I really don't want to be a doctor

Chapter 220 Principles

"What do you think of this unexplained anemia?"

Zhang Hang thought for a moment, then asked Jing Xiaoran.

Although he has been in the hematology department for two years, subconsciously, he is still willing to listen to Jing Xiaoran's opinion.

"I carefully compared Xu Yongnian's recent blood routine examinations, and the hemoglobin results fluctuated around 90g/L." Jing Xiaoran said slowly.

贫血可以根据血常规中血红蛋白的数值划分严重程度，小于30g/L是极重度贫血；30-60g/L是重度贫血；60-90g/L是中度贫血；90g/L以上正常值以下是轻度贫血。

"The patient belongs to mild-moderate anemia, but the bone marrow picture is basically normal, so abnormalities in the hematopoietic system can be basically ruled out."

"Secondly, in his blood routine report, the MCV mean corpuscular volume is 25fl, and the MCH mean corpuscular hemoglobin is 74pg. It can be judged that his blood loss type is chronic blood loss."

Acute blood loss, in such a short period of time, the data about red blood cell volume in blood routine will not change; once these data about red blood cells change, it must be caused by long-term blood loss.

Zhang Hang nodded, and said: "Your analysis is good. But he has checked many items in the outer hospital. If the cause of anemia is not a blood system disease, what exactly is it?"

In terms of anemia, in general, the results of unexplained anemia in men are more serious than in women.

Because women have natural blood loss every month, the high probability of anemia is usually benign iron deficiency anemia.

But men do not lose blood every month, so once anemia occurs, it often means more serious consequences, such as gastrointestinal tumors.

"I think he has a disease of the digestive system, and tumors cannot be ruled out."

According to all the clues so far, Jing Xiaoran expressed his opinion.

In fact, the fewer medical records with abnormal test results, the harder it is to diagnose; just like a detective solving a case, the fewer clues, the harder it is to catch the real culprit.

"Digestive tract disease, tumors are not excluded?" Zhang Hang was surprised, "But the patient has no black stools, and he had a gastroscopy a month ago, and it was just superficial gastritis..."

Jing Xiaoran said: "Whether there is black stool or not, it doesn't mean that he doesn't have it, sometimes it needs to rely on laboratory tests to get the results. Besides, he didn't have a colonoscopy!"

One of the more common symptoms of gastrointestinal tumors is black stools; the growth of the tumor can cause gastrointestinal bleeding, blood is excreted from the digestive tract, and there is blood in the stool.When the amount of bleeding reaches 50-100 ml, the content of fiber and iron in the stool is too high, and black blood will appear in the stool.

When the patient's bleeding volume is relatively small, the feces discharged by the patient generally do not appear as black blood stool, but when the stool is routinely checked, it can be found that there will be positive occult blood in the stool.

"Could it really be a tumor in the gastrointestinal tract?"

Zhang Hang was silent for a moment, then said after a while: "Xiao Ran, when Teacher Li comes back, let's let him take a look at the patient."

Teacher Li is the senior deputy chief physician of Zhang Hang's group. Basically, all medical orders of a medical team need to be checked by the senior physician.

Jing Xiaoran nodded and continued to deal with the work at hand.

It was almost noon, and it was almost time to get off work. Unexpectedly, Weng Huijin came to the doctor's office suddenly.

"Hello, who are you looking for?"

A boy intern immediately stepped forward and asked, and other boys in the office turned their corners of the eye to Weng Huijin who was standing at the door.

I don't usually see them being so active towards patients' families, but today is really unusual.

This is really a world of faces.

"Is that Doctor Jing there?"

Jing Xiaoran's position is at the innermost part of the office.

Weng Huijin looked into the office, but didn't see him at first.

"Doctor Jing?" The intern boy frowned. There is no doctor named Jing in the Department of Hematology!
At this time, Jing Xiaoran noticed Weng Huijin standing at the door of the office.

"I'm here." Jing Xiaoran called softly.

Only then did Weng Huijin notice him, and at the same time, everyone in the office turned to Jing Xiaoran, their eyes filled with infinite envy.

It turned out that what this beautiful girl was talking about was the intern who just came to report today.

Weng Huijin nodded slightly to the intern boy in front of him, then walked towards Jing Xiaoran.

"Sister, what can I do for you?" Jing Xiaoran was still sitting on the chair, but turned to face Weng Huijin, and at the same time he pointed to the chair beside him, "Sit down and talk."

"No, I'll just say a word and leave." Weng Huijin smiled and waved his hands, "The nurse has finished taking blood for my uncle, and I'm going out to have lunch with him, so I'll come over and talk to you."

Generally speaking, patients hospitalized in the hospital are not allowed to leave the hospital at will; the patient's doctor's order corresponds to the level of care, such as secondary care, requiring nurses to patrol the ward every 1-2 hours.

If the patient is not in the ward, once an accident occurs outside the hospital, the hospital has an unshirkable responsibility.

This kind of sudden death outside the hospital is not uncommon every year. Even if the patient has signed the informed consent for leaving the hospital (the consequences of leaving the hospital are at their own risk), the hospital will still bear more than 80% of the responsibility.

At this time, a large amount of compensation is inevitable.

"Sister, the hospital doesn't allow inpatients to leave the ward." Jing Xiaoran said, "It's best to go to the cafeteria to buy food to bring back to the ward, or order takeaway."

"Is that so? But I see that the patients in other beds have gone out to eat?" Weng Huijin frowned and said, "Do I need to sign the informed consent for leaving the hospital before letting us go out for dinner?"

Jing Xiaoran patiently explained; "Sister, this is the informed consent for leaving the hospital, which informs you of the risk of leaving the ward, not a document to shirk responsibility; let me tell you like this, if the patient has an accident outside the hospital, even if it happens If there is a car accident, our hospital will be responsible.”

"Okay then." Weng Huijin said helplessly, "Then I'll go to the cafeteria and buy food for my uncle."

"This is the best way." Jing Xiaoran thought deeply.

Looking at Jing Xiaoran with a serious face, Weng Huijin suddenly burst into a smile.

"What's wrong?" Jing Xiaoran looked at Weng Huijin with a puzzled expression, she must have been dizzy from anger, right?
"It's nothing, I just didn't expect you to be such a principled person." Weng Huijin laughed.

Jing Xiaoran shrugged his shoulders: "This is good for both doctors and patients."

In fact, if Xu Yongnian was really just a small problem, just a gastroenteritis or something, then Jing Xiaoran might ask Weng Huijin to sign an informed consent for leaving the hospital, and turn a blind eye to them going out for dinner. .

After all, he is not an unreasonable person, and there are not a few people who walk outside the hospital wearing patient bracelets.

But now Xu Yongnian has the possibility of gastrointestinal tumors. Although he seems to be fine, before the diagnosis is made, he still sails carefully.

(End of this chapter)