This doctor is very stable

Chapter 548 Physical Examination of Children with Congenital Liver Fibrosis 【For subscription, ask for monthly pass. 】

Walking into the changing room in the neonatal care bed area, Lin Rangu and the boss began to disinfect, disinfect, and disinfect again.

Lin Ran and the others wished they could take off their underwear for a full-body disinfection.

When entering the neonatal intensive care unit, strict self-disinfection is required.

Such strict disinfection work is of course to protect the little angels with weak resistance in the ward.

After taking off their white gowns and masks, Lin Ran and the others put on the newly prepared white gowns and put on the thick medical masks again after two sterile disinfections.

"Let's go."

Liu Simimei, who also just finished the disinfection work, came out from the dressing room on the female side.

A group of four walked out of the locker room, and went straight to the ward where the child was located without too much pause.

Entering the neonatal intensive care unit, Liu Simei led Lin Ran and the others quickly found the patient.

There were seven or eight patients in one ward, and Lin Ran was not distracted to observe other patients.

They saw that the child with congenital liver fibrosis in front of them was lying quietly on a small hospital bed, wearing a small eye mask and enjoying blue light care. He seemed to be asleep, and even breathing seemed very cautious.

The indoor temperature is about 25 degrees, and the children are all naked and small, so there is no need to worry about catching cold.

Accompanied by the child's small chest rising and falling with the breathing, very rhythmic.

It's just that the breathing rhythm of the child in front of Lin Ran and the others is obviously faster than that of other patients.

The stature is also weaker than other children, and the skin is yellow and dull.

The child was being infused with fluids. Lin Ran took a look at the carbamate and Lizhixue used to treat sepsis and excessive blood loss...

"When the child was admitted to the hospital, we had already transfused blood. After giving the medicine, the symptoms have been relieved, but if the root cause of the disease is liver fibrosis, if the liver fibrosis is not resolved, the child will still have various complications even after being discharged from the hospital. It may be too late for the relapsed child to be sent to the hospital next time, so I think surgery is the only treatment option to save the life of the child.”

Generally, children with congenital hepatic fibrosis with mild symptoms can be cured by symptomatic treatment.

However, once the condition becomes severe and severe, such as upper gastrointestinal bleeding, cholecystitis, bile accumulation in the liver, sepsis and other serious complications, surgical treatment has to be considered.

Because the fibrosis of the liver in children is irreversible!
Therefore, the root cause of the disease cannot be completely resolved without surgery.

Hearing what Liu Simei said, Boss Gu didn't go crazy right away.

He glanced at Lin Ran and said, "Give the child a physical examination by auscultation!"

Lin Ran glanced at the child's slightly distended belly, and nodded.

Effusion?Or ascites?
Children with congenital hepatic fibrosis will have abdominal distension only when there is fluid accumulation or hepatic ascites.

This is obviously one of the complications.

Without thinking too much, Lin Ran took off the stethoscope tied around his neck.

Put the headset into his ears, and carefully stick the earpiece on the patient's small chest.

Although congenital liver fibrosis generally does not affect the heart and lungs, all diseases never develop according to the textbooks.

Clinically, children with hepatic fibrosis have heart disease, pulmonary hypoplasia, and other complications. Therefore, we must be very careful when dealing with children directly in the clinic. Don’t find out if the hepatic portal hypertension is not resolved during the operation. Cardiac portal hypertension or pulmonary venous hypertension!

Lin Ran carefully attached the receiver to the patient's chest.

It's a girl!Maybe she will be a beautiful girl when she grows up.

But the most important thing now is to cure her disease.

The cold receiver touched the child's chest, and the child shrank in reflex, and raised his hand to push the receiver away from Lin Ran's hand.

This kind of action made people feel a little distressed.

Although the child in front of me is not as good-looking, cute and pink as other healthy children, she is still a precious little life.

Although children come to this world for the first time, it does not mean that they are unconscious.

Crying when sad, smiling when happy, these are their words...

Of course, it was impossible for Lin Ran to let a child under one month interrupt his auscultation.

Gently holding the child's small hand with his left hand, Lin Ran listened carefully to the child's heart and lung sounds.

Heartbeat, breathing will produce sound.

And because the child with the disease breathes, the sound produced by the heartbeat will have murmurs.

Fortunately, after listening to the class quietly for a while, Lin Ran didn't hear any heart and lung murmurs.

If the noise is heard, the treatment of this child will be more difficult, and the child will have less hope of survival!

After listening to the heart and lungs, Lin Ran immediately put the receiver on the child's belly.

Different from the heart and lung sounds heard above, the earpiece was placed on the child's stomach, and soon he heard blood vessel murmurs and friction sounds produced by gastrointestinal peristalsis.
Left side, right side, upper part, lower part, Lin Ran didn't let go,
Vibrating water sound and voiced sound!

All the sounds from the stethoscope were very weak, but Lin Ran listened very carefully.

Friction:
Splenic infarction, perisplenic inflammation, perihepatitis, or cholecystitis involving the local peritoneum, etc., can be heard in each corresponding part when taking a deep breath, and friction can be felt in severe cases.

Vascular murmur:
Normal people have no vascular murmur in the abdomen.Pathological vascular murmurs include arterial murmurs and venous murmurs.Arterial bruits are often in the mid-abdomen or one side of the abdomen.

A systolic bruit (jet bruit) in the mid-abdomen often suggests an abdominal aortic aneurysm or narrowing of the abdominal aorta.The former can touch the pulsating mass here; the latter has weakened pulsation, the blood pressure of the lower limbs is lower than that of the upper limbs, and in severe cases, the pulsation of the dorsalis pedis artery cannot be felt.

If the systolic vascular murmur is in the left and right upper abdomen, it often indicates renal artery stenosis, which can be seen in young hypertensive patients.If the murmur is on both sides of the lower abdomen, iliac artery stenosis should be considered.

If the murmur is on both sides of the lower abdomen, iliac artery stenosis should be considered.

When the left lobe liver cancer compresses the hepatic artery or abdominal aorta, a blowing-like vascular murmur can also be heard at the mass site.Venous bruit is a continuous buzzing sound, which is caused by the eddy current in the vein, without systolic and diastolic properties.

It often occurs around the umbilical cord or in the upper abdomen, especially when portal hypertension causes severe abdominal varicose veins. This sound suggests that portal hypertension has collateral circulation.This murmur can be intensified by compression of the spleen.

Vibrating water sound: Hear the sound produced by the collision of gas and liquid in the stomach. Normal people can appear vibrating water sound after drinking a lot of liquid.If there is still a vibration of water on an empty stomach or more than 6 hours after a meal, it means gastric retention, which is caused by pyloric obstruction, gastric dilatation, and excessive secretion of gastric juice.

Dullness is caused by fluid accumulation in the peritoneal cavity or hepatic ascites in children.

After the auscultation was completed, Lin Ran frowned!

It was the first time that Lin Ran could hear such murmurs in the same abdominal cavity.

But the disease always manifests itself, and Lin Ran is sure that he heard correctly.

(End of this chapter)