Sleepless Doctor

The latest website: "Teacher Wu, you are here." Matthew was polite with respect, not like the dean, but like a lower-level doctor.

"Mayuan, hard work." Wu Mian turned off the car, walked down and bowed slightly.

"This is Director Zou of the Medical Department of the First Hospital." Matthew De introduced, "Old Zou, this is Teacher Wu. You always talk about meeting each other someday, don't you have a chance?"

"Mr. Wu, hello, hello." Director Zou politely stretched out his hands.

"Chief Zou, thanks for your hard work, I haven't returned home so late."

After a simple greeting and polite greetings, Chief Zou knew that Wu Zhongtai was here, and Wu Mianlai would definitely have to talk about business first, so he said, "Now the patient is in a stable condition, and 400ml of dark brown and "coffee grounds" stomach contents are drawn from the stomach tube. Now The patients were treated with normal saline, vancomycin, cefepime and metronidazole. There were also symptomatic treatments such as hemostasis and acid suppression."

"I will look at the eye medical record first, and then the patient." Wu Mian nodded and said.

"The directors of the departments have not left, they are all waiting for you." Director Zou said.

"Um?"

"Mr. Wu, we have consulted for the diagnosis of this patient for nearly 2 hours and have not found out what the cause is." Chief Zou said frankly, "Everyone is also curious and want to see your diagnosis."

If you change someone else, you will inevitably have pressure under your reputation. The greater your reputation, the greater the pressure. But Wu Mian didn't feel any pressure. He had seen this situation a lot, and he had become accustomed to it a long time ago.

When they came to the Department of Gastroenterology, a dozen or so doctors in their 40s and 50s in the office stood up and greeted Wu Mian.

"Sorry, teachers, let me take a look at the medical records first." Wu Mian was planning to look at his father first, but in front of so many directors and professors, he was still going to see the medical records first.

"Brother, let me take a look at the patient." Chu Zhixi blinked and said while holding the insulated lunch box and insulated cup from Wu Mian's hand.

"Go." Wu Mian is familiar with this process. In a sense, Chu Zhixi is his eyes.

Seeing Chu Zhixi greeted a female doctor about the same height to go out, Wu Mian smiled and sat in front of the computer.

The chief complaint and the past Chief Shi Zou have already read, Wu Mian remembers it clearly. After a glance, continue to look at the patient’s current medical history and treatment, as well as various laboratory tests.

Physical examination revealed: body temperature of 36.7°C, heart rate of 108 beats/minute, blood pressure of 161/96mmHg, respiratory rate of 22 beats/minute, oxygen saturation of 98%, weight of 55.4kg, height of 162cm, body mass index of 27.5 ; The patient appears restless, anxious...

Wu Mian's medical records and laboratory test values ​​were almost swept away. The index finger of his right hand slides on the mouse wheel, and the medical records are swiped down [天籁www.23txt.xyz].

Chief Zou frowned slightly, what can you tell?

Urinalysis showed that the urine was slightly turbid, with trace ketones, and the rest was normal; electrocardiogram showed sinus tachycardia and left atrium enlargement; chest X-ray showed no abnormalities; head CT plain scan showed no intracranial hemorrhage, mass or stroke.

The patient was treated with folic acid, multivitamins, intravenous saline, thiamine, and lorazepam after hospitalization.

The laboratory examination was performed again after 10 hours, and the indicators were normal.

After the patient was admitted to the hospital, he was given phenobarbital in gradually reduced doses to control alcohol withdrawal syndrome. Tremors, hallucinations, and tachycardia were reduced after phenobarbital treatment, but alcohol cravings persisted.

According to the description in the medical record, remission is a very typical alcoholism and withdrawal syndrome. It is said that it is not appropriate to be hospitalized in the First Hospital of the Medical University, but domestic hospitals are basically general hospitals, and the strength of mental hospitals is very weak. Wu Mian understands this.

After the problem of alcoholism is resolved, it can be transferred to a mental hospital for treatment of alcohol dependence.

Up to this point, the treatment was routine and effective, and the patient recovered quickly. The problem was that last night, Wu Mian didn't slow down when he saw this paragraph, it was still a flash.

As Director Zou described, the patient was in a very good condition last night, and he was going to be discharged the next day. But suddenly I became anxious, chatting and quarreling with other patients in the ward and family members of the patients, and then went to the doctor.

When the patient is nagging with the doctor, he suddenly becomes unconscious, drowsy, and has very poor reactivity.

At that time, doctors first considered hypoglycemia caused by too long fasting with water. At that time, the measured peripheral blood glucose was 8.4.

Physical examination showed tachycardia 107 beats/min, breathing rate 30 beats/min, oxygen saturation of 95% under oxygen inhalation, new abdominal distension but no tenderness; no tremor, seizures, urinary incontinence or tongue bite .

eccentric.

After reading a series of reports, Wu Mian tapped his fingers on the mouse pad lightly.

There are many problems, and the only possibility that can be solved perfectly is-drinking a lot of alcohol.

"Is the video surveillance called?" Wu Mian asked in a deep voice.

"Teacher Wu, it's adjusted." Director Zou said, "My staff watched the video surveillance within 48 hours a little bit. The patient didn't even walk around except for going to the bathroom."

So lazy... Wu Mian seemed to see Lin Daoshi's father. But Lao Lao Lin has his own reasons, not just laziness.

Director Zou’s words prove one point—the patient has no chance to sneak out to drink or buy alcohol.

In this case, you can only start thinking about your own disease.

I have already done a differential diagnosis with the girl in the car, what else can it be? Wu Mian began to retrieve a large number of relevant documents and his own experience in the database in his mind, and compare them with each other.

"Brother, I took a look at the patient." Chu Zhixi came back at this time. Wu Zhongtai stopped at the door and looked surprisedly at the directors of the room. Only his son was sitting in front of the computer, full of momentum.

"Um."

"The neurological examination is normal. The patient is in a typical alcoholic state, very thin, irritable, slurred in speech, and a small amount of old blood in the gastric juice drawn from the stomach tube."

Chu Zhixi briefly reported the results of the physical examination ~ www.wuxiaspot.com ~ Wu Mian pondered.

After experiencing the wildfire, Wu Mian rarely asked Chu Zhixi to do physical examinations and see patients on his behalf. But this set of practices has been deeply rooted in the bones of the two of them, and it has been revealed inadvertently.

"What do you think?" Wu Mian asked.

"Alcoholism, or poisoning caused by a large amount of alcohol, accompanied by stomach bleeding." Chu Zhixi said affirmatively.

Director Zou frowned and said in a deep voice, "The patient did not go out to buy spirits, and the medical alcohol in the department was checked and it was not lost."

"I think about it." Wu Mian said.

"Xiao Mian." Wu Zhongtai beckoned at the door.

"Dad, come in and talk." Wu Mian stood up and said seriously, "Dad, you were in the hospital a few days ago and talked about the patient's daily life."

Matthew De stepped forward immediately, although he did not reach out to support Wu Zhongtai, he was more respectful than when he faced Wu Mian.