The system takes me for surgery

But Director Li changed the mouse too quickly just now, and Liang Yi flashed past it before his eyes could see clearly.

I can only wait for Director Li to finish his lecture, and then take a look to confirm.

"Next, I will ask you a few basic questions." Li Zhengping said.

"What is a cerebral infarction?"

A graduate student with broad shoulders and thick thighs and calves said: "Cerebral infarction is the ischemic necrosis of brain tissue caused by acute cerebrovascular occlusion. Pathologically, it can be divided into ischemic, hemorrhagic and lacunar infarction."

Li Zhengping smiled and said, "That's right, is there any other students who can talk about how to distinguish these three diseases of cerebral infarction."

A fat man wearing glasses as thick as the bottom of a wine bottle said: "Ischemic cerebral infarction mainly manifests as low-density lesions in the area of ​​occluded blood vessel supply."

"What about the bleeding one?"

"Hemorrhagic cerebral infarction is the hemorrhage in the infarct area that occurs simultaneously on the basis of ischemic cerebral infarction. CT will show that there are speckled or patchy high-density lesions in large low-density areas."

"That's right!" Li Zhengping glanced at Liang Yi and found that his eyes were blurred, so he knocked on the table.

Originally, the fat man wanted to talk about the third point, but Li Zhengping stopped him and said, "Come on, Liang Yi, can you tell me the last one?"

Liang Yi was stunned for a while and didn't speak for a long time.

The tall girl next to him saw that he was deserting, and whispered, "Lacunar cerebral infarction."

Liang Yi panicked and said, "Oh, lacunar infarction is a small area of ​​ischemic infarction in deep brain tissue caused by the occlusion of cerebral perforating small arteries. Low-density lesions are generally less than 1cm in diameter."

"That's right." Li Zhengping said: "You should be more serious when you are listening to the lectures. If there are any things you can think about after get off work, if you miss some knowledge points, the next time you encounter them, you may be in clinical practice."

Liang Yi wasn't thinking wildly, he kept staring at the CT image, using the system to reconstruct the suspicious high-density image in his mind.

He finally told Li Zhengping truthfully: "Teacher, I saw a high-density shadow at the junction of the cortex and medulla in the blood supply area of ​​the middle cerebral artery, with a clear boundary and extensive edema around it."

Li Zhengping, who originally had some complaints about Liang Yi's improper attitude, opened his slightly squinted eyes after hearing Liang Yi's words, and asked, "Really?"

"Go back and have a look, I don't know if I read it wrong." Liang Yi said cautiously.

In an unfamiliar working environment, even with 100% evidence, Liang Yi did not dare to make a 100% conclusion. There are too many uncertain factors in medical care, and you should give yourself a leeway at any time, not to pave the way for your own mistakes. Instead, always keep the courage to completely overthrow your original judgment.

And such an unspecific expression method is actually quite contrary to human nature. People's social attributes determine paranoia, and everyone will be more or less paranoid.

And doctors must minimize their paranoia, strictly follow the thinking of evidence-based medicine to diagnose the disease, and reduce the occurrence of misdiagnosis and missed diagnosis. Ordinary people’s paranoia is just a big fight, but doctors who are too paranoid may kill patients. Life.

Li Zhengping went back to look at the images carefully, and saw a high-density shadow at the junction of the cortex and medulla in the blood supply area of ​​the middle cerebral artery, with a clear boundary and extensive edema around it.

He pointed to the high-density film and said: "Liang Yi is right, this point is very suspicious, and we need to do an enhanced examination to check the lesion."

Liang Yi looked down at the word "cough" marked by Li Zhengping on the A4 paper, and said, "The brain is not the primary lesion. Is it possible that it has been transferred from the lungs?"

Li Zhengping called out the chest plain film and looked at it. There was a small suspicious shadow, but he couldn't see it clearly.

"I'll order another chest CT scan for him," Li Zhengping said.He moved and turned around and said with a smile to Gui Peisheng: "It's like this clinically. This patient came in because of diarrhea. He said he was dizzy and checked the brain CT. He has been coughing for a while recently. It may be that the cancer has metastasized to the brain in other places. It's probably lung cancer."

Some of the training doctors are postgraduates. They have little clinical experience like the interns. When they heard this, they all showed a look of panic.

You can read their thoughts from their expressions. They are all thinking at the moment, it is too difficult to be a doctor!

Li Zhengping boasted: "Liang Yi has done clinical work, so he is more experienced than you. Even I almost missed the diagnosis. Fortunately, he found out. You can learn from him in the future. What the director said is better than the people's hospital." Lower-level hospitals also have excellent doctors, and the People’s Hospital is an excellent hospital, but not every doctor is an excellent doctor.”

This remark obviously meant Xie Tianmu, and everyone could hear it, and dared not respond.

After a CT scan, it turned out that the lung cancer had metastasized to the brain, as Liang Yi predicted.

This also made Li Zhengping have a different view of Liang Yi who came from this lower-level hospital. In fact, lower-level hospitals sometimes do not lack excellent and meticulous doctors.

In the eyes of Gui Peisheng, Liang Yi has also become their free dot reader in human form, and they can't click anywhere. They were surprised to find that this undergraduate dean who has worked for three years has all the knowledge points about internal and external women and children. In their group, these students didn't bother to check the Internet and ask Liang Yi directly when they encountered unfamiliar knowledge points.

the next day.

Zhong Yubo was on duty, and Liang Yi was on duty.

Although Liang Yi has been on duty in the affiliated hospital for two or three years, it is the first time he is on duty at the People's Hospital today, and he still feels a little uneasy, because what happens in the emergency department.

During the daytime, it was actually fine. There were no particularly serious patients and it was relatively routine. Most of them were patients with trauma.

When I am free at night, in fact, every hospital is the same. The doctor will gossip with the nurses and tell anecdotes about the hospital.

They were chatting about a patient who was hospitalized because of appendicitis. He met another patient who suffered from appendicitis next door, and later got married together. They got married today. They brought a lot of wedding candy to thank them, saying that the emergency department is theirs. Yue Lao, the emergency department unit, helped them draw this red line.

Just when they were chatting, a man with blood all over his lower body rushed in.

Standing behind the nurse's desk, he was frightened and froze, Zhong Yubo hurried over and asked, "What's wrong?"

The big man, at least 1.8 meters tall, said in northern dialect: "My leg was hurt by a beer bottle."

There was a strong smell of alcohol when he spoke.

Zhong Yubo shouted: "Liang Yi, go and get the gauze first."

"Okay." Liang Yi rushed into the debridement room and took out some large gauze for the wounded to cover his wound.