Great doctor starts with adding points

The patient in bed 15 was still Liu Chunhua, the patient who underwent puncture for the intra-abdominal abscess, and the wound was re-debrided!

Originally, Wu Xie agreed to let her be discharged from the hospital, but later her son Qin Chongyuan was not happy.

I was very worried, so I had to wait until the stitches were removed and I was discharged from the hospital. I said a lot of good things to Lu Junyin, Wu Xie and others, and I went to the house to persuade them, which is also a filial piety.

This is not easy to drive people away.

After checking the room, Liu Chunhua said: "Director Lu, Dr. Wu, Dr. He, thank you..."

...

After walking out of the ward and continuing towards the office, Wu Xie pulled Guo Lixiang back: "Guo Lixiang, have you ever asked about Chu Yuming's travel history?"

Everyone was taken aback when they heard the words.

The medical history is generally related to syphilis and AIDS. This Lu Junyin has only seen the film of the knee joint, can he still see the problem in this area?

This can't be so magical, can it?

I have never heard of anyone being able to see AIDS or syphilis through MRI.

In fact, it is not easy to ask about the history of medical treatment in the department of orthopedics. If it is in the department of infectious diseases, it must be asked.

Because once the history of Yeyou is discovered, the illness may be cured, but the family will be broken. Therefore, the clinic is extremely afraid of asking about this kind of medical history, although this medical history article is specifically mentioned in the textbook.

Luo Wei asked curiously: "Doctor Wu, are you thinking about it?"

"Syphilitic Arthritis with Bacterial Infection."

"If the preliminary screening is negative, the joint fluid has to be drawn to look for spirochetes. It is best to ask about the medical history." Wu Xie suggested very firmly.

This knowledge point instantly touched everyone's knowledge blind spot.

Syphilis can also cause arthritis?

"Xiao Wu, what? Why don't you check directly?" Luo Wei asked.

This directly checks for syphilis in orthopedic inpatients. Isn't this breaking the relationship between other people's husband and wife?

Wu Xie looked at Lu Junyin: "Director Lu, what do you think?"

"If he insists on concealing it, he will not get proper treatment in the end, and it will be life-threatening."

Syphilis can be cured in the early stage, but if it is delayed to the later stage, it will be really troublesome.

This is not just family harmony, a relationship between husband and wife, but also a life.

Everyone was silent and quickened their pace towards the office.

Halfway through the walk, Lu Junyin deliberately called Wu Xie into the director's office. Confess to Guo Lixiang: "Xiao Guo, help Xiao Wu with the doctor's order."

Luo Wei realized what Lu Junyin wanted to do, so he smiled and suggested in a low voice: "Director Lu, can you let me increase my knowledge too?"

Lu Junyin said: "He Ling also come in together."

Two minutes later, the door to the director's office was locked.

Wu Xie didn't hide it, and explained directly and frankly: "During tertiary syphilis, syphilitic osteitis and gum swelling can spread to the bone end and cause joint changes. The skin is not red."

"And there is no fever symptom in the joint cavity. The infection caused by syphilis is not a traditional bacterial infection."

"In addition, both the articular cartilage and the bone ends that make up the joint can be affected, but the lesion is often limited to one articular surface. This is consistent with Chu Yuming's symptoms."

"Osteitis or osteomyelitis can occur in the bone, multiple irregular hyperosteogeny in the diaphysis, or scattered subchondral bone erosion. Joint lesions are mostly single, common in the knee joint, and subluxation or Charcot joint can occur. "

"This patient fits the corresponding characteristics very well. Of course, it's just a guess now..."

"The most important thing is to have a clear history of cultivation and find the diseased plants."

The reason why Wu Xie was so sure was because if he was diagnosed with syphilitic arthritis, then what he needed to treat first was not arthritis, but a dermatology or venereal disease department, or even transfer to another hospital.

This disease must be reported, and then the local disease control department will directly contact the family members, and even find his suspicious sexual partners to check them or their physical conditions.

Hearing Wu Xie's detailed and well-founded words, everyone looked at each other in blank dismay.

Unexpectedly, Wu Xie really determined it by reading the film.

It's just that things like this make everyone feel horrified and their scalps tingle.

Seeing everyone's reaction, Wu Xie continued to explain: "Director Lu, if it's not easy to ask directly or if you want to make a diagnosis, you can directly check the four items before blood transfusion as a routine examination for admission, and you will be able to find antibodies. .”

"At this time, if we go deeper to check the antigen, it will also become evidence-based."

Wu Xie knew that the reason why he was so good was not because his film reading skills were unbelievably advanced, but because he had a more thorough understanding of surgical infectious diseases.

When he was reading the film, his ability to capture the details of the film did not become stronger, but his sensitivity and processing ability to the captured information and indicators became better.

This is the advantage of good theory.

Lu Junyin said, "I'll ask."

"But Xiao Wu, have you thought about it? If you are diagnosed, should you stay for treatment or transfer to a hospital for treatment?"

"Transfer it out. We are in the Department of Infectious Diseases, not the Department of Infectious Diseases. Of course, we can also stay for treatment. Director Lu, it mainly depends on your opinion. His current situation is not particularly complicated."

