This doctor is very stable

Chapter 202 Liver Cirrhosis with Liver Cancer

After reading the patient's detailed information, Gu Tianyi turned to look at the patient again.

His face was yellow and thin, but his stomach was slightly bulging.

"Uncle Li, what's wrong with you? Do you usually smoke or drink?"

Li Dafei sighed, and said: "Doctor, I have been having stomach troubles recently, indigestion, burns, drinking water doesn't help, and I feel tired after taking two steps. .”

Gu Tian nodded and asked again: "Uncle Li, please open your mouth."

"Tongue sticking out."

Li Dafei opened his mouth wide and stuck out his tongue coating, while Gu Tianyi took a small flashlight to investigate.

"Okay, you can close it now." Gu Tianyi already knew the patient's tongue coating to check!

The skin is sallow, the complexion is thin, and there are ecchymosis on both sides of the tongue coating, suspected symptoms of hepatitis!
But Boss Gu still showed no signs of expression, stood up unhurriedly and said, "Let's do a physical examination."

"Okay." Li Dafei replied, and Li Xiaoyu was busy supporting his father.

Qin Xiaoming, who was sitting recently, had already stood up, hurried forward to help.

Walking to the treatment desk, Li Dafei looked at Gu Tianyi and asked, "Doctor, what's wrong with me?"

Gu Tianyi patiently explained, "Uncle Li, the inspection is not finished yet, and we are not sure yet, you should lie down first!"

Boss Gu was doing a physical examination, so Lin Ran and the others naturally had no reason to sit still.

"Uncle Li, take off your coat first, then roll up the sweater, and then expose your stomach, so we can do the next inspection."

As soon as Gu Tian said that, he had already taken off the stethoscope.

With the help of his daughter Li Xiaoyu, Uncle Li took off his coat and curly fur sweater.

As soon as the patient's abdomen was exposed, Lin Ran frowned slightly.

It is obviously abnormal for a thin body to have a raised belly.

Could it be liver ascites?
As soon as I thought of this, the system's notification sound came.

【V4 patients】

[Basic chronic diseases: hypertension, diabetes, hyperlipidemia, liver ascites...]

【Abdomen is red, liver cirrhosis stage 2, diameter of right liver cirrhosis is 6cm...】

[Combined with small liver cancer, liver cancer diameter 3cm, surgical resection is required...]

Hearing this, Lin Ran couldn't help being stunned. The patient originally had three highs, but now he found that liver cirrhosis had developed into small liver cancer.

This form is not optimistic!
The patient's body is like a gunpowder keg full of gunpowder, which explodes at a touch!
After confirming the cause, Lin Ran began to calculate the treatment plan in his mind.

Cirrhosis is a chronic liver disease that can be controlled with drugs.

Hepatic ascites caused by cirrhosis and liver cancer can also be drained.

Small liver cancers can also be resected.

But the point is that the patient's physical condition is too unsatisfactory.

Almost an unsolvable question.

…………

Auscultate, press, measure blood pressure, body temperature...

A full set of physical examinations is done.

Li Xiaoyu on the side also became nervous, Li Dafei sat up and asked, "Doctor, how is my condition?"

The patient's condition and physical condition were clearly far from ideal.

The terms cirrhosis or liver cancer appeared in Gu Tianyi's mind.

There is an obvious hard object feedback feeling when pressing the liver.

Jaundice, ascites, diarrhea, fatigue...

Have a history of hepatitis.

All symptoms point to liver cancer and cirrhosis.

As soon as Gu Tian sat back in his seat, he paused for a moment and then replied: "Uncle Li, your illness cannot be diagnosed yet, I suggest you have a comprehensive examination first!"

"Do a comprehensive inspection again!" Li Dafei was obviously not interested in the inspection!

But Gu Tianyi checked the record form, and after finishing writing, he took a deep look at Li Xiaoyu and said, "The patient's family members also leave a contact information. After the examination, bring back the examination results, and we will proceed to the next step of diagnosis..."

In front of the patient, Boss Gu certainly couldn't say that he was suspected of having liver cancer!
And it's not impossible to diagnose without a thorough examination.

Li Xiaoyu, who is in his 20s, frowned when Boss Gu saw it this way.

They are not children, and this is leaving a phone call and doing an inspection. Thinking about it, it's not right!

Thinking of her father's physical condition, Li Xiaoyu's heart skipped a beat, and she hurriedly said, "Good doctor, my contact information is..."

After writing down Li Xiaoyu's phone number and sending him the written checklist, Gu Tianyi smiled and said, "Let's do a checkup first! The problem is not too big, don't worry, Uncle Li."

It turns out that smiles are used at such times!

Lin Ran is quite knowledgeable.

Li Xiaoyu helped his own Li Dafei out of the consultation room, Boss Gu looked at Qin Xiaoming and said, "Close the door and see if the patient has left."

Everyone is a medical student, and more or less has their own judgment in their hearts.

Even interns and regular training doctors will subconsciously have their own judgments when they encounter patients.

Finally, compare it with the diagnosis of the superior doctor, and find out your own shortcomings and merits. This is the correct way to learn.

Walking out of the consulting room, Li Dafei lost his temper, "Girl, let's not do this test! It's a waste of money, and now those neighbors say that the hospital is doing tests besides the test! Let's go back and buy some medicine at the pharmacy and take it first." Eat, maybe it will be fine in a few days!"

