"That little boy was obviously found to be a brain tumor, and he also showed a brain disease, how could it be related to cardiovascular?" Director Qu's wrinkled face was already full of red.

Embarrassment, shame, and unwillingness made her old face unbearable.

This kind of old expert values face more than anything else.

Lin Jinzhi just listened silently and didn't speak. However, it can be seen from his expression that he has significantly more trust in Zhou Can.

"The brain tumor was only a benign meningioma, and it was not large in size, and it did not cause substantial damage to the patient's brain. Later, it was found that the artery on the aorta that was transfused to the head and neck had a congenital stenosis, which caused the little boy's brain to be insufficient. In particular, when the little boy turns his head, he compresses and stretches the narrowed section of the blood vessel, which aggravates the tension of the blood supply to the blood vessel, so the phenomenon of syncope often occurs. Dr. Chow placed a vascular stent to expand the narrowed blood vessel segment, and the little boy was cured and discharged from the hospital. ”

Director Zhuang was also very curious about the cause of the little boy at that time.

So I made a special inquiry.

In the end, I didn't expect the harvest to be quite big.

After listening to his detailed explanation, Director Qu stopped speaking with a gloomy expression.

"Okay, let's continue to study the cause of Ambiguous Xi! Dr. Chow, tell me why you think the disease is malignant. ”

Director Tang Fei saw that Director Qu's face had turned from red to white, and was worried that something was wrong with her body.

also for the unity of the department, quickly change the topic.

Discussing the little boy's meningioma again will only make Director Qu even more embarrassed.

She also secretly wondered why many doctors in the department got along well with Zhou Can, why did some experts treat Zhou Can so-for-tat?

Not only do people get older and weirder.

Moreover, many veteran experts have an instinctive sense of protection of their own authority and achievements. When doctors who are too young surpass them in the field of medicine they are good at, it can make them feel a sense of crisis and jealousy.

In the end, they were hostile and opposed to Zhou Can.

It's just normal.

As Zhou Can's strength becomes stronger and stronger, they will eventually lower their arrogant heads and accept Zhou Can's rise and excellence.

To be honest, at Zhou Can's age, many newly graduated doctoral medical students may not even be able to do simple sewing skin. Tie a knot, grind for a long time, and be scolded by a senior doctor for cutting threads.

There are many regular trainees and interns who can't cut threads in clinical practice.

Needless to say, the rotation of interns is almost entirely a superficial initial contact with clinical practice. The work is basically handy, and the technical content is very low. The most that many interns do is learn to write medical records and run errands.

As for entering the operating room, let alone an intern, even a regular trainee has to depend on whether his fate is good or not.

When you meet a good instructor, you may take it into the operating room and give you a chance to observe it.

The vast majority of trainees enjoy the treatment of not only wanting you to work, but also not giving you the opportunity to grow and learn the best skills. Because the department is not stupid, knowing that you will leave after two or three months, it is better to focus on training doctors in the department than to spend effort and resources on cultivating you.

Speaking of which, I would like to discuss the importance of choosing an undergraduate department for trainees.

For example, Zhou Can was originally admitted to the emergency department, and this is his undergraduate department.

Normally, the department will make great efforts to train its own trainees. All kinds of growth opportunities will be abundant.

As for the rotation to other departments, it depends on fate.

If it is a demon like Zhou Can, or a special talent with a top degree like Du Leng, he can be treated preferentially in any department. Ordinary trainees rotate to other departments, especially the surgical department, and may not even have many opportunities to get into the operating room.

You don't need to pull the hook.

Zhou Can saw that Director Qu was honest, so he didn't care about her anymore.

Rather, he said aloud: "The symptoms of intestinal malignant histiocytosis are variable. I have been exposed to cases in both the Department of Digestive Surgery and the Department of Gastroenterology, which are characterized by a sudden and ferocious onset, often accompanied by prolonged high fever, progressive failure, jaundice, and bleeding. If you want to confirm whether Lin Yuxi is a malignant group disease, there is another way to check whether her liver, spleen, and lymph nodes are swollen. ”

Also, her decrease in blood count is consistent with the disease. Judging from the symptoms that have manifested so far, many of the symptoms are highly consistent with the disease. In addition, the Provincial Children's Hospital has no effect on her treatment with antibiotics and glucocorticoids, which can also indirectly prove that it is a malignant group disease. ”

Zhou Can repeatedly said a number of reasons for the high suspicion of this disease.

These are rich clinical experience, profound medical knowledge, and need to be flexibly used in clinical practice to be so free to go straight to the source of the lesion.

