Gou is practicing medicine in the clinic
Chapter 425: There is no doubt about venous thrombosis, Director Lin wants to turn over
There are many diseases that can cause muscle pain, such as myolysis, cramps, myositis, dermatomyositis, polymyalgia rheumatica, fibromyalgia syndrome, etc.
Even leptospirosis can cause similar severe muscle pain.
Clinically, pain in muscular dystrophy is also common.
This patient's body temperature is normal and he has no other symptoms. The cause of the disease started from a fall, so the possibility of leptospirosis is very small.
Nutritionally, the patient did not have muscular dystrophy.
The patient also had no symptoms such as rash, oral ulcers, and joint pain.
Li Jingsheng decided to start with this red vein.
Recalling that when I examined the calf of the patient's right hand and left lower limb just now, hard cord-like lumps were found.But it is obviously different from the 'stone' feeling during muscle spasm.
After much thought, the most likely possibility was that a blood clot had formed in the vein.
Especially the lower limbs are prone to deep vein thrombosis.
When I examined the patient just now, no varicose veins were found, indicating that the patient's vascular health is not bad.At least no obvious lesions were found.
If the patient does have venous thrombosis, it is most likely caused by a fall.
Under normal circumstances, hematoma is most likely to occur after a fall, and venous thrombosis generally does not occur.
We can only wait for the patient to complete the color ultrasound before making further diagnosis.
Less than an hour later, the patient came back with the color ultrasound results.
Thrombus formation occurred in the left superficial femoral vein, bilateral popliteal veins, upper posterior tibial vein, and tibiofibular trunk.
Superficial vein thrombosis on the left medial calf.
There was nothing abnormal about the arteries of the lower extremities.
No wonder the lump that looked like a cord to the touch turned out to have formed so many venous thrombosis.
Simply terrifying.
Then it goes without saying that venous thrombosis must have formed in the right hand.
The thrombus in the right upper limb should have been transferred from the left lower limb.
Judging from the patient's current symptoms and condition, he should be able to try low-molecular-weight heparin injection.If symptoms are significantly relieved, drug treatment can be continued.
This kind of vascular disease cannot be treated by orthopedic surgery.
After all, this is not what we do. We admit and treat patients indiscriminately, and it's okay if they are cured. But if something goes wrong, the department leaders will have to be criticized.
Now the cause of the patient's pain has been discovered.
But why thrombosis occurs remains to be further investigated.
For ordinary people, bumps and falls are inevitable.
If you injure your lower limbs in daily life, venous thrombosis will form, which would be too scary.
Li Jingsheng's outpatient clinic is too busy. The cause of this patient's illness has been determined, and further investigation is left to other doctors.
Although the second hospital is small, it has all the internal organs.
It actually has a dedicated vascular surgery department, but because of poor business, this department is worse than the endocrinology department.
We can't admit two patients at the end of the day.
"In this case, I will write you a note. You go to the fourth floor of Building [-] to find Director Lin of the Vascular Surgery Department."
Li Jingsheng said to the patient.
This is because Li Jingsheng is kind-hearted and helped write this note considering that the patient's family has a heavy financial burden.
Otherwise, the normal procedure is for the patient to call a vascular surgery department and find a doctor by himself.
To register as a director, the minimum fee is 32 yuan.
There is no such privilege of not queuing.
Originally, venous thrombosis in the lower limbs and upper limbs like this could be treated by vascular surgery.You can also go to a general surgery department.
General surgery is the originator of the surgical department. It is like the Taoist saying that Tao gives birth to one, one gives birth to two, two gives birth to three, and three gives birth to all things.
All surgeries are actually born and developed from general surgery.
There are still many large hospitals that have all-inclusive general surgery departments and can perform most surgeries.
Li Jingsheng introduced the patient to the vascular surgery department not only to support the vascular surgery department, but also to allow the patient to choose a more appropriate department.
The general surgery department of the Second Hospital is developing very well.
It doesn’t matter if there is one more patient or one less patient.For vascular surgery, if you admit a patient, you may not need to eat duck eggs for that day's business.
