The results of cardiac ultrasound were very straightforward, congestive heart failure, and at the same time indicated that Zhou Xiufang had a large pleural effusion in her chest.

Luo Yiping, deputy director of the Department of Cardiology, was invited to do a consultation, and he made a joke as soon as he saw Sun Lien. "Boss Sun, do you have another business to take care of us? I heard Director Wang say that you invited him to dinner the day before yesterday. ”

"Director Luo, please take a look at this patient's situation. Sun Lien ignored Luo Yiping's jokes, he didn't have the heart to joke with others now. He lowered his voice and said, "The patient is a relative of my teacher. ”

Luo Yiping put away the relaxed appearance and glanced at the printed cardiac color ultrasound results, "Congestive heart failure is no problem, pleural effusion is one of the typical manifestations." ”

"How to deal with it?" Sun Lien asked, "Direct diuretics?" I am worried that the old man is too old and may have low blood potassium. ”

Kidney function is generally poor in the elderly, especially the reabsorption of potassium by the kidneys, which is much weaker than that of young people. Rash use of diuretics to reduce fluid may relieve pressure on the heart, but it can cause symptoms of hypokalemia, which can lead to more serious heart problems.

"Looking at it now, giving home diuretics to the elderly definitely has more benefits than risks. Luo Yiping thought about it for a moment and said firmly, "Look at the blood potassium level, as long as it is greater than 3mmol/L, take diuretics first." He paused suddenly, "You also have to judge the cause of heart failure, generally speaking, the elderly suddenly have heart failure in winter, and eight out of ten are lung infections." ”

"Blood samples have been sent out. Sun Lien nodded. Xu Yourong added, "The results should be available within half an hour." ”

Luo Yiping thought for a while and continued, "I suggest simply doing another CT. Clarify the pleural effusion in the elderly. If the effusion is too large, consider asking for a drain from outside the chest. ”

The human chest cavity itself has some effusion. The dissection between the visceral layer and the parietal pleura is called the pleural cavity, and there is usually a ten-milliliter effusion in it, which plays a lubricating role when the person breathes. In the pleural cavity, about 1,000 milliliters of fluid is formed and absorbed every day. Pleural effusion can result from increased production or decreased absorption of fluid in the pleural space.

In congestive heart failure, the patient's pulmonary capillary pressure is much higher, resulting in increased production of fluid in the pleural space. Pleural effusions form when production exceeds the amount of drainage from the lymphatic system.

Zhou Xiufang was lying on the hospital bed, her mind still a little unclear. Occasionally, he responds to the nurse's call, but he can't tell where he is or what his name is.

"Send the video. Sun Lien looked at the old man and sighed, when people are old, they are afraid that there is something wrong. Minor illnesses and disasters can become fatal in an instant due to age.

The queue in the imaging department is much less than the previous two days, as a major emergency pilot unit, as long as the emergency room can be a little easier, the other departments will be a lot more relaxed.

Brother Imaging Coroe rested today, and Zhou Jun personally pushed the old lady's gurney into the CT room. And his father, Comrade Lao Zhou, also asked for leave from the unit and came to the hospital to take care of his wife.

Comrade Lao Zhou is an engineer of the local power company, and he said that the biggest regret in his life is that he did not persuade his son to study medicine - Zhou Jun, who became a doctor, attached great importance to the health management of the old couple, and forced Comrade Lao Zhou to quit smoking, which lasted for more than 20 years. At the same time, a strict daily schedule and daily recipes were also formulated for the old couple. Comrade Zhou's favorite steamed sausage was ordered to eat only half a month. Sometimes secretly eating sausages while his son is not there has become Comrade Zhou's biggest hobby. It's a pity that his wife has always stood on a united front with his son, and as long as he steals food, he will be arrested. Zhou Jun had a cold face, and even the old Comrade Zhou was a little unbearable.

"What's the matter with your grandmother?" and his son carried the old lady into the CT machine. Comrade Zhou, who was not afraid of heaven and earth, finally panicked, "Is this an old illness again?"

"It's not coronary heart disease. Zhou Jun shook his head with a somewhat ugly face, "The preliminary diagnosis is congestive heart failure complicated by pleural effusion. ”

"I've never heard you say there's something wrong with this before. Comrade Zhou's face became ugly, "Is it new?"

Zhou Jun also had a cold face, "I don't know." Why didn't you stop your grandmother from going out for a walk on such a cold day?"

"I'm not a doctor!" Comrade Zhou called out to hit Tianqu, "There are only two doctors in our family, one for you and one for your grandmother." When have you two heard me talk?"

Zhou Jun shook his head, "Let's see the results first." If the pleural effusion is small, medication is sufficient. ”

Lao Zhou sighed and said, "I hope you don't have a knife." This is about to be the New Year in a blink of an eye, and if the old lady is stabbed, this year will not pass. Let's take your turn to come to the hospital and keep watch. ”

Old Comrade Zhou was loitering outside the CT room, and Zhou Jun dragged Sun Lien aside and interrogated about the situation.

"What do you think?" Zhou Jun still looked like a teacher, but the anxious look on his face couldn't be concealed. "How serious is the situation?"

"The type of pleural effusion still needs to be determined. Sun Lien thought about it for a moment and said his thoughts, "If it's just a simple effusion caused by congestive heart failure, it's okay to say, what I'm worried about now is that the effusion may be caused by an infection." ”

"No, the old lady has no signs of infection these days. Zhou Jun has a different opinion on Sun Lien's judgment, "There is no fever and cough, it doesn't look like an infection." ”

Sun Lien shook his head and said, "Coronary heart disease, high blood pressure, and senile degenerative valvular heart disease can all cause congestive heart failure. But it shouldn't be so fast. ”

"Coronary heart disease is more likely to be caused. Zhou Jun frowned and said, "She has a history of coronary heart disease......

"If the elderly don't usually have the habit of walking, this is indeed possible. Sun Lien understood that his tutor was really a little panicked, "Many elderly people have low athletic ability and habits, and third-level heart failure may not be manifested." But the old lady has to go out for a walk every day, and if it is heart failure caused by coronary heart disease, the symptoms should have been there long ago. The timing is not right. ”

"Do you think it's an infection?" Sun Lien's reason was very strong, and Zhou Jun had to admit that his student's judgment was correct. "But I haven't had any symptoms before......

"All I can say is hope it's the infection. Sun Lien sighed, "If it's not an infection, it's troublesome." ”

Lung infections that can cause heart failure are fatal to young people, and Sun Lien is now secretly praying that the old man is really infected.

Low hemoglobin, elevated IgG antibodies, heart failure, pleural effusion. The combined answer to these four symptoms, if it is not an infection, leads the diagnosis to slip to another horrific conclusion.

Leukaemia.