Sleepless Doctor

Wu Mian looked at Han Kui'en with a smile, and asked, "The commission for the bill is also about the department performance, which is suppressed by the hospital. As long as the dean is a person, this does not exist. Director Han, what do you think is the province of Montenegro? Can a dean hold me down?"

"This shouldn't be a commission for billing. It may be because of the bad habit you developed when you were studying in the United States." Han Kuien said when he saw it, without hiding it, and continued.

"You made a mistake from the beginning. CT is a must, not like you think, this is a useless examination." Wu Mian turned slightly, the chair faced Han Kui'en, and Erlang's legs were raised. Hold him.

One sitting and the other standing, Han Kuien felt like a little clinical doctor who was reporting on medical history and being picked up by the director, with a sense of humiliation spontaneously.

"Teacher Wu, please explain, what I was wrong." Han Kuien asked directly, leaving no room for maneuver.

"Oh, that's the case. When you asked about the medical history, did the patient have a history of strenuous exercise recently?" Wu Mian asked.

"..." Han Kuien was taken aback for a moment, could it be rhabdomyolysis?

MB! If this were the case, just over an hour had been delayed, which would be fatal.

"You are thinking about rhabdomyolysis." Wu Mian saw Han Kui's expression and smiled slightly. "Rhabdomyolysis syndrome refers to a series of genetic or acquired diseases that affect the cell membrane, membrane channels and energy supply of rhabdomyomuscularis. The striated muscle is injured, the integrity of the cell membrane is changed, and the cell contents leak out, which are often accompanied by acute renal failure and metabolic disorders."

"I asked, the patient's urine and bowel were normal, and the color did not change. Moreover, the first symptom of rhabdomyolysis was muscle soreness, mainly muscles in the extremities." Wu Mian said, "The patient only has limited abdominal pain. The diagnosis of rhabdomyolysis may not be possible. Big."

"..." Han Kuien felt that there was a big invisible net covering himself in it, just like catching a house sparrow when he was a child.

It's just that now the house sparrow is himself, and the bear child who is hiding aside expecting a smile is Wu Mian.

He knew exactly what he was thinking, and Han Kuien felt helpless.

"The patient was losing weight recently. I asked the patient's family members about this period of mistrust, but the patient still explained some of the situation at that time."

"Because I want to lose weight, the patient suddenly thought of exercising. Vsitup in various exercise methods in the gym... V-shaped sit-ups and various fitness equipment used a lap, suddenly abdominal pain. The timing is highly consistent, I will finish asking. The first feeling after the medical history is the undesirable consequences of excessive fitness."

"Excessive fitness, especially if people who are usually lack of exercise, suddenly increase the amount of exercise may cause a lot of diseases. The patient inadvertently emphasized the V-shaped sit-ups, which is psychologically...Haha, don't explain too much, in short, this situation The first judgment is definitely not appendicitis."

"Then what do you think is..." Han Kuien was really persuaded this time. Wu Mian didn't take advantage of the situation to suppress others, but rather talked about the condition seriously.

As a doctor, you can't even ask questions about the medical history... But who is all right to care about the patient's eating, drinking, and sleeping.

Although in theory any activity may lead to the occurrence of disease, sometimes even the patient himself does not remember what he has done recently.

Even if you ask something, most of it is redundant information, which is meaningless!

"There is a complication of excessive fitness called rectus abdominis sheath hematoma. I don't know if you have encountered it, Director Han." Wu Mian said, "Because it rarely occurs, I hesitated again and again when writing "Diagnostics". My teacher said a bit before removing this one."

"..." Han Kuien's mouth was bitter, and his heart was full of mixed feelings.

What do you have to say? He opened his mouth and shut his mouth to compile "Diagnostics", and this alone crushed himself to death.

As for the hematoma of the rectus abdominis sheath, Han Kuien has only seen it twice, and all of them have been seen with naked eyes after surgery.

"When the blood vessel behind the rectus abdominis muscle ruptures and hemorrhages under the action of certain factors, a hematoma is easily formed in the tendon sheath. This injury is called an intrathecal hematoma of the rectus abdominis.

After coughing, vomiting, or strong contraction of the abdominal muscles, pain in the lower abdomen appears, accompanied by nausea and vomiting, and then abdominal masses appear. "

"No matter the symptoms or manifestations, they are similar to the inflammation of the abdomen, so we need to distinguish them." Like a teacher in class, Wu Mian explained patiently and meticulously.

"This patient is in a special condition. There is no nausea or vomiting. During the physical examination, I carefully touched the tender spots and vaguely felt that there was a small mass of 0.8×1.2cm in diameter."

"What I said is relatively simple, but that's probably what I mean." Wu Mian said while tilting his legs, "After asking the medical history and physical examination, I think the patient is more likely to have a rectus abdominis sheath hematoma, so I recommend seeing it. Take a CT look."

"..." Han Kuien was speechless.

"Director Han, do you have any other questions? For example, where did you not understand?" Wu Mian asked.

"..." Han Kuien was speechless.

"If it's okay, take the patient to pay the money, and then go to the CT room to have an abdominal wall CT. It's getting late, and I will go home with a glance at the CT." Wu Mian said, "I was called out by Dr. Wei before I had a meal. , I have to be disciplined by my mother again when I go home."

Han Kuien was half-believing, but Mrs. Wu Mianwu said clearly, what can he do?

Accompany the patient to the CT, if it is really a hematoma of the rectus abdominis sheath, kneel and kneel, there is no shame.

If not...hey!

Han Kuien glanced at Wu Mian who was sitting on the chair with Da Ma Jin Dao, said something politely, and then turned to go out.

Wei Dabao and Yang Lei saw that Director Han took the patient and the patient's family away ~www.wuxiaspot.com~, they were curious, and immediately walked into the consulting room.

"Doctor Yang, come and sit down." Wu Mian said, "I have just received six patients, among them..."

Wu Mian and Yang Lei "switched over" for the first time. As for Director Han, he had already forgotten to go aside.

After handing over the whereabouts of the six patients, Wu Mian said, "Doctor Yang, I was so embarrassed just now."

"..." Yang Lei's left cheek seemed to have been shot again at close range, that feeling...don't want it so sour. The area of ​​psychological shadow is huge, and the three rooms and one hall can't be stopped.

"I don't know what to do with the charges. I asked Xiaohui, a night shift nurse, a little bit." Wu Mian said with a smile, "Sui Wenyuan has already left after paying the fees. Please check again. If there is something wrong... Dr. Wei , You can help with the aftermath."

"Good, good." Wei Dabao said repeatedly.

This is not the point. Yang Lei leaned over and asked, "Section Chief Wu, Director Han...You didn't fight with Director Han just now."