Gou is practicing medicine in the clinic

This is a good opportunity, and Director Lin must seize it.

"There is no problem with the consultation, but my level is limited and I may not be able to help a lot. I can only do my best."

Li Jingsheng readily agreed.

After eating, Li Jingsheng looked at Ou Qinglan apologetically.

"Qinglan, I'll go find you after work later! Now I'll go to the vascular surgery department to diagnose the patient with Director Lin."

"Yeah, remember to come to the office to find me in the evening!" Ou Qinglan's eyes were a bit resentful, but in front of Director Lin, she behaved quite appropriately.

After all, she is a daughter of a wealthy family, and she doesn't need any guidance at all when it comes to maintaining her boyfriend's dignity.

She had never caused any embarrassment to Li Jingsheng in front of everyone.

Follow Director Lin to the Vascular Surgery Department.

There is only one doctor under his command, a dark and thin young male doctor.There seems to be only one nurse.

Vascular surgery is really miserable.

There is only one nurse, how to do a shift?
Li Jingsheng heard about the practice of 'parasitism'.The department's revenue generation is poor, and there is only one nurse, so it is impossible to take shifts under normal circumstances.

How to do it?

Spend some money and go to other departments.

Ask someone to help take care of the patient.

That is to say, Director Fu worked hard and had the ambition and long-term vision of a powerful second hospital.That's why "sesame departments" like endocrinology and vascular surgery are allowed to exist.

In an ordinary large hospital, departments would have been directly merged.

"Doctor Li, you are here!"

When the patient saw Li Jingsheng, he was immediately as excited as seeing a relative.

The woman accompanying him at the bedside must be his wife. She wears glasses and looks like an old scalper in the workplace.

This woman should work very hard in the company.

Many working women dress up beautifully, but her hair is slightly messy.

Under the large black-rimmed glasses, his tired eyes and serious dark circles were exposed.

This kind of long-term pigmentation cannot be formed in a day or two.

It's just working overtime for a long time and accumulating that can lead to such serious dark circles.

Seeing the doctor come in, the woman immediately stood up and looked at Li Jingsheng and Director Lin with a flattering smile.

"Is the situation getting better?"

Li Jingsheng asked the patient.

"After the intravenous drip, the pain is less. Do I need an operation? If possible, I would like to avoid the operation and be discharged from the hospital as soon as possible. My wife is already very busy at work, and now she has to take time to take care of her. I."

The patient told Li Jingsheng all his difficulties and thoughts.

Director Lin next to him was quite embarrassed.

He is the attending doctor.

The patient should respond to him if he has any thoughts.

"Don't be anxious about being discharged from the hospital. You must be cured before you leave. Otherwise, if you go home after being discharged from the hospital, something will happen again two days later, and you will have to go back to the hospital. And did you know? There are many things in your veins. Thrombi, they move within the blood vessels, which is very dangerous. Now judging from your test results, fortunately the thrombus did not enter the artery, otherwise it may directly be life-threatening.

The blood vessels of the human body are all connected. If there is a problem with your right hand, it means that the blood clots in the lower limbs have migrated to the hand.

If this reaches the cardiovascular system, it will immediately lead to a myocardial infarction.

Entering the cerebral blood vessels is a cerebral infarction.

Deep vein thrombosis is most likely to enter the pulmonary blood vessels and cause pulmonary artery or pulmonary vein embolism, which can directly threaten your life. "

Li Jingsheng said very seriously.

We understand that patients are worried that hospitalization will cost a lot of money and are eager to be discharged.

But when we get here, we must cure the disease.

The patient does not know the dangers of this disease, so Li Jingsheng has the obligation to educate him about the disease.

"Is it so serious? Husband, listen to the doctor. No matter how much money we spend, we must cure the disease. The worst we can do is transfer our baby to a regular school next year."

When the woman heard that the disease was so serious, she was so frightened that her face changed.

Immediately express her position that she must help her husband treat his illness.

This is actually the correct understanding.

Some parents always put all their hopes on the cultivation of their children, which is very bad.

If you don't succeed yourself, you just want to make your children successful and stand out. The idea is good, but you invest hundreds of thousands a year to eventually train your children to study abroad.

As a result, when the children returned from studying abroad, they found that their monthly salary was not as good as that of ordinary college students.

That kind of psychological gap will be very big.

Moreover, children are under great pressure.

"Whether you need surgery for this disease depends on Director Lin. Director Lin is an expert in vascular surgery and your attending doctor. He knows the disease best."