……
Li Jingsheng was busy until about 20:[-] noon, and then hurried to the canteen to eat.
A total of 41 patients were treated in the morning, which is a pretty good record.
It was also because of the rapid growth of Ye Hui, Yang Luqing and others that they were able to help, so Li Jingsheng was able to handle so many patients in one morning.
Simple joint dislocations and displacements can basically be left to students to handle.
All five students can get some exercise opportunities.
Yang Luqing sat on the bench for a while, and later approached Li Jingsheng many times to express his goodwill, but he never apologized or admitted his mistake.Li Jingsheng also beat this kid in this way.
It's not really because Yang Luqing didn't save him at the critical moment that he was thrown into the cold palace.
He was even kicked out of the manual reduction clinic.
Although Yang Luqing behaved timidly when facing gangsters, he had a good talent for learning bone-setting techniques and was very responsible in treating patients.Also, his character is not bad.
After proper beating, Li Jingsheng still taught him the bone-setting and repositioning techniques, and also gave him the opportunity to practice.
But if he wants to obtain the core bone-setting medical skills, he may have to wait until he unties the knot with Li Jingsheng.
Or there is something that can impress Li Jingsheng.
So far, only Ye Hui has been taught the art of bone touching.I have to say that after learning the bone palpation technique, it will be of great help to manual bone setting.
Ye Hui has not been learning the bone-touching technique for too long, only more than a month, but her bone-setting ability has far surpassed that of several others.
Currently, Li Jingsheng is secretly investigating Liu Xian.
As long as there are no major problems, the second person to be taught the bone-touching technique should be Liu Xian.
As for Jin Yanyu, he still needs more polishing.
This guy still has a bit of a young master's temper and acts in a high-profile manner.
If placed in a TV series or novel, Jin Yanyu should belong to the second generation of rich people and officials who have fallen into decline. They first experienced a period of miserable life, and then became practical and stable.
The fate of the protagonist who finally begins his counterattack.
Under normal circumstances, a passionate and narrow-minded person like him can't be any worse.
Dr. Chen, the elder brother of the manual reduction clinic, is now down to earth and practices a basic manual bone reduction technique every day.If you can persevere, there is still hope to make up for your shortcomings through diligence.
Li Jingsheng had just entered the dining hall when he saw Ou Qinglan waving to him.
She is always a beautiful sight in the crowd, whether sitting or standing.
"Qinglan, have you been waiting for a long time?"
Li Jingsheng looked at her pretty face affectionately, his eyes full of doting and love from the bottom of his heart.
As for gratitude, no need.
She will become Li Jingsheng's wife in the near future.
Then we will be a family.
There is no need for politeness and gratitude between relatives.Because all contributions are selfless and love.
"It's okay! I'm actually quite happy waiting for you. Eat quickly!"
Her casual words touched the softest heartstring deep in Li Jingsheng's heart.
The most important thing between people is two hearts.
"How about it? You didn't receive any difficult patients today, did you?"
Li Jingsheng asked her about work.
"It would be weird if I didn't. Professor Wu has always taken good care of me, and it's not like you don't know it. I have already admitted two patients who are difficult to diagnose and treat this morning, and they are waiting for you, the hero, to help me deal with them."
When she encounters difficult cases, she has never been afraid or worried.
Because she has a great boyfriend behind her.
"No problem. After dinner, I will go to the inpatient department with you."
Li Jingsheng readily agreed.
He has the ability to dote on his girlfriend.
While we were eating here, a 45-year-old male doctor came over.
"Can I sit here?"
The male doctor asked Li Jingsheng with a smile.
"Yes, please sit down!"
Li Jingsheng moved the rice bowl this way and took the initiative to express his kindness.
"Nice to meet Dr. Li. I am Lin Zhengwei from the Department of Vascular Surgery."
After the man sat down, he smiled and extended his right hand to Li Jingsheng.
"Ah...you, you are Director Lin! Disrespectful!"
Li Jingsheng quickly put down the spoon and grasped the opponent's right hand with both hands.It's a gesture.As a junior medical student with a lower professional title than others, he should be more humble.