Li Xiaoyu just peeked at the inspection checklist, seeing the densely packed inspection items on it, she couldn't help feeling a little uneasy!

Suppressing her emotions, she said, "Dad, let's listen to the doctor, we have an expert account! An expert account costs 100 yuan, and there is no specific diagnosis result without an examination. Our 100 yuan is not wasted ?
And there is no shortage of money at home, we come to the hospital to see a doctor, how can we listen to the neighbors in the neighborhood!If you don't do the examination, I'll call my eldest sister and second brother back tomorrow..."

Li Dafei hesitated for a moment, then nodded and agreed, "This... alright! Don't bother them when they are so busy."

…………

After seeing the father and daughter leave, Qin Xiaofeng gently closed the door of the consulting room, "The patient is gone."

Gu Tian nodded, and then said: "Tell me about the patient just now, what did you see? Come first, Yu!"

Yu Hao pondered for a while, and then said: "The patient's complexion is thin and slightly yellow, the abdomen is protruding, and there are obvious symptoms of fatigue. The patient complains of indigestion and abdominal discomfort. If he has a history of hepatitis, smoking, drinking, or liver cirrhosis If so, then I suspect it is small liver cancer or early liver cancer..."

Boss Gu’s disease did not explain the disease history and auscultation, so Yu Hao can only infer from the symptoms. Of course, whether this inference is correct or not is not too important.

Because Boss Gu has already sent the patient for an examination!Boss Gu can ask someone to do further laboratory tests if he is not ill!

Boss Gu's examination of the illnesses of these little doctors, let's infer logic!
"Well, yes, Lin Ran, come here."

Lin Ran nodded, "My judgment is similar to that of Dr. Yu. The patient's complexion is thin, and the skin on the abdomen is also sallow, which may be jaundice. The abdomen is protruding, the body is thin, and the body shape is not proportional. It may be liver ascites;

Based on the symptoms such as diarrhea and fatigue that the patient complained of, I also think that the patient must have liver disease. It is not ruled out that severe hepatitis, cirrhosis, liver tumor, and liver cancer may also be concurrent. "

"Well, very good, the two of you are doing well without a medical history, you don't need to talk about Xiao Qin;

Let me announce the answer. The patient's medical history includes high blood pressure, diabetes, and high blood lipids, which are the three highs. He also has a history of hepatitis, and bowel sounds on auscultation... The feedback of pressing is that the liver feels hard, and there are ecchymosis on both sides of the tongue coating. My diagnosis is liver cirrhosis or liver cancer, and the combination is not excluded..."

When Boss Gu said this, Qin Xiaoming and Yu Hao started to record in those small notebooks.

Lin Ran asked, "Teacher, if the patient is diagnosed with liver cirrhosis and early liver cancer, shall we admit him?"

When Lin Ran asked this question, Gu Tianyi also frowned!The physical condition of the patient is already evident.

Whether to receive it or not is really a question.

It is not sure to cure it after receiving it.

If you don’t accept it, how can you advise patients where to seek medical treatment?

They are already a top three hospital here!
A famous doctor in bj's top three hospitals?

Does the patient's family have such a relationship?

Boss Gu thought for a while and said: "This question is a good one, but I can't answer it right now. We still have to wait for the test results to come out. According to the progress of the disease, we can discuss it with the patient's family before making a decision!"

Terminal illness is also different from person to person.

The financial conditions of the patient's family members are good enough, they can be transferred to a better hospital, they can visit famous doctors at home and abroad, etc...

It is not necessary to fight to the end in their hospital.

If the patient's family insists on treatment in the third hospital, Boss Gu really can't come up with a cure plan.

However, there are still conservative treatment options, and the combined treatment effect of radiotherapy and chemotherapy is still very good.

There is no complete cure for liver cirrhosis combined with liver cancer itself, and even if surgery is possible, it may recur soon.

What's more, the patient has an underlying disease!The physical condition does not allow surgery, so conservative treatment can only be done, and the quality of life of the patient should be improved as much as possible!
But admitting a terminally ill patient who can only be treated conservatively is the last thing a specialist director wants to see.

Watching the patients I admitted for treatment are dying little by little under the torment of the disease.

Watching the patient's family pay a heavy price, but unable to keep their loved ones.

It is also a difficult thing for doctors.

Making money is the business of the hospital, and the doctor is the one who sees and treats the disease!
After all, doctors are also responsible, obliged, and emotional people!

After listening to Boss Gu's words, Lin Ran immediately wrote down that he does not lack medical vision, but what he lacks is the response plan and experience for different cases.

Seeing Lin Ran rushing to copy, Boss Gu was very satisfied, and chuckled lightly, "Xiao Qin, call a patient!"

The atmosphere in the consulting room was a little heavy. Although the results of their discussion may not be [-]% correct, it should be nine out of ten.

Then Uncle Li's final result is also conceivable.

Seeing the result, but a little helpless, is a very helpless thing.

　Recommend a high-quality novel by a big guy, "My Low-key Book Writer Was Exposed by My Wife's Live Broadcast", entertainment live broadcast food, God of War stream, very good, everyone hurry to watch a wave.

　　


(End of this chapter)