Doctor Peerless

Chapter 551 The Patient's Opinion

Enhanced CT?

MRI?

When Zhou Sheng spit out these two inspection items.

Both Liu Jing and Su Quan beside him were startled.

Generally speaking, ordinary CT and X-ray examinations are often performed in emergency departments.

X-ray examination is similar to CT.

They all use the high penetrability of X-rays.

The inventor is the famous Roentgen, also known as Roentgen rays.

This thing is simply a milestone invention of modern Western medicine, which has since allowed human beings to see the "essence" through the body.

Roentgen also won the Nobel Prize in Physics for this discovery.

You can see its importance.

The difference between CT and X-ray examination is that CT is a product of recent decades.

The principle is the same, but the function is more powerful. With the aid of computer imaging, it can scan a certain thickness of a certain part of the human body.

But that doesn't mean X-rays are out of date.

X-ray inspection has advantages in bone inspection and other aspects, and the price is also cheap.

CT is stronger for viscera and intracranial organs.The price is a bit more expensive.

Enhanced CT, on the basis of CT, injects a contrast agent into the examinee's body intravenously, usually an iodine-containing preparation, which can better image blood vessels.

MRI is the latest imaging inspection equipment, which has better imaging effects on soft tissues.Even tiny blood vessels can be seen clearly.

Of course, the costs of these four inspections are also different.

The cheapest X-ray examination is about 100 yuan, and CT is several hundred.

Enhanced CT is of course more expensive.

The most expensive one is nuclear magnetic resonance, which is almost twice as expensive as CT, nearly thousands of yuan per visit.

CT examination, that is, ordinary plain scan, can already see symptoms such as intracranial hemorrhage.

Therefore, the emergency department usually prescribes this examination.

Enhanced CT and MRI are expensive and generally not chosen for emergency treatment.

Only in some specialties, more detailed examination is required, or when the CT examination fails to achieve the expected effect, it will be considered.

Both Liu Jing and Su Quan didn't understand why Zhou Sheng had to do these two tests directly on the patient.

The middle-aged man lying on the hospital bed is now conscious.

He heard everything Zhou Sheng said.

He doesn't know what enhanced CT is, but anyone with a little common sense about MRI knows it.

That thing, a ring-shaped cabin, people lie on the platform and are sent into the cabin, just like the shots in science fiction movies.

This stuff isn't cheap.

And for ordinary diseases, it is rarely used to do that.

In his mind, an internet joke that he had seen before immediately emerged, saying that a person with a cold went to the hospital for a checkup and cost thousands of dollars.At that time, only a few dozen dollars of medicine were prescribed.

People who see a doctor, in addition to holding the first goal, to see a cure.

The second concern is the price.

Although this middle-aged man has a headache.

But I feel good about myself.

It would cost him thousands of yuan to check, and he felt a little heartbroken.

Without hesitation, he said to Zhou Sheng: "What about MRI, enhanced CT, headache, wouldn't it be enough to do a normal CT?"

Patients, sometimes, like to be their own doctors.

But today's situation is a bit special, even Liu Jing and Su Quan think that a normal plain CT scan will do.

Of course, Zhou Sheng is not one of the few doctors in the joke who likes to prescribe random examinations.

He has his own reasons.

Sudden headache, drooping eyelids.

These symptoms are most likely early symptoms of cerebral aneurysm hemorrhage.

Cerebral aneurysm is a cerebrovascular disease.

Ordinary unenhanced CT is not good for angiography.

If you want to know the location and status of vascular lesions, it is better to enhance CT and MRI.

Facing the patient's questions.

Of course Zhou Sheng had to answer.

As soon as Zhou Sheng answered, Liu Jing and Su Quan also understood.

At this time, Liu Jing also found that the patient still had a stiff neck and discomfort in activities.

Very consistent with the symptoms of subarachnoid hemorrhage.

Subarachnoid hemorrhage is most likely a cerebral aneurysm hemorrhage.

It is very difficult to judge without enhanced CT.

Su Quan's clinical experience is not rich.

Can't judge.

It's just that he believes in his brother.

When the patient heard it, he didn't believe it.

My head is bleeding?Or is there a high possibility of cerebral aneurysm bleeding?

How severe the cerebral hemorrhage is, I just have a little headache, maybe it's just that I haven't had a good rest.

Going to have a CT is already very good.

Also do enhanced CT?MRI?
Then I am not being fooled.

He yelled that he didn't need it.

Liu Jing and Su Quan were of course standing by Zhou Sheng's side.

They persuaded the patient to follow the examination that Zhou Sheng said.

The patient is determined not to do it.

Zhou Sheng was also quite helpless.

Forget it, give him an A-level auxiliary scan first.

Based on experience, Zhou Sheng has judged that this middle-aged man has a high probability of bleeding from a cerebral aneurysm.

However, he couldn't judge the future development.

A-level auxiliary scans will also give judgments on subsequent changes in the condition.

If the condition is not serious, follow this guy's suggestion and do a plain CT scan first.

He will do other tests later.

no way.

In order to avoid unnecessary disputes, doctors can only give opinions.

Su Quan and Liu Jing are still persuading.

Zhou Sheng remained silent and started the auxiliary scan.

After a few minutes.

The scan result comes out.

The patient's condition: Cerebral aneurysm bleeding, the current condition is grade II.

It is estimated that 10 minutes later, there will be a second bleeding, and the condition will develop into grade III.

Four hours later, the third bleeding was expected, and the condition progressed to grade IV.

Twenty hours later, the fourth bleeding was expected, and the condition developed to grade V.

Zhou Sheng saw the result.

His brows were furrowed.

The Roman numerals II, III, IV, and V in the system are internationally accepted classification methods for primary subarachnoid hemorrhage.

As long as the doctor sees the numbers, he knows the current condition of the patient.

This is graded into five levels.

Grade Ⅰ, asymptomatic or mild headache and mild neck stiffness.

Grade II, moderate to severe headache.Neck stiffness, oculomotor and other cranial nerve paralysis.

The patient is now in level II status.

Grade Ⅲ, confusion, restlessness and mild cerebral symptoms.

Grade Ⅳ, stupor, semi-consciousness, hemiplegia, early decerebrate rigidity and autonomic disturbance.

Level Ⅴ, deep coma, decerebrate tonic, near-death state

Generally, a cerebral aneurysm bleeds, if there is no secondary bleed.

If the symptoms are not particularly severe, conservative treatment is possible.

However, if there is secondary bleeding and the disease progresses, surgery is the best treatment.

And it is better to perform surgery within 4 hours after bleeding.

If it occurs three times, bleeding everywhere, it will enter into the state of IV and V grades.

That is even if the operation is successful.

If you save your life, there is a high probability that you will have sequelae.

This bleeding symptom is so fierce.

Bleeding 3 times in 3 hours.

Apparently, surgery is not an option.

Persuasion from Su Quan and Liu Jing.

Attracted Liu Zhengqing who happened to pass by the observation room.

Liu Zhengqing saw that there were actually three doctors gathered around one patient.

Not sure what happened.

As the temporary acting team leader, although he is too lazy to take care of things.

But since he is the team leader, he still has to show up sometimes.

Otherwise, in case something happens, he will not be easy to deal with.

He walked towards Zhou Sheng and the three of them...

(End of this chapter)