After the two shook hands, Director Lin looked at Ou Qinglan, "Doctor Ou, please forgive me for borrowing your boyfriend for a few minutes."
"It doesn't matter to me. If you have anything to do, feel free to chat."
Ou Qinglan seemed a little flattered.She was just a young resident doctor, but she was able to have a chief physician treat him so politely. This sense of status was very useful to her.
Of course, she knew that Director Lin was so polite to her because of Li Jingsheng's face.
"Dr. Li, thank you for taking care of our vascular surgery department and introducing an inpatient to me. It's just that the cause of this patient's disease is very obscure, and I'm a little worried that I can't figure it out!"
Director Lin is also 45 years old and has become the director of a department.
The career is quite good.
Although the performance of this department is very poor and he is basically equivalent to a polished commander, this does not affect his rank.
“Is the cause of thrombosis difficult to diagnose?”
Li Jingsheng asked straight to the point.
"Yes! The cause of this patient's disease is not as simple as it seems. Although it has been found that there is venous thrombosis in the right upper limb and left lower limb. After taking the current medication, the symptoms have also improved significantly, but the cause is quite complicated. I know that Dr. Li is here He is very good at diagnosing and treating difficult cases. Can you please take some time out of your busy schedule to help me consult with Dr. Li?"
Director Lin's mood was very complicated.
I want to take this business, but my skills are limited, and I am worried that something will happen.
Then I thought about asking Li Jingsheng for help.
Being able to connect with Li Jingsheng was something he had wanted to do for a long time.
The gastroenterology and endocrinology departments have seen significant improvement in their business after cooperating with Li Jingsheng.Orthopedic surgery began to take off immediately because of Li Jingsheng.It has moved from a second-rate department to a first-rate department.
If nothing unexpected happens, within a year or two at most, the performance of orthopedic surgery is likely to surpass that of cardiothoracic surgery and neurosurgery, directly becoming a first-class department second only to general surgery.
Director Lin also wants to make progress, even in his dreams.
He just asked him to fawn over Li Jingsheng for no reason, and he couldn't break the reputation. (End of chapter)
Even leptospirosis can cause similar severe muscle pain.
Clinically, pain in muscular dystrophy is also common.
This patient's body temperature is normal and he has no other symptoms. The cause of the disease started from a fall, so the possibility of leptospirosis is very small.
Nutritionally, the patient did not have muscular dystrophy.
The patient also had no symptoms such as rash, oral ulcers, and joint pain.
Li Jingsheng decided to start with this red vein.
Recalling that when I examined the calf of the patient's right hand and left lower limb just now, hard cord-like lumps were found.But it is obviously different from the 'stone' feeling during muscle spasm.
After much thought, the most likely possibility was that a blood clot had formed in the vein.
Especially the lower limbs are prone to deep vein thrombosis.
When I examined the patient just now, no varicose veins were found, indicating that the patient's vascular health is not bad.At least no obvious lesions were found.
If the patient does have venous thrombosis, it is most likely caused by a fall.
Under normal circumstances, hematoma is most likely to occur after a fall, and venous thrombosis generally does not occur.
We can only wait for the patient to complete the color ultrasound before making further diagnosis.
Less than an hour later, the patient came back with the color ultrasound results.
Thrombus formation occurred in the left superficial femoral vein, bilateral popliteal veins, upper posterior tibial vein, and tibiofibular trunk.
Superficial vein thrombosis on the left medial calf.
There was nothing abnormal about the arteries of the lower extremities.
No wonder the lump that looked like a cord to the touch turned out to have formed so many venous thrombosis.
Simply terrifying.
Then it goes without saying that venous thrombosis must have formed in the right hand.
The thrombus in the right upper limb should have been transferred from the left lower limb.
Judging from the patient's current symptoms and condition, he should be able to try low-molecular-weight heparin injection.If symptoms are significantly relieved, drug treatment can be continued.
This kind of vascular disease cannot be treated by orthopedic surgery.
