Sleepless Doctor
Chapter 813: insist
"The examination hasn't been done yet." Wu Mian ignored Han Kui'en's nonsense, but asked the patient gently.
"..." Han Kuien lowered his head and followed Wu Mian.
"In the lobby, you did a simple physical examination and asked about the medical history. I was right." Wu Mian continued, "Director Han, tell me your judgment."
"Teacher Wu... I just told them that the patient should do the CT first." Han Kuien felt that Wu Mian was a bit annoying.
I took it all by myself, and I acted respectfully. They all came here after drinking two sips of cat urine.
The murder is nothing but a head nod, so why keep asking knowingly.
"Haha, I think the patient's situation is also very special." Wu Mian said as he came to the clinic, and sat down on his own. "Director Han, let's talk about it and treat it as a condition analysis and discussion. Don't be so restrictive. You sit and say, don't be too polite."
Han Kuien was in a daze.
Sitting alone in a formal chair in the consulting room, the person who spoke to himself was too young, dazzlingly young.
If it were...Han Kuien had countless thoughts in his mind, especially that unconvinced energy surged again.
He himself is such a person, and all his passion for drinking is an excuse.
"Ms. Wu, I don't think the patient needs CT." Han Kuien raised his head and said.
"Oh? How did you judge it?" Wu Mian didn't mind, his tone remained the same, even the smile on his face was like wearing a mask, unchanged.
"I asked about the medical history, and did a physical examination." Han Kuien was angry when Wu Mian was sitting alone in the "master" seat. He suppressed the anger in his heart and tried to let his words be flat, "Although the patient's abdomen The pain point is not at Maxwell's point, but it is very close to Maxwell's point."
"Then what?" Wu Mian asked.
"I think the patient should do a B-ultrasound now to rule out pelvic and appendage diseases. If nothing happens, the diagnosis of appendicitis is no problem. As for CT..." Han Kuien paused, and then firmly said, "I don't think it is necessary. "
"Director Han, the patient must lie flat and try to keep the abdominal wall as soft as possible." Wu Mian said with a smile.
"..." Han Kuien didn't know what Wu Mian meant.
I speak straight enough, and the meaning is very clear, but Teacher Wu seems to have not understood.
shrewdness? Han Kuien thinks that people of Wu Mian's age will never have a city mansion.
Is it true what he said? Still nitpicking again?
"Okay, then I'll check my body, and I would like to ask Teacher Wu to give more pointers." Han Kuien couldn't understand, so he looked directly at Wu Mian's eyes and said loudly.
After finishing speaking, he asked the patient's family to help the patient in. Like Wu Mian's physical examination before, he lay down with his head facing the window, his legs bent and erected, and Han Kuien's hand was placed on the patient's abdomen.
The basic physical examinations are almost the same, and Han Kuien did it meticulously, unlike the previous patient sitting and simply touching it twice.
But the result was the same. The lower right side of the belly button was tender and painful, with slight rebound pain and muscle tension.
Rebound pain and muscle tension prove that the inflammation in the patient's abdominal cavity is severe, irritating the peritoneum, so the body will respond.
Moreover, this position is far from the pelvic cavity, so it is great to check a B-ultrasound to rule out the fallopian tube problems. But Han Kuien believes that it is unnecessary. Acute appendicitis is a high probability diagnosis.
After checking the body, he knew in his heart, it was not that he had overlooked something that made Wu Mian grasp the handle.
"Ms. Wu, the check is over." Han Kui'en then briefly talked about the symptoms found in the physical examination, and then said, "I still think that a blood test and a B-ultrasound at most will be enough. There is no need to do a CT."
Wu Mian looked at Han Kui'en with a smile, and asked, "If there is tenderness, rebound pain, muscle tension, it must be caused by inflammation?"
Wei Dabao had heard the gunfire in Han Kui'en's words a long time ago, and the question just now was weird. He remembered a description of rebound pain in "Diagnostics".
Rebound pain is a clinical sign. During the physical examination, use 3 to 4 fingers together to press against the deep abdomen, and then suddenly leave the examination site. The patient feels a kind of throbbing pain, called rebound pain.
Normal abdomen does not cause pain during palpation, and rebound pain is only caused when the infection is tired.
The disease book corresponding to this situation is also very clear-in patients with appendicitis and peritonitis, abdominal palpation can cause rebound pain, but in children with appendicitis, rebound pain is often atypical or inaccurate and should be strengthened observe.
Why did Section Chief Wu also play the trick of vomiting?
"Ms. Wu, how do you judge?" Han Kuien asked.
"I won't talk about the definitions of rebound pain and muscle tension. You are also an veteran doctor who has been practicing for 20 or 30 years." Wu Mian said, "But are you sure it is really rebound pain and muscle tension?"
"..." Han Kuien was startled.
Is this a joke?
Could it be that the person in front of me is not the legendary Mian Shao, not the teacher Wu, but a young doctor with the same name and surname?
"Are you Teacher Wu Mian of Xiehe? "Diagnostics"...... Are you the deputy editor?" Han Kuien asked tentatively.
"You are right." Wu Mian said, "You don't have to doubt my identity, as you know it, there is nothing wrong."
Han Kui'en frowned, thinking badly.
This person doesn't speak medical ethics at all, and speaks nonsense with his eyes open. At the level of Han Kui'en, he is far from the level of the school clan, he is just a surgeon.
Legend has it that when the middle school lords suppressed dissidents, they did everything they could. Today, I encountered it myself.
Although a little scared, Wu Mian's actions aroused the indignation in Han Kui'en's heart.
He first recalled the process of the physical examination just now, and confirmed that the patient had tenderness, rebound pain, muscle tension, and the location was also close to McDonald’s point. .
"You go out first, and I will discuss the condition with Teacher Wu." Han Kuien said in a deep voice.
Wei Dabao and Yang Lei looked at each other, and the patient's family and the patient also looked at Han Kuien in a daze.
"Go out." Han Kuien said in a deep voice.
Seeing that he was angry, the few people dared not to neglect, and hurriedly walked out of the clinic. Wei Dabao finally left, took a look inside, and closed the door smoothly.
Anyway, I don't worry about Chief Wu's loss. With an old bone like Han Kuien, Chief Wu can hit ten with one hand. I just don't know what Han Kuien wants to say after closing the door, he is really curious!
Wei Dabao looked back reluctantly.
"Teacher Wu, I will reiterate that the patient's condition is relatively certain, at most a B-ultrasound can be done, no CT is required." Han Kuien said when they closed, he was no longer polite, and said directly.
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