Gou is practicing medicine in the clinic

"Jingsheng, are you here? The two cases sent to you today are each more difficult to deal with. Whether my brother can sleep well tonight depends entirely on you."

Lian Tao was never polite to him.

Basically, if you have something to say, tell it directly.

It's just like being honest when you don't expect to meet someone, and being honest when you don't welcome or see someone off.

There is really no need to be too polite between true close friends.

Excessive politeness is reserved for strangers.

Lian Tao was nearly 17 years older than him, and his academic achievements, medical status, and all other conditions were far superior to his.

It stands to reason that such two people are definitely not on the same line.

The fate in the world is so wonderful that the two became friends by accident.On the contrary, it was because Director Yang, the real protagonist of the baby incident, did not become Li Jingsheng's close friend.

The two are friends, a little more advanced than ordinary friends, that's all.

With Lian Tao, they are true buddies.

If anything happens to Li Jingsheng, just let him know and Lian Tao will do his best to help him.

"Don't worry, I'm having dinner. I studied the case of cough, cyanosis, and general edema at noon, but I feel that the cause is not that simple. I will finish my meal later and come over to discuss it with you."

Li Jingsheng had just finished speaking, but before Lian Tao could say anything, Ou Qinglan next to him quit.

"Director Lian? Hello, I am Li Jingsheng's girlfriend. He was stabbed in the arm during the consultation today and needed a lot of stitches. I want him to have a good rest at home. You should consult someone else for your difficult case! "

Ou Qinglan never interfered in Li Jingsheng's personal affairs.

At this moment, when she saw that her boyfriend was almost dead, had not even taken a few bites of rice, and promised to go over to help Lian Tao diagnose difficult cases, her anger that had been pent up for a long time also exploded at this moment.

"Ah...Jingsheng was stabbed?"

Lian Tao looked very surprised after hearing this.

"Jingsheng, then you should stay home and have a good rest! I didn't even know you were injured, so I just thought of grabbing a free man. I'll come over to see you later."

"It's just a minor injury, it doesn't matter! I'll communicate with my boss and I'll go over and give you a consultation. It shouldn't be a big problem."

Li Jingsheng didn't seem to care about the injury on his hand.

But it still made him feel good to have his girlfriend care so much.

"It seems that your leader is very important! How did you get stabbed? You should be working in the hospital today, right? Could it be that you were retaliated for stealing someone's girlfriend?"

Lian Tao obviously cares about him.

It turned into gossip.

"If I was really stabbed for stealing someone's girlfriend, it would still be worth it. I really suffered an unreasonable disaster today. I was obsessed with a mental patient, and then pretended to be a patient, and suddenly drew a knife and wanted to kill me. The police are still investigating. No specific conclusion has been made. We only know that the patient was injured in a car accident two months ago and was sent to the Second Hospital for emergency treatment.

I was asked to go to the emergency room for consultation to see if I could perform a manual repositioning operation.I found that the patient's bone injury was serious and could not be reduced manually, so I gave the advice to save life first and then treat the bone.

As a result, the patient's legs became lame after recovery, and he may have resented me for this.

It is also possible that the patient became insane and believed that I had killed his daughter.

Because his daughter was in a car accident with him.

In the end, his daughter failed to be rescued and passed away. "

Li Jingsheng was quite speechless when he encountered such an unfortunate incident.

Some disasters are truly unimaginable.

If he didn't cure the patient's disease, he would still be able to figure it out.The patient who killed him had never received any treatment from him. I really don’t know where this hatred came from.

"Oh, it's really dangerous for us to be doctors. We treat patients with all our heart every day, but we have to keep our heads in our belts. I really hope that the doctor-patient relationship can become more and more harmonious, and the safety of doctors can be guaranteed. If you want to be more open-minded, at least you can I'm lucky that only my arm was injured."

Lian Tao comforted him.

"Is the wound deep? Your hand is injured and you can't work. Wouldn't the manual reduction clinic of the Second Hospital have to be suspended?"

He knew very well that Li Jingsheng's special status in the Second Hospital was largely due to his manual bone setting.

Because this is a monopoly technology that no one can replace.

"I tried it this afternoon and guided the doctors under me. As long as the cases are not too complicated, they can basically handle them. When it comes to particularly complex cases, I can't help but ask them to consider surgery."

Li Jingsheng decided to accept a group of apprentices as a precautionary measure.

Not only did he solve the problem of academic improvement, but he also had helpers around him if he had an accident.

"You returned to work just after being assassinated. You have such a strong psychological quality!"

Lian Tao said with great admiration.

"Okay, you can rest well at home! If you are injured, don't come here. Check it for me on your phone. If you have any diagnostic opinions, you can send me a message or call me at any time."

I originally thought that I could ask Li Jingsheng to come over and help me a lot.

Now this plan can only come to nothing.

Looking at the patient information on the mobile phone for diagnosis and going for a consultation in person are actually two different concepts.

Doctors at the scene can not only view and understand the patient's real-time condition, but also communicate with the patient in a timely manner or discuss with other doctors on-site if they have any questions.

After ending the call, Ou Qinglan stared at him with her bright eyes.

An angry look.

"Okay, don't be angry! Can't I just do it?"

Li Jingsheng poked her cheek.

Really, the skin color is like snow and feels like satin.A woman is good when she is young, and her skin and body are in the most beautiful period of her life.

"You are already injured and you are not recovering well. Do you still need this body? The patient's body is important, but your body is not important? I don't care. I only know that you are very important to me. I can't let your body be damaged." Any mistakes."

The tenderness that flashed deep in her eyes could melt a man's heart.