After all, this is not what we do. We admit and treat patients indiscriminately, and it's okay if they are cured. But if something goes wrong, the department leaders will have to be criticized.
Now the cause of the patient's pain has been discovered.
But why thrombosis occurs remains to be further investigated.
For ordinary people, bumps and falls are inevitable.
If you injure your lower limbs in daily life, venous thrombosis will form, which would be too scary.
Li Jingsheng's outpatient clinic is too busy. The cause of this patient's illness has been determined, and further investigation is left to other doctors.
Although the second hospital is small, it has all the internal organs.
It actually has a dedicated vascular surgery department, but because of poor business, this department is worse than the endocrinology department.
We can't admit two patients at the end of the day.
"In this case, I will write you a note. You go to the fourth floor of Building [-] to find Director Lin of the Vascular Surgery Department."
Li Jingsheng said to the patient.
This is because Li Jingsheng is kind-hearted and helped write this note considering that the patient's family has a heavy financial burden.
Otherwise, the normal procedure is for the patient to call a vascular surgery department and find a doctor by himself.
To register as a director, the minimum fee is 32 yuan.
There is no such privilege of not queuing.
Originally, venous thrombosis in the lower limbs and upper limbs like this could be treated by vascular surgery.You can also go to a general surgery department.
General surgery is the originator of the surgical department. It is like the Taoist saying that Tao gives birth to one, one gives birth to two, two gives birth to three, and three gives birth to all things.
All surgeries are actually born and developed from general surgery.
There are still many large hospitals that have all-inclusive general surgery departments and can perform most surgeries.
Li Jingsheng introduced the patient to the vascular surgery department not only to support the vascular surgery department, but also to allow the patient to choose a more appropriate department.
The general surgery department of the Second Hospital is developing very well.
It doesn’t matter if there is one more patient or one less patient.For vascular surgery, if you admit a patient, you may not need to eat duck eggs for that day's business.
……
Li Jingsheng was busy until about 20:[-] noon, and then hurried to the canteen to eat.
A total of 41 patients were treated in the morning, which is a pretty good record.
It was also because of the rapid growth of Ye Hui, Yang Luqing and others that they were able to help, so Li Jingsheng was able to handle so many patients in one morning.
Simple joint dislocations and displacements can basically be left to students to handle.
All five students can get some exercise opportunities.
Yang Luqing sat on the bench for a while, and later approached Li Jingsheng many times to express his goodwill, but he never apologized or admitted his mistake.Li Jingsheng also beat this kid in this way.
It's not really because Yang Luqing didn't save him at the critical moment that he was thrown into the cold palace.
He was even kicked out of the manual reduction clinic.
Although Yang Luqing behaved timidly when facing gangsters, he had a good talent for learning bone-setting techniques and was very responsible in treating patients.Also, his character is not bad.
After proper beating, Li Jingsheng still taught him the bone-setting and repositioning techniques, and also gave him the opportunity to practice.
But if he wants to obtain the core bone-setting medical skills, he may have to wait until he unties the knot with Li Jingsheng.
Or there is something that can impress Li Jingsheng.
So far, only Ye Hui has been taught the art of bone touching.I have to say that after learning the bone palpation technique, it will be of great help to manual bone setting.
Ye Hui has not been learning the bone-touching technique for too long, only more than a month, but her bone-setting ability has far surpassed that of several others.
Currently, Li Jingsheng is secretly investigating Liu Xian.
As long as there are no major problems, the second person to be taught the bone-touching technique should be Liu Xian.
As for Jin Yanyu, he still needs more polishing.
This guy still has a bit of a young master's temper and acts in a high-profile manner.
If placed in a TV series or novel, Jin Yanyu should belong to the second generation of rich people and officials who have fallen into decline. They first experienced a period of miserable life, and then became practical and stable.
The fate of the protagonist who finally begins his counterattack.
Under normal circumstances, a passionate and narrow-minded person like him can't be any worse.
Dr. Chen, the elder brother of the manual reduction clinic, is now down to earth and practices a basic manual bone reduction technique every day.If you can persevere, there is still hope to make up for your shortcomings through diligence.
