"Teacher Wu, you are here. Matthew was polite and respectful, not like a dean, but like a junior doctor.

"Horse yard, hard work. Wu Mian turned off the car, walked down and bowed slightly.

"This is Director Zou of the Medical Department of the First Hospital. Ma Xiude introduced, "Lao Zou, this is Mr. Wu, you always talk about meeting one day, won't you have a chance?" ”

"Hello, Mr. Wu. Director Zou politely stretched out his hands.

"Director Zou, thank you for your hard work, you haven't gone home so late. ”

After a brief greeting and politeness, Director Zou knew that Wu Zhongtai was there, and Wu Mian must get down to business first, so he said, "Now that the patient is in stable condition, 400ml of dark brown and "coffee grounds" stomach contents were taken out of the gastric tube. Patients are now given saline, vancomycin, cefepime, and metronidazole. There are also symptomatic treatments such as hemostasis and acid suppression. ”

"I look at the eye records first, then at the patients. Wu Mian nodded and said.

"The directors of the departments are waiting for you before they leave. Director Zou said.

"Huh?"

"Mr. Wu, we have been consulting for nearly 2 hours for this patient's diagnosis, but we have not found out what the cause is. Director Zou said calmly, "Everyone is also curious and wants to see your diagnosis." ”

If you change to someone else, there will inevitably be pressure under the fame, and the greater the reputation, the greater the pressure. But Wu Mian didn't feel any pressure, he had seen this situation a lot, and he had long been accustomed to it.

When I came to the Department of Gastroenterology, more than a dozen doctors in their forties and fifties in the office stood up one after another and greeted Wu Mian.

"I'm sorry, teachers, I'll take a look at the medical records first. Wu Mian was going to look at his old man first, but in front of so many directors and professors, he was still going to look at the medical records first.

"Brother, I'll take a look at the patient. Chu Zhixi blinked, took the insulated lunch box and thermos cup from Wu Mian's hand and said.

"Go ahead. Wu Mian is familiar with this process, and in a sense, Chu Zhixi is his eyes.

Seeing that Chu Zhixi beckoned a female doctor of about the same height to go out, Wu Mian smiled and sat down in front of the computer.

The chief complaint and the previous Director Shi Zou have read it, and Wu Mian remembers it very clearly. After a glance, he continued to look at the patient's current medical history and treatment history, as well as various laboratory tests.

On examination, the body temperature was 36.7°C, the heart rate was 108 beats/min, the blood pressure was 161/96 mm Hg, the respiratory rate was 22 beats/min, the oxygen saturation was 98%, the weight was 55.4 kg, the height was 162 cm, and the body mass index was 27.5......

The medical records and laboratory examination values Wu Mian almost swept over, the index finger of his right hand slid on the mouse wheel, and the medical record brush [Tian Lai www.23txt.xyz] brushed down.

Director Zou frowned slightly, what can be seen from this?

Urinalysis showed slightly cloudy urine with trace ketones and normal remains, electrocardiogram showed sinus tachycardia and left atrial enlargement, chest x-ray showed no abnormalities, and noncontrast CT scan of the head showed no intracranial hemorrhage, mass, or stroke.

Patients were hospitalized with folic acid, multivitamins, intravenous saline, thiamine, and lorazepam.

Laboratory tests were performed again after 10 hours, and the indicators were normal.

After admission, phenobarbital is given in tapering doses to control alcohol withdrawal syndrome. Phenobarbital treatment reduced tremor, hallucinations, and tachycardia, but alcohol cravings persisted.

According to the description in the medical record, remission is a typical alcoholism and withdrawal syndrome. It is said that it is not appropriate to be hospitalized in the first hospital of the Medical University, but the hospitals in China are basically general hospitals, and the strength of the psychiatric hospital is very weak, and Wu Mian understands this.

He was placed in the first hospital of the medical university for treatment, and after the problem of alcohol poisoning was resolved, he could be transferred to a psychiatric hospital for treatment of alcohol dependence.

At this point, the treatment is very routine and effective, and the patient recovers quickly. The problem was that last night, Wu Mian didn't slow down when he saw this section, and it was still a flash.

As Director Zou described, the patient was in good condition last night and was ready to be discharged the next day. But suddenly I started to feel anxious, chatted and quarreled with other patients in the ward and the patient's family, and then went to the doctor.

When the patient is nagging with the doctor, he suddenly becomes confused, drowsy, and has very poor reactivity.

At that time, the doctor first thought that it was hypoglycemia caused by prolonged water fasting, and the peripheral blood glucose was measured at 8.4 at that time.

On examination, tachycardia is 107 bpm, respiratory rate is 30 bpm, oxygen saturation is 95% on oxygen, new abdominal distension is not tender, and no tremor, seizures, urinary incontinence, or tongue bite are seen.

Eccentric.

After reading a series of reports, Wu Mian tapped his fingers lightly on the mouse pad.

There are many problems, and the only possibility that can be solved perfectly is - heavy drinking.

"Has the video surveillance been retrieved?" Wu Mian asked in a deep voice.

"Teacher Wu, it's changed. Director Zou said, "The video surveillance within 48 hours was watched by my staff little by little. The patient did not even walk except for going to the bathroom. ”

It's lazy...... Wu Mian seemed to see Lin Daoshi's father. But Lao Lao Lin has his own reasons, not blindly lazy.

Director Zou's words prove that patients do not have the opportunity to sneak out to drink or buy alcohol.

In this case, you can only start thinking about your own illness.

Wu Mian began to retrieve a large amount of relevant literature in the database in his mind and compare it with his own experience.

"Brother, I took one look at the patient. Chu Zhixi came back at this time, Wu Zhongtai stopped at the door, and looked at the directors in a room in surprise, only his son was sitting in front of the computer, full of momentum.

"Hmm. ”

"The neurological examination is unremarkable, and the patient is typically alcoholic, thin, restless, slurred in speech, and a small amount of stale blood in the gastric juice drained from the gastric tube. ”

Chu Zhixi briefly reported the results of the physical examination, and Wu Mian groaned.

After experiencing the wildfires, Wu Mian rarely asked Chu Zhixi to check his body and see patients instead. But this practice has been deeply rooted in the bones of the two, and it has been inadvertently revealed.

"What do you think?" Wu Mian asked.

"Alcoholism, or poisoning caused by a large amount of alcohol, with stomach bleeding. Chu Zhixi said with certainty.

Director Zou frowned and said in a deep voice, "The patient did not go out to buy spirits, and the medical alcohol in the department was also checked and not lost." ”

"Think about it. Wu Mian said.

"Little Crown. Wu Zhongtai beckoned at the door.

"Dad, come in and say. Wu Mian stood up and said very seriously, "Dad, you were in the hospital a few days ago and talked about the daily life of the patient. ”

Ma Xiude stepped forward as soon as possible, although he did not stretch out his hand to support Wu Zhongtai, but he was more respectful than when he faced Wu Mian.