"I have already examined her and her liver area is indeed enlarged, and the right upper abdomen can even be seen to be asymmetrically enlarged. Swollen lymph nodes are also present, especially in the armpits. ”

Director Tang Fei said.

As soon as these words came out, the cause of the child was directly pointed to the malignant group disease.

"I have also been exposed to two cases of malignant disease, which is relatively rare in clinical practice. In the two cases I came into contact with, no abdominal mass was found. Malignant cells have a characteristic that they are mostly scattered and unevenly distributed. ”

An old expert objected.

"Its symptoms are variable, and I don't think it's the only gold standard for being mostly scattered and unevenly distributed."

Zhou Can argued.

"Well, even if this can't be used as the gold standard, the Provincial Children's Hospital has done a bone marrow aspiration on the patient, and the test result is negative. No abnormal cells were found, so this always overturns the conclusion of malignant disease, right? ”

The level of this old expert is still quite high.

Grasp some of the important doubts for argumentation, and overturn Zhou Can's diagnostic conclusion.

This is also the biggest difference between Zhou Can and the diagnosis of old experts.

Zhou Can's mind is very young, bold and careful, and he often dares to think and do. Some difficult diseases have complex symptoms, and the results of various examinations are confusing, and it is difficult to draw effective conclusions according to conventional diagnostic ideas.

Old experts tend to be conservative and too cautious, and the probability of error is much smaller.

However, it can also be difficult to diagnose the true cause.

"I disagree with the exclusion of malignant disease on the basis of a negative bone marrow aspirate result. In intestinal malignant histiocytosis, bone marrow involvement is rare, and a negative bone puncture is normal. To determine the cause, I recommend exploratory laparotomy or abdominal puncture. However, abdominal puncture is extremely difficult, and laparoscopic exploration should be a patient-friendly method that can maximize the identification of the cause. ”

Zhou Can also knew that the little girl was young, only five years old.

And he is currently seriously ill and in an extremely dangerous condition.

In this case, it is difficult for the family to accept the laparotomy and exploration.

There is also great harm to sick children.

"Thank you to the experts, Director Tang and Dr. Zhou for their in-depth discussion on the cause of my daughter's illness. It's just that my daughter's current condition is very unsatisfactory, and she can bear laparoscopic exploration? Will there be danger? ”

Lin Jinzhi objected.

The doctor can only give a diagnosis and treatment plan, and the family is the real decision-maker.

No matter how good the treatment plan is given by the doctor, it is in vain for the family to disagree with the treatment.

"There are risks associated with any surgery. Exploratory laparoscopy is less risky than exploratory laparotomy, although there are still significant risks. The risk of abdominal puncture is relatively low, but it is extremely difficult to perform and the results are not always accurate. In clinical practice, the identification of malignant group disease is actually mostly autopsy. If there is a concern, depending on the location of your daughter's abdominal mass, I recommend a fiberoptic colonoscopy with a biopsy, which should also be able to diagnose the cause. ”

Zhou Can proposed a new inspection plan.

In general, malignant disease is located in the colon and is easy to detect with colonoscopy and biopsy.

But the little girl's mass is in the ileocecal region, so the conclusion is unknown.

Considering the concerns of his family, Zhou Can could only propose such a compromise solution.

"Choosing a fiberoptic colonoscopy is indeed more suitable for Ambiguous Xi."

Director Tang Fei spoke.

"I listen to the experts, since you think it is necessary to check a colonoscopy, then check one."

Lin Jinzhi no longer hesitated.

In particular, when I heard Zhou Can say that the cause of the evil group was identified, it often appeared in the corpse.

It terrified his heart.

"Okay, since the Forestry Bureau agrees, then I'll arrange it immediately. The malignant group disease is very dangerous, and the condition has dragged on for so long, in fact, it has been a little delayed, so I'll go and see the situation of Ambiguous Xi first. If she meets the requirements of colonoscopy, arrange for her to do one tonight. ”

Director Tang Fei's words are obviously opening a green channel for the daughter of the Forestry Bureau.

There are many ways to show goodwill.

Her kind of show of favor is much more clever than Director Qu's kind of merit-grabbing show of goodwill.

"Director Tang and Forestry Bureau, it is certainly a good way to do fiber colonoscopy, but considering that Lin Yuxi currently has blood in the stool, colonoscopy may not be possible. If that doesn't work, I recommend laparoscopy. ”

Zhou Can said to the two very sincerely.

"Okay, thank you Dr. Zhou, I'll think about it carefully."

