Chapter 593: Treat first, then investigate, the despised general
Hospitals are equally afraid of being criticized.
Whether it is surgery, ward care, medication, or diagnosis, there are always things that can go wrong.
However, when faced with such super VIP patients, the hospital is in a very weak position and has no other choice but to fully cooperate and strive to provide the best service.
Of course, if the hospital's top brass is stubborn and determined to try their own death, then there are no taboos.
The girl was only five years old and had been suffering from fever for nearly a month. She was hospitalized in the Provincial Children's Hospital for eight days.
The main symptoms upon admission were fever, abdominal pain, and bloody stools.
To be honest, it is not common for children to have bloody stools.
Considering the patient's young age, the Provincial Children's Hospital conducted a screening for genetic diseases and found no history of related genetic diseases in the child's family.
The child had a large amount of blood in his stool. When he was admitted to the hospital for treatment, he was in a state of severe blood loss and was almost in shock.
The Provincial Children's Hospital performed emergency blood transfusion on the child.
At that time, the child's blood pressure was only 81/35 mmhg, which is a very scary low blood pressure.
Under normal circumstances, even in an ordinary family, a child this sick would have been sent to the hospital for treatment long ago. But the family of the Health and Family Planning Bureau boss is very special, as the child is born to him and his ex-wife.
Due to the busy work schedule, the responsibility of taking care of the children falls almost entirely on the stepmother and the nanny.
Now that this has happened, the stepmother must be to blame.
As for how others deal with it, that is a family matter.
When the child was admitted to the hospital for physical examination, his temperature was 39.6 degrees, his pulse was 110 beats/minute, his respirations were 28 times/minute, he was in a trance, and had severe anemia.
In fact, if the blood pressure is so low, it means you have severe anemia.
When the specialist examined the patient, he found that there was no yellowing of the skin or sclera, no rash or bleeding spots, no enlargement of the superficial lymph nodes, a soft neck, and a centered trachea.
Regular heart rhythm.
Auscultation of both lungs was unremarkable.
The abdomen is flat and soft, and a cord-like mass can be felt in the lower right abdomen. The length is nearly 10 cm and the width is nearly 6 cm. The child cries out in pain as soon as it is touched.
Seeing this, Zhou Can first suspected intestinal tumor.
The right lower abdomen should belong to the ileocecal part of the intestine.
Experts from the Provincial Children's Hospital conducted further examinations on the child and found that his hemoglobin level was only 36-85g/L.
Blood and stool cultures were performed multiple times, all of which were negative.
This should be used to rule out the possibility of malignant intestinal bacteria.
The intestinal environment of the human body is extremely complex, with countless bacteria and toxins. However, under normal circumstances, these bacteria are beneficial, not only harmless to the human body, but also can provide certain help for the digestion of food.
Just like earthworms help plants break down organic matter in the soil.
These tests failed to reveal any problems, so the experts at the Provincial Children's Hospital worked very hard and tested the child's antinuclear antibodies and rheumatoid factor.
Rheumatoid disease has always been one of the most bizarre diseases in clinical practice.
It is like a ghost, making it difficult for doctors to diagnose.
And it can cause many diseases.
Doctors are very likely to misdiagnose during the diagnosis process. Nowadays, many experienced doctors will check this item whenever they encounter a case that is difficult to diagnose and whose symptoms are basically similar to rheumatoid arthritis.
Sadly, not much was gained.
Next, the Widal and Weilfi reactions were checked.
The results showed that Salmonella typhi H and O, Salmonella paratyphi A, B and C, and Proteus were all negative. At this point, the experts at the Provincial Children's Hospital must have started scratching their heads.
It turns out that the experts were a little confused, because they then checked the child's hepatitis B virus antigen, serum potassium, serum sodium, serum chloride, carbon dioxide binding capacity, blood urea nitrogen, blood creatinine, serum protein electrophoresis...
It's simply a matter of checking everything that can be checked.
This also illustrates a problem. If Western medicine uses this kind of wide-ranging examination method to diagnose and check everything, it is a sign of poor medical skills.
A truly skilled doctor will prescribe necessary examinations for the patient.
There won't be any unnecessary checks.
Of course, this girl is a super VIP, so it is understandable that the experts from the Provincial Children's Hospital conducted various examinations on her in such a high-profile manner when they were unable to find the cause of the disease.
The more prestigious the patient, the more cautious the doctors are.
