Auto chess in the operating room

Chapter 161
When Wu Ye hummed:

Alone in the peak, the cold wind blows constantly

Invincible how lonely

Invincible is how empty

When entering Tang Lou's operating room, he was stunned.

Couldn't speak for a long time.

There are no patients in the operating room, and there is no Tanglou at all.

Only Lin Dong and Yuan Aldehyde were left to clean up the final mess in Tanglou.

"Xiao Yuan, I'll leave the rest to you. I'll go first."

"Okay, Dr. Lin."

Yuan Xun would naturally be very willing to wipe Dr. Tang's ass.

Lin Dong saw Wu Ye standing not far away with a dull expression, sighed, walked over, and said softly: "Let's go, everyone has already changed clothes and sat in the office."

"So, he also used laparoscopic surgery?"

Wu Ye said tremblingly, still a little unbelievable.

"No, conventional tension-free hernia repair."

"how is this possible!"

Wu Ye's mentality completely collapsed now.

[Ding, task: complete the first tension-free indirect inguinal hernia repair in 90 minutes, complete.Reward 5 gold coins, refresh the card library once]

Of course, Tang Lou cleaned up early and returned to the office. Ye Kai was typing the medical records of this operation for him.

After more than ten minutes, Lin Dong also returned to the office.After him, Wu Ye walked into the office dejectedly and returned to his seat.

Regarding the two hernia repair operations performed at the same time this morning, there were naturally a few insiders who looked at Wu Ye's state and guessed a little bit, and they all looked at the direction of the tenement building very interestingly.

"Amazing."

However, on the bright side, naturally no one will expose it. Tang Lou, the person involved, doesn't seem to care at all, and everyone naturally doesn't care about it.

Soon they all threw themselves into the busy work.

In the afternoon, Fang Qing, who was attending the internal medicine department, walked into the general surgery office with his wolfberry cup.

"Doctor Fang, what is this?"

Fang Qing held a medical record in his hand, his brows were furrowed, and his already dark face became even more greasy.

"I'm looking for Qingping and Yan Ruoyun."

Dr. Fang cut straight to the point. The general surgery office has a large area, and various medical groups are distributed in various places. He heard Fang Qing's sonorous voice.

Qingping happened to be in the office and stood up: "What's going on, I'm so anxious."

Yan Ruoyun from the other corner also came over with some puzzlement.

"Let's talk at the conference table, Marne, go and help me receive the projection."

Because patients' diseases are often very comprehensive and involve multiple diseases, consultations between various departments are often required to solve problems collaboratively.

Hearing what Fang Qing said, Ma En hurried forward to take the materials, and ran to the conference table in the middle of the general surgery department.

Fang Qing drank several sips of tea one after another, worried, and lost a few hairs in the past few days.

Soon Marne was ready to project.

"Doctor Qing, Doctor Yan, our department has consulted with this patient several times, and we have not been able to find the reason for the patient's abnormally high fever and unresponsiveness."

"So, I asked you to see if it might be caused by some diseases in the surgery. If you still can't find it, you can only look at it again in other departments. If it doesn't work, you can only send it to a higher-level hospital."

However, Fang Qing did not hold out much hope, after all, the patient's symptoms were all in the category of internal medicine.

Both Qingping and Yan Ruoyun nodded solemnly. For doctors, undiagnosed patients are too common.

There are also many people who died because the cause of the disease was not found and the treatment was delayed.

After all, the human body is too complicated, and there are too many possible etiologies for treating diseases, so it is really difficult to find out in a short time.

Fang Qing took another sip of tea, then swipe the computer to introduce the patient's information from the beginning:
Patient male: 68 years old

Brief medical history: The chief complaint was "found blood sugar increased for more than 1 month".

The patient self-monitored his blood sugar 1 month ago and found that his blood sugar was elevated, and the fasting was above 8mmol/L, and he did not detect it after a meal. The treatment is unknown.

2 days ago, I came to our hospital for treatment due to upper abdominal discomfort. The fasting blood sugar was 9.0+mmol/L, and the glycated serum albumin was 20.0+%. I took metformin and glipizide tablets to control it. The self-test blood sugar was still high, and it was 13-14 mmol after meals /L.