Li Jingsheng listened to her arrangement and took a good rest in the clinic.

I took my mobile phone and repeatedly checked the information of the patient with cough, cyanosis, and edema. At present, I can only confirm that there is a heart problem, and the lung problem is equally serious.

But this person's respiratory failure was most likely caused by an enlarged heart.

When there is a problem with the blood supply to the heart, the lungs are the most susceptible organ to be affected.

Clinical respiratory failure is divided into ventilatory failure and ventilation failure.

There are also patients who fail in both aspects at the same time.No matter what kind of respiratory failure, it is a serious disease.If left unchecked, it can easily endanger lives.

And even if the respiratory failure is not severe, over time, it can cause multi-system diseases.

Li Jingsheng has worked in the Department of Respiratory Medicine for several years and is well aware of the dangers of respiratory failure.

I am also familiar with the various causes of respiratory failure.

For example, airway obstruction, lung disease, heart disease, pulmonary vascular disease, etc. may all cause respiratory failure.

This patient's hemoglobin is much higher than the normal value, indicating that the respiratory failure is no longer a day or two.

Also, lack of oxygen in the body is not necessarily caused by respiratory failure.

Poor blood exchange in the heart, or severe reflux, may cause the efficiency and quality of blood oxygen exchange to deteriorate.

The blood supply of the heart and the blood oxygen exchange of the lungs are actually integrated.

They are related to each other.

Any problem in any aspect will trigger a chain reaction.

Especially if the problem persists for a long time, it is more likely to cause multiple chain diseases.

The pathogenesis of respiratory failure should be the reduction of gas exchange in the lungs and insufficient ventilation, resulting in hypoxia or carbon dioxide retention in the body that cannot be discharged.

Li Jingsheng decided to start with respiratory failure and mitral valve disease.

"Brother Lian Tao, this patient named Mu Youlin, does his mitral valve have insufficiency?"

He sent an inquiry message to Lian Tao.

Did not answer him.

Probably busy.

It is impossible for a doctor to hold a mobile phone all day long.As long as doctors want to make progress, the time they can spend scrolling through their mobile phones is pitiful.

Li Jingsheng is preparing to check the second difficult case.

Lian Tao has already replied to him.

First he sent a thumbs up emoticon.

"After examination, the patient had mitral valve stenosis and insufficiency. He also had total heart failure. His heart function was level 4."

There are two systems for rating cardiac function.

NYHA and Killip cardiac functional classification.

Killip cardiac function classification is mostly used in clinical acute myocardial infarction.

This patient obviously does not have acute myocardial infarction, so the former rating system applies.

Heart function can be divided into levels one to four.

Level one symptoms are mild, and level four is the worst.

In the first-level heart function state, patients can perform daily physical activities, work or exercise normally, and will not experience heart failure symptoms such as dyspnea.

Clinically, cardiac function level one is often considered to be a better performance.

If there are no organic lesions and no major problems, it is often considered to be a normal state.

This patient has reached cardiac function level [-], which is already very serious.

Even in a quiet state, breathing difficulties, wheezing, etc. may occur. In severe cases, as long as you receive a little stimulation or exercise a little vigorously, you may faint from lack of oxygen.

In fact, as long as you have difficulty breathing when brushing your teeth or defecating, you should be alert to whether there is a serious problem with your heart function.

Because at this time, it is already level three in the heart function rating.

Li Jingsheng frowned and thought carefully. The patient's cardiopulmonary function was so poor and he had general edema. He must further investigate bronchitis, respiratory infection, chronic obstructive emphysema and other problems.

Respiratory failure accompanied by COPD will make the patient's symptoms more severe.And it is easy for sudden and serious problems to occur.

Such as respiratory arrest, etc.

“Have respiratory infections and chronic obstructive pulmonary emphysema been ruled out?”

"You can do it, young man. If there is any problem, you can diagnose it without looking at further examination results. It has just been found that the patient has chronic bronchitis and infection. Chronic obstructive pulmonary disease also exists, and emphysema is quite serious. .

Anti-infective, diuretic, cardiotonic and other symptomatic treatments have been given to him. "

Lian Tao admired Li Jingsheng very much.

These causes cannot be inferred by reading a few medical books and studying some case analyses.

You need to have very rich clinical experience and have flexible and clear diagnostic ideas to be able to diagnose these related problems one by one.

"I think diuretic treatment for this patient is a double-edged sword and quite dangerous!"

Li Jingsheng ignored his compliments, and while giving necessary reminders, he also further investigated to find the source of the real cause.

I always feel that it is not as simple as heart failure causing respiratory failure.

After reading the patient's examination information and medical history at first glance, he felt that the patient's disease was a chronic disease.

Otherwise, it would be impossible to have a seven-year medical history.

But what exactly causes mitral regurgitation?

The result of heart and lung harming each other?
He thinks it's open to question.

"How to treat edema and heart failure without diuresis and cardiotonic treatment?"

Lian Tao asked him back.

"Solve the real cause of the disease!"

Li Jingsheng rolled his eyes. The treatment of heart failure and edema is indeed based on these routines, but he can also use conventional routines.Cut off the root cause of the disease directly and solve it in one go.

"To put it lightly, let's perform mitral valve repair surgery on him now?"

Lian Tao was also unconvinced.

"Repairing the mitral valve now won't solve the problem at all. His heart is enlarged and if the enlargement is not resolved, your repair will be ineffective. Brother Lian Tao, do you think the patient's cause is caused by mutual damage between the heart and lungs?"

Li Jingsheng asked. (End of chapter)