This can be seen from the ancient imperial doctors treating the emperor, concubines, and princes. Basically, they had their heads on their belts and could offend the emperor at any time and be beheaded.
Modern society has made great progress in civilization, and the situation where doctors are dragged out and beheaded for no reason no longer occurs.
However, it is normal for a doctor to be benched and have his future ruined if he makes a major mistake when diagnosing an important patient.
Therefore, Zhou Can could understand the mentality of the experts at the Provincial Children's Hospital.
After a series of laboratory tests failed to yield any significant results, the experts performed chest and abdominal X-rays on the child, but found no abnormalities.
A bone marrow puncture was performed, which showed a decreased granulocyte-erythrocyte ratio, intracellular iron deficiency, and no abnormal cells.
To put it bluntly, this bone marrow puncture is in vain .
It does not provide much practical significance in diagnosis.
After the child is admitted to the hospital, the cause of the disease must be found out, but the child's condition is very serious and cannot wait. Besides, the child's father is watching him.
Experts must first give the sick child some symptomatic treatment to save his life.
This is also the most common operation in clinical practice.
Some tests take several days to get results. If you insist on waiting until the results come out before giving the patient medication, the patient may not even be able to wait for the results.
Before finding out the cause of the disease, experts from the Provincial Children's Hospital provided the child with a number of symptomatic treatments, including blood transfusion, hemostasis, and anti-infection.
Diseases currently suspected are intestinal hookworm disease, Crohn's disease, lymphoma, and intestinal tuberculosis.
Judging from the treatment drugs, experts seem to prefer intestinal tuberculosis.
Because many of the symptoms of the sick children are similar to intestinal tuberculosis, and intestinal tuberculosis is a common disease in our country.
After taking the X-ray, the possibility of intestinal tumor can be basically ruled out.
At the beginning, everyone had high hopes for intestinal tumors.
Because a huge cord-like mass can be felt in the ileocecal region.
Unfortunately, after many days of treatment, a lot of antibiotics and glucocorticoids were used , and the child's condition kept recurring. When taking the medicine, the temperature could be controlled and the bleeding seemed to have improved significantly.
However, relapse occurred soon after stopping the medication.
This shows that the real cause of the disease has not been found.
Zhou Can began to carefully deduce the possible causes in his mind. First, he listed all the diseases that matched the symptoms, and then eliminated them one by one. This is the most commonly used method for clinical diagnosis of difficult diseases.
At this time, a middle-aged man with big ears and a dignified look walked into the consultation room.
It can be seen that the face of this middle-aged man is quite haggard.
His daughter had been seriously ill for many days and had not shown any significant improvement after treatment, which must have put enormous pressure on the man.
"My name is Lin Jinzhi, and my daughter's name is Lin Nuanxi. I am very sorry to bother you directors, experts, and nurses so late today. But my daughter is in danger, and I can't delay any longer. I would like to express my sincere gratitude to you all here. No matter what the result is, I will remember this kindness today."
After saying this, the man bowed to everyone.
As expected of a big leader, he is very capable in speaking and doing things, and his grasp of human nature and control of people's hearts is perfect.
Just a few words and a bow were enough to make the medical staff present go all out to save his daughter.
And the impression he has on you will be very good.
"My daughter was born to my ex-wife. She married me when I was the poorest and most destitute. Later, due to work reasons, we did not have children until my job became more stable, and then I gave birth to Lin Aixi. However, she suffered from heavy bleeding during childbirth and amniotic fluid embolism, and eventually abandoned me and my newborn daughter. It can be said that my daughter is my lifeblood. I sincerely ask the experts present here to think of a way to save my daughter. If you have any questions you want to know, you can ask me at any time, and I will fully cooperate with the doctors' diagnosis and treatment."
Lin Jinzhi expressed his position to everyone again.
Zhou Can originally thought that Lin Jinzhi was like most successful men, who got promoted, got rich, and changed for a wife.
Unexpectedly, there was a reason for this.
It turned out that the man’s wife died of amniotic fluid embolism and postpartum hemorrhage.
It is not easy for one person to be both a father and a mother.
There is nothing wrong with marrying another wife for personal physiological needs and family needs.
But he didn't expect that his second wife was not a good person, but a vicious woman.
It would be great if children could be sent to the hospital for treatment as soon as possible when they have health problems!
There are many diseases, especially malignant diseases, that are more beneficial the earlier they are treated.
For example, cancer, which is a very scary disease in my country, is not taken seriously in many developed countries because they attach great importance to physical examinations and can often detect cancer in its early stages.
