Great doctor starts with adding points

Because of the arrival of Longyuan, there are not a few orthopedic patients who come to the department attracted by the name, and there are also some emergency patients in general surgery...

The first five beds were all patients with appendicitis or cholecystitis, and Luo Wei also looked at them.

Beds 6-11 are all preoperative and postoperative patients with fractures, which coincides with Lowe's specialty.

But at the 12th bed, Luo Wei stayed in front of Chu Yuming's bed for a while, and after hearing Guo Lixiang's report on his condition, Luo Wei slowly moved away from the leading position.

To be honest, he can still mix simple appendicitis and cholecystitis ward rounds with his own experience, but he can't handle Chu Yuming's severe knee infection.

But I have to make a statement, after all, I took the lead in it: "This patient is a patient with a knee joint infection. Currently, he has a serious joint deformity, with the medial side being the most serious. If the situation is right, I think it can be done on the knee joint." After the joint infection is controlled, a unicompartmental replacement will be performed. What does Director Lu think?"

The Department of Orthopaedics in Xuanxian People's Hospital has only two divisions, the Department of Orthopedics and the Department of Spine. There are also diseases in the Department of Arthritis in the Department of Trauma Surgery. The director occasionally performs joint replacements, so Luo Wei starts with a disease he has often seen and treats patients Push it to Lu Junyin.

This is a step.

After speaking, Luo Wei handed the film to Wu Xie.

At this moment, Lu Junyin asked directly: "Chu Yuming, how long has your situation lasted?"

Lu Junyin was delaying time by asking questions. To be honest, although he saw Wu Xie developing infectious surgery in the department, he wanted to learn, but after all, the degree of depth was different, and the situation of Chu Yuming, that is The case was so complicated that he couldn't even plug in the pins.

Lu Junyin didn't dare to talk nonsense, but his years of work experience let him know how to give up his position and leave it to Wu Xie, who has more research on infection, to express his opinion.

Wu Xie also took the very old CT that Lu Junyin and Luo Wei hadn't looked at, and after reading it, his brows flickered fiercely a few times.

Why is the articular surface deformed like this? I didn't look at it very carefully yesterday.

Wu Xie handed the CT to Guo Lixiang and gave him enough learning opportunities. After all, he is in charge of this patient.

"Is this very serious bacterial arthritis?" Zhong Yusheng said in a low voice after watching it with Guo Lixiang.

He has started to take charge of the patients. Although most of them still rely on Wu Xie's opinion, at least he has started to think about the problem. Unlike Guo Lixiang, who is still a medical assistant now, Lu Junyin still dare not let him go.

Wu Xie glanced at Guo Lixiang: "Xiao Guo, tell me about your medical history first."

Guo Lixiang briefly reported the medical history to everyone. The course of the disease was quite long, and it looked like four or five years. When he was outside, he had received sodium hyaluronate for knee pain. The symptoms fluctuated from good to bad. Half a year ago, Chu Yu Ming's right knee joint started to swell and heat up, and then developed into this...

Chu Yuming had many inspection results outside.

From X-ray and CT, it can be seen that there is infectious joint inflammation, and the joints are deformed.

Bacteria are not visible on X-rays and CT, at least they are not particularly visible.

Thinking of yesterday, the brother taught how to read the film, so he handed the X-ray to Luo Wei: "Brother Wei, there seem to be two unbroken sinuses on it, can you show it?"

This can be regarded as reciprocity, and it won't be too embarrassing to give Luo Wei a certain chance and find him something to do.

The second is that you can leave yourself a certain amount of time to read the MRI.

Studying is definitely not for killing anyone, crushing other colleagues to death, not for pretending, forcing, and showing that you are better than others.

Learning is to improve yourself and make yourself better, not just to be better than others.

Under Wu Xie's reminder, Guo Lixiang also moved to Luo Wei's place, and found two insignificant imprints from one part of the CT plane, pointed to them, and asked if they were here.

Zhong Yusheng didn't follow up with the outpatient clinic yesterday, and now he was so panicked that he rushed to Luo Wei and Guo Lixiang to ask what to do.

The voice is very low, so as not to disturb Lu Junyin who pretended to watch the MRI and Wu Xie who actually watched the MRI reading and diagnosis...

After watching it for a while, Luo Wei felt that it was inappropriate for everyone to only watch movies and not communicate with the patient, so he said to the patient very firmly: "This is a very complicated infectious arthritis, which is what ordinary people often say. It's festered, and the bones are severely destroyed, you shouldn't be able to stand up now, right?"

Yesterday, I discussed with Long Yuan how to look at arthritis. When Luo Wei spoke about such joints, his tone was relatively positive.

"That's right, Director Luo, what you said is right. Let alone stand up now, even if I lift my leg, it hurts a lot. I don't know what's going on."

"It's been several years. It was intermittent before, but I can bear it."

"But now the pain is unbearable, and it hurts especially at night." The patient is in his thirties, and he manages himself well.

He has a strong body, and when he is trying to demonstrate the leg lift at the moment, he can see the muscle lines. It can be seen that his strength is not small, but he is trembling because of the pain, and he may also be afflicted by this disease.

The wife standing next to him looked older than Chu Yuming, perhaps due to the urging of the years, but she was actually the same age as Chu Yuming, only in her forties.

She said worriedly: "My husband has been working outside, and I told him before, to go to the hospital, but the burden on the family is heavy, and he has not been willing to go."