No obvious polyuria, dry mouth, no blurred vision, no numbness of hands and feet.

In the past 2 days, I have poor appetite, and I feel that my upper abdomen is a little full, and my back is swollen.The symptoms were slightly relieved after topical application of Voltaren.

The initial diagnosis was "type 2 diabetes" and he was admitted to the endocrinology department.

After reading these materials, Qingping and Yan Ruoyun naturally had no clue, it was basically a symptom of diabetes.

Fang Qing continued to swipe the computer and began to introduce the patient's past history:
The patient underwent coronary three-vessel bypass surgery in the Second Hospital of the city for acute myocardial infarction 5 months ago. After the operation, he took aspirin, clopidogrel (Taijia), rosuvastatin calcium, and betalocpine tablets ( 12.5mg bid).

An echocardiogram 2 days ago indicated that the left heart was enlarged, the segmental motion of the left ventricular wall was abnormal, and the ejection fraction was 33%;

Electrocardiogram: sinus tachycardia, heart rate 101 beats/min, pathological Q waves in leads II, III, avF, abnormal ST-T, abnormal ST-T in leads V4-V6;

Anterior chest radiograph: thickening of bilateral lung textures, disappearance of the left costophrenic angle, and left pleural reaction;
Blood routine: 1 white blood cells.He denied any history of hypertension, hyperlipidemia, or cerebrovascular disease.He denied a history of smoking and drinking.No history of drug allergy.No family history.

After reading these, Qingping and Yan Ruoyun's faces were also not looking good, and the patient's physical condition can be said to be very poor.

Yan Ruoyun asked: "Where is the latest physical examination?"

Fang Qing paused, and scrolled to the next page of information:
The patient was conscious, unresponsive, and had a relatively indifferent expression. His body temperature was 38.5°C, his breathing was 20 times/min, his blood pressure was 120/80mmHg, and his heart rate was 102 beats/min.

There is no yellow staining and bleeding points on the skin and mucous membranes of the whole body. An old surgical scar about 18cm in length can be seen on the midline of the front chest, and a circular keyhole-shaped old surgical scar can be seen on both sides of the upper midline of the xiphoid process. There is no redness on the local skin , ulceration, hematoma, no sense of fluctuation.

Fang Qing turned to the patient's auxiliary examination again:
Admission electrocardiogram: sinus tachycardia, heart rate 103 beats/min, II, III, avF lead pathological Q wave, ST-T abnormality, V4-V6 lead ST-T abnormality.

急查血常规：白细胞1万9，中性率百分比90.4%，CRP 155。凝血：纤维蛋白原753。生化：肝功正常，肌酐正常，尿素氮7.2。TNI、MYO阴性。BNP 1096。尿常规：尿糖3+，酮体1+。快速血糖17.6mmol/L。

Fang Qing was also a little depressed and listed a lot: "We can only diagnose type 2 diabetes, diabetic ketosis, coronary atherosclerotic heart disease, old myocardial infarction, coronary artery bypass surgery, sinus rhythm Too fast, the left side of the heart circle is large, and the heart function is class II (NYHA classification)."

"However, these are not enough to cause abnormally high body temperature and unresponsiveness in patients."

What Qingping and Yan Ruoyun saw was also scalp numbness. This patient is really sick all over. It is really difficult to find the cause of this systemic syndrome!
Yan Ruoyun flipped through the data again and analyzed: "The patient has too many diseases and too many interference items. The patient has previous myocardial infarction surgery. The rise in blood sugar cannot be said to be typical diabetes. , drinking too much will lead to loss of appetite.”

"An increase in white blood cells indicates inflammation. There must be something going on somewhere that is causing the inflammation."

Qingping nodded and added: "I agree with Dr. Yan's point of view. There must be a lesion somewhere that caused inflammation and high temperature. The heart wound may be inflamed. A little yellow phlegm may be inflammation of the lungs. Loss of appetite, under the xiphoid process Tenderness could also be inflammation of the digestive tract."

After listening to it, Fang Qing agreed, but the scope was still too wide, and there were too many possibilities, so he could only investigate one by one.

Still can't diagnose, if only he had a pair of piercing eyes.

(End of this chapter)