Through surgery and drug treatment, a radical cure can be achieved.
Many people hope that drugs to treat cancer will be invented in the future. One day, treating cancer will be as simple as treating a minor cold.
This is very likely, but it will take time.
Before such medicine is developed, the most correct prevention and treatment method is to have regular physical examinations and detect and treat the disease early.
Lin Jinzhi glanced at everyone and slowly took out a heart-shaped peach made of paper from his arms.
"This is my birthday present from my daughter. She said, Dad, I know you are very busy at work, but I hope you can spend more time with me because you always smile so happily every time you see me. Happy birthday to you!"
As the boss of the Health and Family Planning Bureau, his lips were trembling when he read out the above content.
Emotion is the most precious thing of human beings.
Even money and work are not as important as emotions. For the one we love, we can go bankrupt, work hard, and then when we get our salary, we spend it all on the one we love without any complaints.
This is the charm of emotion.
The medical staff present were also moved after hearing this.
The nurse in charge of the tea service and several female doctors were wiping away tears.
"Is your daughter vomiting a lot of blood? When did she start vomiting blood? How many times has she vomited blood so far?"
Zhou Can asked the first question.
It wasn't that he wanted to be in the spotlight, but he was wholeheartedly diagnosing the sick child and needed to know more detailed information.
Lin Jinzhi looked up at Zhou Can, and seemed a little disappointed when he found that the first person to ask the question was a very young doctor.
But still answered.
"The amount of vomited blood was not large. The symptoms of vomiting blood began this morning. When I coughed, there was blood in the sputum. I vomited a few times in total, but I didn't really count them."
It seems that vomiting blood is not as serious as imagined.
Zhou Can initially suspected that it was a drug-induced injury or a worsening of the disease, which had invaded the upper digestive tract from the lower digestive tract.
Or it may have invaded the lungs.
Coughing up blood is mostly related to lung diseases.
For example, lung cancer and pneumonia are prone to coughing up blood.
"Is your daughter still vomiting blood? I mean, is there still blood in her sputum?"
Zhou Can continued to ask.
Lin Jinzhi frowned slightly.
"Sometimes the sputum may contain blood. I am very grateful for your enthusiasm, but I suggest that you leave your questioning time to the senior experts present here. Because they have more experience, they are more likely to diagnose the cause of my daughter's illness."
Obviously, he thought Zhou Can asked too many questions and was worried that he would take up the questioning time of other experts.
Almost everyone has a deep-rooted subconscious idea that the older the doctor, the better, the higher his level and the more experience he has.
"OK."
Zhou Can's expression was calm and he didn't ask any more questions.
Director Tang Fei wanted to explain to Lin Jinzhi that although Zhou Can was young, his level was not low. But someone started to ask questions, so she swallowed her words for the time being.
"Director Lin, what kind of food does your daughter usually eat?"
"My daughter has been taken care of by the nanny and my current wife. I am very busy at work and often come home very late. So I am not very clear about it."
"Do they eat a lot of snacks? Because when such a young child develops serious intestinal diseases, after excluding genetic factors, the disease is often caused by eating."
"Well... she does eat a lot of snacks. I see she likes them, so I often buy some for her. Because she eats too many sweets, my daughter has serious tooth decay."
…
Zhou Can just listened quietly, still analyzing the cause of the child's illness in his mind.
Half an hour later, the experts had asked almost all the questions they needed to ask.
We also started several new rounds of discussions.
Director Tang Fei began to make a summary speech.
"Based on the results of the discussion just now, we suspect five diseases: intestinal tuberculosis, typhoid fever, Crohn's disease, myeloma, and malignant or intestinal lymphoma. First of all, I think intestinal tuberculosis should be ruled out. From the analysis of Aixi's overall condition, there are no symptoms of tuberculosis toxemia, no obvious increase in erythrocyte sedimentation rate, no similar genetic disease history or past medical history, and her condition is very critical, so I think intestinal tuberculosis can be basically ruled out."
Director Tang Fei is able to become the director of pediatrics because of her first-class medical and academic levels.
It is definitely not just a vase with beautiful looks.
She is talented in many areas of pediatrics.
The only thing lacking, perhaps, is surgical ability.
Because surgery is highly practical, requires strong skills, and requires high physical strength, it is generally difficult for female doctors to make significant achievements in this field.
Only a few cases can achieve good results.
That is also concentrated in the two major areas of obstetrics and gynecology.