It is clear that the Forestry Department is still concerned about the risks of laparoscopy.

After all, life is not child's play.

He never wanted anything to happen to his daughter.

……

After the consultation, Zhou Can also went home.

After a busy day, he was also very tired, and since then, he has been busy every day, and he has not taken care of the daughter of the Forestry Bureau.

Until six days, according to the rules, he will go to the pediatric clinic again the next day.

But in the middle of the night on the sixth day, I received a strange phone call.

At that time, Zhou Can was sleeping with Su Qianqian in his arms. Seeing that it was a strange call, I wasn't going to answer it.

Out of the doctor's sense of responsibility, he finally took it.

As soon as I connected it, I heard the trembling voice of a middle-aged man with a crying voice on the other end of the phone.

"Doctor Zhou, help......"

"Who are you?"

Zhou Can's heart tightened, could it be that this person had a sudden heart attack or something like that? In this case, it is indeed more efficient to call for help from him, the doctor.

"I'm Lin Jinzhi from the Health and Family Planning Bureau! My daughter's condition continues to deteriorate and she is dying, I regret not following your advice for laparoscopy, please come and save my daughter! I can't help it......"

can make the boss of the dignified Health and Planning Bureau cry so silently, it can be seen that the daughter of the Forest Bureau has become extremely ill.

During the consultation that night, Zhou Can repeatedly persuaded the Forestry Bureau to give his daughter a laparoscopy.

Surgeons perform any surgery that will take into account the harm and benefits of the surgery.

Laparoscopy is more harmful, but compared to saving lives, this risk is really nothing.

This means that the medical technology is now developed, and the level of laparoscopic surgery in Tuya Hospital is very high. Otherwise, according to the previous traditional method, only an open examination can be done.

"Okay, I'll rush to the hospital right away!"

Zhou Can considered that the other party's identity was special, and this matter was really hard to shirk.

In his heart, he actually knew that even if it passed, it would be difficult to save people.

There are so many specialists in pediatrics who don't eat dry food.

Zhou Can can think of any treatment method, they can think of.

When he arrived at the hospital, Director Tang Fei was already there.

can make her rush to the hospital in the middle of the night, and only a boss of the level of the forest bureau can do it.

The directors are actually very busy on weekdays, and their work and rest time are disrupted, which has a great impact on their bodies and work.

"Doctor Zhou, please find a way to save my daughter! I regret that I didn't listen to your advice in the first place, and I shouldn't have hesitated. Now Shengsheng has harmed my daughter like this......"

When Lin Jinzhi saw Zhou Can, he hurriedly grabbed Zhou Can's hand and asked him for help with a crying voice.

In the face of life and death, what status, fame, power, and majesty...... Everything is a floating cloud.

At this moment, Lin Jinzhi is just the most ordinary father, afraid and worried about his daughter's imminent death. I tried my best to get the doctor to save her.

"Forest Bureau, don't worry. Let me start with the situation. ”

After Zhou Can finished speaking, he looked at Director Tang Fei.

"Director Tang, where is the sick child now?"

"Inside the ICU, the situation is very bad, I'm afraid it's ...... Let's go check it out first! ”

Director Tang Fei should have wanted to say that he was afraid that he wouldn't be able to survive tonight.

Eventually, he swallowed the words back.

She must consider the feelings of the family.

Zhou Can is actually reluctant to enter the ICU, because of various strict disinfection and sterilization procedures, which is very troublesome.

Just one clean hand will take a while.

You also have to change into protective clothing and shoes.

And the atmosphere inside is very solemn, which makes him very dislike the depression of fighting with death all the time.

When he entered, he saw that the little girl was already very emaciated, her upper abdomen was more swollen, her breathing was short, and her face was so pale that there was no blood. There is hardly much difference from the face of a dead man.

"Alas!"

He let out a long sigh.

After reading it, I came to the lounge outside with Director Tang and Lin Jinzhi, who accompanied him.

"It's terrible, and the malignant disease itself is very dangerous. With every hour of delay, the condition can progress greatly. My level is limited, and I really can't do anything about it. ”

Zhou Can is not a god, his medical skills are very high, but there is a limit.

If you can raise a number of medical skills to level seven, you may be able to try to save the little girl's life. Now, he doesn't even have the idea of trying.

Because it's really helpless.

"Dr. Zhou, I have heard a lot of anecdotes about you in the pediatric department in the past few days. I know you're very capable, please, save my daughter. You just have to let go and save people, and you don't have to take any risks. ”

Lin Jinzhi begged bitterly again.

(End of chapter)