"I went to the hospital and got a few injections of sodium hyaluronate."

"If you knew it was going to be postponed to surgery, you would have gone for treatment earlier." Her skin was rather rough, and she had a capable demeanor. She should be a very hardworking peasant woman.

The words were not very harsh, and she complained a little, but more of it was distressed, and she felt that being a man was not easy.

Raising a family is also stressful.

"Heavy physical work itself is easy to induce osteoarthritis. After osteoarthritis, if the puncture is improper, it is easy to cause secondary infection, and if it is not treated in time, then osteoarthritis and infectious arthritis are intertwined, which will make people The consequences became more serious."

"You may have to go to the state hospital for a big operation." Lowe said.

When Luo Wei said this, the couple's faces were slightly embarrassed, and they looked at Wu Xie, and they came here for Wu Xie.

Wu Xie is their doctor in charge and has a good reputation in the department, so they look forward to Wu Xie speaking even more. As for whether the director, Lu Junyin, expresses his opinion, they don't particularly care.

Wu Xie, who was on the side, found a very puzzling question after watching the NMR.

It can be clearly seen on MRI that the joint capsule and synovium are thickened and swollen.

The naked eye can see that the joint space is full, which is an absolute sign of infection, but the local skin is not very red, and the skin temperature is not high, and there is no blackish pigmentation after multiple infections.

This is very abnormal.

In the medical field, abnormality means abnormality. Some abnormalities are disease mutations, and some abnormal factors are the key points in the differential diagnosis of different diseases...

Wu Xie kept searching for some special joint infections in his mind, such as typhoid fever, tuberculosis, chlamydia, mycoplasma, viral...

Wu Xie's expression flickered, and he still didn't speak, so the patient could only reply: "I know, Director Luo, they also said the same when I was in the hospital outside, but I think it's too expensive, so I want to know if there are other Method……"

Not every patient has a good family background, and not every patient has enough financial strength to afford the best treatment. It is really a last resort to come to the town hospital. Too much money.

Wu Xie finally finished watching the film, and while putting down the MRI, asked, "Are you planning to have surgery outside?"

"Haven't you completed the preoperative examination?"

Wu Xie finally spoke, and everyone stopped talking.

Chu Yuming shook his head quickly: "Isn't it because I haven't planned to have an operation outside, so I haven't had an examination."

"Doctor Wu, in my situation, do I have to have an operation? Is there no other way?"

"Help me, it's too expensive to treat outside." Chu Yuming's tone was sincere.

His wife said: "Doctor Wu, we came from the county on purpose, just to join us. We are from Lijiahe. We heard from our fellow villagers that your medical skills are good."

"If you can help us, we will be grateful to you."

With money, anyone can find professors, and everyone will live in the best hospitals and receive the best medical resources.

Wu Xie thanked after hearing the words: "Thank you for your trust, but your husband's situation is very complicated, and I have to explore it carefully. Director Luo and Director Lu also watched your film just now, and they still think surgery is better. .”

"So, come and find me later, let's talk in detail, for a while, I really can't make up my mind."

"You can't just guess one." Wu Xie then made a joke.

"Thank you, Doctor Wu, I will trouble you and work hard on you this weekend." Both Chu Yuming and his wife thanked and apologized repeatedly.

...

Bed 12 is the last bed in this ward, and everyone went out after explaining to him like this.

After leaving the ward, Lu Junyin asked, "Xiao Wu, what do you think about this patient?"

"Director Lu, let's talk about this patient after the ward round. Let's go to bed 13-15 first." Wu Xie suggested, as if there was something unspeakable.

The group checked the room first.

Then at the 13th bed, Wu Xie didn't express his opinion at all, his mouth was very hard, and he suggested transferring to another hospital. Lu Junyin took the initiative to undertake everything.

For Zhang Chunmei in bed 14, not to mention, after the dressing was not covered last night, and a hair dryer was added, the amount of exudate really decreased a lot after one night.

Liang Hongsheng was very happy when he saw this scene: "Brother Xie, I dare not brag about it today, but I can see that my mother's condition is better than last night."

Removed the small characters of Brother Xiaoxie.

"Well, let's change the medicine first, and you don't have to blow too hard. Remember to turn on the cold wind, not the hot wind, and definitely not the hot wind. Don't blow your mother's skin, and the speed of the wind Don't be too fast." Wu Xie explained in detail.

"Okay, I remember Brother Xie." Liang Hongsheng nodded.

At this moment, Liang Hongping walked in, carrying a bag, which contained rice lunch box and stir-fried vegetables in the thermal box.

After entering the door, the younger brother Liang Hongping looked miserable: "Brother, I forgot to bring lunch for Brother Xie!"

"I'll go back and get it." Liang Hongping put down his pocket and ran out again, youthful and lively...

Everyone laughed at this behavior, but Lu Junyin and Luo Wei were full of unrestrained envy.

Although Liang Hongping is not childish, these words represent his gratitude and gratitude to Wu Xie.

"Is your brother cooking? Are you lazy brother?" Wu Xie asked.

Liang Hongsheng said guiltily and bluntly: "My younger brother's cooking skills are better than mine. It's my fault. When I was in the first year of high school, my younger brother practiced cooking at home for a year. I have been cooking for four or five years. None of them taste good."

Zhang Chunmei said with a happy face: "Everything is delicious..."