"Accurate diagnosis is very important."

"After all, there is more than one person who needs treatment." Wu Xie explained.

Although it is possible to cure Chu Yuming's illness in a muddle-headed way, it cannot be done that way, because this time the treatment is not only for Chu Yuming, but also for his wife.

If a doctor only considers the patients he is in charge of, and everyone else ignores it, it is actually not considered responsible.

...

Lu Junyin walked out, called Chu Yuming into the office alone, and then pushed his wife out of the office.

But Lu Junyin came out in a few minutes.

Then he asked Chu Yuming's wife: "Your husband just said, you already know about his situation?"

Chu Yuming's wife nodded, looking a little lonely.

The smell of excrement in the trouser pocket cannot be spread out, and no one knows what he did, but if it spreads out and is known to outsiders, it will be a little bit deadly, but what can be done?

Lu Junyin said, "That girl, I won't hide it from you."

"Now, the most serious part of your husband's condition may not be the joints. If the result of the final inspection is true, he will have to go to the dermatologist."

"This is already the third stage, and it may be the end stage. If you can't treat this well. Even after surgery, the postoperative wound will be difficult to heal. You have to be mentally prepared."

"Besides, if you are free, you should check one yourself." Lu Junyin said very straightforwardly.

Chu Yuming's wife looked a little gloomy and began to wipe the corners of her eyes.

But soon she raised her head again and said, "Director Lu, I'm not afraid of your jokes. In fact, when a man is stressed, he needs to relax and vent. Our family doesn't have this condition, so I can't be with him..."

The medical history is not judged by the doctor, it is the name created by the patient himself!

Lu Junyin patted her on the shoulder and explained: "I am not asking you these questions to expose your sadness or embarrass you, but our doctor is considering your safety. Can you understand? Sister, you also want to Just get treatment."

"Phase III is contagious."

"Fortunately, Dr. Wu from our hospital noticed this situation. Otherwise, it would be very, very troublesome when we reach the fourth stage and the terminal stage. Now this situation needs to be treated together! Our hospital can also It’s just about your husband’s situation, he may still need to be observed in our surgery department.”

Syphilis can be treated in the county hospital, and Xuan County Hospital of Integrated Traditional Chinese and Western Medicine also has a dermatology department, so Zhang Chunmei can go there. There was no need to transfer to another hospital, and after Chu Yuming's syphilis was cured, the arthritis infection would also need to be dealt with, so there was no need to worry about it.

...

After such a thing, Lu Junyin told Wu Xie the final result.

Wu Xie didn't express his opinion, just said: "Thank you, Director."

"It's all trivial matters. There are some questions that you young people are not easy to ask."

"Work hard, Xiao Wu, you are really the lucky star of our department." Lu Junyin laughed heartily, full of relief.

This Chu Yuming, if there is no accurate diagnosis, even if the arthritis is cured, and then he does not go for treatment, and then he is gone, then the treatment this time is meaningless.

And since he hadn't been to a formal dermatology department in the third period, he knew that Chu Yuming's awareness of this aspect was shallow.

This is not just an accurate diagnosis, but also a life-saving.

...

Luo Wei and He Ling went fishing together, Zhong Yusheng was arranged for a blind date, and Lu Junyin gave him another vacation.

Seeing that there was almost no one in the department, Guo Lixiang asked, "Brother Xie, where is this patient's second sinus path?"

"It's like this. The sinus tract that you didn't find in this patient is going to the popliteal fossa. It's hard to find the sinus tract in this direction. Come here. Let me tell you about it. When you tomorrow, you will Go watch the movie carefully." Wu Xie said...

"Then how did you see this syphilis on the MRI?" When Guo Lixiang asked, his eyes lit up.

Today's Wu Xie is simply too eye-catching. Looking at syphilis through nuclear magnetic resonance, he has not found such a magical skill on Baidu.

And such skills, Wu Xie will know, this is the awesomeness.

Wu Xie smiled and said: "It's purely speculation, of course there is also some luck in it, I can't tell you clearly about this now, maybe you should have a deeper understanding of the corresponding clinical manifestations of syphilis, and then you can sort it out yourself .”

"Of course, this is not under our surgical control. The number of such cases is very small. In fact, even if you learn about it, the chance of applying it in the future is very small."

"I don't recommend you to do this, because the benefit ratio of learning it is not very high."

"Oh! Well then, I won't study anymore." Guo Lixiang hurriedly thanked Wu Xie, and just as he was about to say more, he saw two brothers, Liang Hongping and Liang Hongsheng, walking over with food. He probably wanted to have lunch with Wu Xie.

Considering that the other party's family might not have prepared extra meals, Guo Lixiang hurried away.

"Brother Crab, those two little brothers are here. I'm going home to eat. Thank you. Next time if I have any questions, I'll ask you again." Guo Lixiang left first after speaking. Tricked the two young men into saying that they had reported meals to their families.

Let the two teenagers breathe a sigh of relief, it seems that they have been limped.

This made Wu Xie feel that this Guo Lixiang also had skills.

The leave due during the May 1st period and the monthly ticket for the previous month have all been made up. Please support the monthly ticket, book friends.