as you happen to meet a child who is physically vulnerable, or when doing dance training, the lumbar spine is too heavy, which can easily lead to hemiplegia.

Some children may be fine on the spot, or they may just be in pain.

The teacher also thought she was hypocritical.

Then after a period of time, mostly for more than ten hours to two or three days, the child suddenly became paralyzed.

At this point, it's too late to say anything.

So, stop stupidly confusing the outside of the mind with the outside of the brain.

The nerve center is in the head, but the diseases treated outside the brain are not only neurological diseases, but also cerebrovascular, brain herniation, and so on.

While eating, Zhou Can checked WeChat on his mobile phone.

No way, he's just too busy.

Replying to Su Qianqian's messages, or checking private messages sent by others, can only be at noon or when he gets off work.

"Dr. Zhou, the child's test results have come out. I'll send it to you. ”

Director Tang Fei really hasn't been affected, so he should send a private message to Zhou Can and chat about it.

Director Xueyan hasn't been in contact with Zhou Can for the past two days, which inevitably makes him a little worried.

Zhou Can checked the child's test results, and the anti-gluten antibodies LGC and LGA were all positive. It seems that Zhou Can's diagnosis is correct, and the child is indeed celiac disease.

Anti-endomysial LGA antibody shows weak positive.

This is consistent with the patient's condition.

The child has celiac disease, but it is atypical.

Capsule endoscopy showed that the mucosa of the small intestine in groups 2, 3 and 4 was swollen and gyrus-like, and the mucosal surface was punctate erosion.

At this point, the diagnosis can be made without a doubt.

It is no wonder that the child has intermittent positive fecal occult blood.

The small intestine is one of the three major nutrient absorption organs of the human body, and it is also the most important nutrient absorption organ, and it has advantages that other organs do not have, which can be called unique.

The small intestine is not only the longest organ, but it also has a lot of wrinkles, and the inner wall has countless villi and fine villi.

This makes it have a total absorption area of more than 200 square meters.

Think about it, what is this concept?

Most of us live in a house of more than 100 square meters, which is about the size of two small three-bedroom houses.

Moving on, the small intestine of the children in groups 5 and 6 was swollen and granular, and bleeding spots were found on the mucosal surface.

Ulcers were found in the small intestine in group 6.

The area is not large, only about 2.5mm*2.5mm. It was covered with white moss, and Zhou Can's mucous membrane was even more obviously congested.

After this step is checked, there is no need to check again, and the diagnosis of celiac disease is undoubted.

"It's good to find out the cause, just treat it with celiac disease. I hope that the child will recover soon. ”

After reading the inspection results, Zhou Can breathed a sigh of relief.

Every time he successfully identifies the cause of a patient's illness, or watches a patient recover and be discharged from the hospital after treatment, he feels very happy and fulfilled.

The purpose of studying medicine is to help patients relieve their pain.

For example, this child, so many experts have examined and treated him, but the condition has been repeated. When the family brought the child to Tuya Hospital for treatment, they were probably quite desperate.

This is also a true portrayal of many patients and their families.

As long as there is no effect on the treatment of a disease in two or three hospitals, they will no longer have any confidence. I think that the disease is very difficult to cure.

As soon as Zhou Can finished replying to the message, Director Tang Fei called directly.

Put through.

"Did Dr. Zhou have surgery?"

"yes, just had surgery, eating in the cafeteria."

"Do you have any suggestions for the treatment of this child?"

For the treatment of celiac disease, pediatrics is no problem at all.

The disease is still difficult to diagnose. In particular, this less typical type can be easily treated as a duodenal ulcer or enteritis.

When the capsule endoscopy was examined, it was indeed found that the 6th group of small intestines had ulcers.

It's just that if you really treat the ulcer, it will definitely have no effect.

Director Tang Fei is now humbly asking Zhou Can for advice and treatment opinions, completely out of respect for Zhou Can.

"Nothing else, no-cho is to go to the gluten diet, and then considering that the patient has almost no diarrhea, you can not use hormone therapy. Finally, it is necessary to greet the family members and prepare for long-term diagnosis and treatment. ”

Zhou Can really doesn't have any special suggestions.

Some methods, techniques, and experience in the treatment of celiac disease are thanks to several chief physicians of the Department of Gastroenterology. When Zhou Can was training in this department, these chief physicians gave him a lot of guidance, and he never hid his secrets.

Director Tang Fei's diagnosis and treatment suggestions for him were all accepted as ordered.

As soon as I finished chatting with Director Tang Fei here, Director Le from the Department of Cardiothoracic Surgery also sent him a private message.

After examination, the patient who had cardia cancer and had a total gastrectomy had already had the results. Consistent with Zhou Can's inference, the patient was indeed due to the reflux of bile and pancreatic juice, which invaded the esophageal mucosa, causing severe pain.

The cause is clear, but the surgery has already been done, and it is quite difficult to solve it.

"If her situation is to be solved, I'm afraid she will need a second operation. And it can only be alleviated, and it is difficult to solve it completely. ”

Zhou Can sent a message back to Director Le.

This operation is purely Director Le's surgical plan that is not well considered. If the reflux of bile and pancreatic juice may occur after surgery when the whole stomach is removed, it is necessary to reserve some leeway and change to another more difficult surgical method.

(End of chapter)