Li Jingsheng had just entered the dining hall when he saw Ou Qinglan waving to him.
She is always a beautiful sight in the crowd, whether sitting or standing.
"Qinglan, have you been waiting for a long time?"
Li Jingsheng looked at her pretty face affectionately, his eyes full of doting and love from the bottom of his heart.
As for gratitude, no need.
She will become Li Jingsheng's wife in the near future.
Then we will be a family.
There is no need for politeness and gratitude between relatives.Because all contributions are selfless and love.
"It's okay! I'm actually quite happy waiting for you. Eat quickly!"
Her casual words touched the softest heartstring deep in Li Jingsheng's heart.
The most important thing between people is two hearts.
"How about it? You didn't receive any difficult patients today, did you?"
Li Jingsheng asked her about work.
"It would be weird if I didn't. Professor Wu has always taken good care of me, and it's not like you don't know it. I have already admitted two patients who are difficult to diagnose and treat this morning, and they are waiting for you, the hero, to help me deal with them."
When she encounters difficult cases, she has never been afraid or worried.
Because she has a great boyfriend behind her.
"No problem. After dinner, I will go to the inpatient department with you."
Li Jingsheng readily agreed.
He has the ability to dote on his girlfriend.
While we were eating here, a 45-year-old male doctor came over.
"Can I sit here?"
The male doctor asked Li Jingsheng with a smile.
"Yes, please sit down!"
Li Jingsheng moved the rice bowl this way and took the initiative to express his kindness.
"Nice to meet Dr. Li. I am Lin Zhengwei from the Department of Vascular Surgery."
After the man sat down, he smiled and extended his right hand to Li Jingsheng.
"Ah...you, you are Director Lin! Disrespectful!"
Li Jingsheng quickly put down the spoon and grasped the opponent's right hand with both hands.It's a gesture.As a junior medical student with a lower professional title than others, he should be more humble.
After the two shook hands, Director Lin looked at Ou Qinglan, "Doctor Ou, please forgive me for borrowing your boyfriend for a few minutes."
"It doesn't matter to me. If you have anything to do, feel free to chat."
Ou Qinglan seemed a little flattered.She was just a young resident doctor, but she was able to have a chief physician treat him so politely. This sense of status was very useful to her.
Of course, she knew that Director Lin was so polite to her because of Li Jingsheng's face.
"Dr. Li, thank you for taking care of our vascular surgery department and introducing an inpatient to me. It's just that the cause of this patient's disease is very obscure, and I'm a little worried that I can't figure it out!"
Director Lin is also 45 years old and has become the director of a department.
The career is quite good.
Although the performance of this department is very poor and he is basically equivalent to a polished commander, this does not affect his rank.
“Is the cause of thrombosis difficult to diagnose?”
Li Jingsheng asked straight to the point.
"Yes! The cause of this patient's disease is not as simple as it seems. Although it has been found that there is venous thrombosis in the right upper limb and left lower limb. After taking the current medication, the symptoms have also improved significantly, but the cause is quite complicated. I know that Dr. Li is here He is very good at diagnosing and treating difficult cases. Can you please take some time out of your busy schedule to help me consult with Dr. Li?"
Director Lin's mood was very complicated.
I want to take this business, but my skills are limited, and I am worried that something will happen.
Then I thought about asking Li Jingsheng for help.
Being able to connect with Li Jingsheng was something he had wanted to do for a long time.
The gastroenterology and endocrinology departments have seen significant improvement in their business after cooperating with Li Jingsheng.Orthopedic surgery began to take off immediately because of Li Jingsheng.It has moved from a second-rate department to a first-rate department.
If nothing unexpected happens, within a year or two at most, the performance of orthopedic surgery is likely to surpass that of cardiothoracic surgery and neurosurgery, directly becoming a first-class department second only to general surgery.
Director Lin also wants to make progress, even in his dreams.
He just asked him to fawn over Li Jingsheng for no reason, and he couldn't break the reputation. (End of chapter)
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