Li Jingsheng is more understanding of human affairs than his patients.

Naturally, it was impossible to embarrass Director Lin next to him.

He knew who was in charge.

He won't do anything that takes the spotlight away from the guest.

"Okay, we must listen to you and Director Lin. Please save my husband. My children and I need him. We cannot live without him. We must not let anything happen to him."

The woman may still be a little worried that her husband will die of illness, so she begged the two doctors repeatedly.

"Don't worry, as long as we can save him, we will definitely do our best to treat him. Your cooperation is also very important."

Director Lin gave a preliminary commitment.

It's just that doctors, especially those at the chief physician level, speak very tactfully.It's impossible to say something like it can definitely be cured.

The same goes for doctors themselves. Doctors are also human beings and can only do their best.

"Let me help you take a look at the condition of your left leg and right hand!"

Li Jingsheng came here with a mission this time, otherwise who would follow him to the ward to chat with the patients?
No doctor has this spare time.I touched the patient's left leg, especially the calf, and found that the cord-like hard lump had disappeared.It shows that after taking the medicine, it has achieved obvious thrombolytic effect.

It feels like the skin of the patient's right hand vein is still a little hot.

This indicates that there is likely to be local inflammation.

Most likely it's phlebitis.

When Li Jingsheng examined the patient, the patient did not complain of pain this time.Only when a large vein is touched, the patient will still show a painful expression.

And he found that the blood vessels still felt a little different from normal blood vessels.

After the examination, he and Director Lin left the ward.

"Let's talk in the office!"

Director Lin invited Li Jingsheng to his office.

A small office, the interior is very elegantly decorated.

Books and items are neatly arranged and hygienic and clean.

"The office is a bit small, not as big as the office of your director of orthopedic surgery. Please take a seat."

Director Lin made tea for him.

The cup is a disposable paper cup.

This is the cup that everyone uses to entertain guests.

Clinicians rarely make tea and serve guests cup after cup in small cups.

Basically brew one cup at a time.

Serve guests in deep paper cups.

"You have just seen the situation of this patient, and the situation is still not optimistic. Venous thrombosis has been clearly diagnosed, and it is basically clear that the patient's veins have an inflammatory reaction. He just suffered an ordinary fall and bruise, and such a large area of ​​venous thrombosis was formed , I think it is unreasonable in itself. There may be other unknown causes."

Although Director Lin has been a bit miserable, his level is not bad.

There are in-depth insights when analyzing the cause of the disease.

"You mean to start the discussion from phlebitis?"

Li Jingsheng asked.

"can."

Director Lin nodded.

Thrombophlebitis is not complicated and can be divided into two types clinically.

One is benign thrombophlebitis.

This is the most common.

It often appears as an inflammatory lesion in a single vein.

This type of phlebitis is mostly caused by trauma to the limbs or varicose veins.

The patient did not have varicose veins, but had limb trauma as a trigger.

In addition, there are many reasons that can cause phlebitis, such as local purulent infection, intravenous injection of hypertonic glucose solution, or other irritating drugs, etc.

The patient had no other problems except limb trauma.

The second type is migrating thrombophlebitis.

This is relatively rare clinically.

However, this patient first injured his left lower limb in a fall, and then more than a month later, he developed pain in his left lower limb and then in his right hand.

It indicates that the patient is likely to have migrating thrombus.

Therefore, the patient meets both conditions.

This requires further diagnosis and syndrome differentiation by Li Jingsheng.

Migrating thrombosis is common in middle-aged men. The most obvious symptom is a red and hot inflammatory reaction on the skin in the superficial veins of the limbs, and scattered flexible nodules are prone to appear.

A blood routine test revealed a significant increase in white blood cells.

At the same time, the patient will also develop fever.

Generally it will not be high fever, but low or medium heat.

Li Jingsheng carefully analyzed the patient's condition and found many things that were consistent with the patient's condition.

"Can I see the patient's blood test results?"

"No problem, all the inspection information is here, you can check it directly."

Director Lin stepped aside and asked Li Jingsheng to sit on the computer and check it.

He has logged into his personal doctor account.

The director's authority is quite high.

Especially patients in the undergraduate department can easily see all the patient's medical records.

After Li Jingsheng carefully checked the patient's blood routine, he found at a glance that the white blood cells were significantly elevated.

This further supports the possibility of migrating thrombophlebitis.

There are many causes of migrating thrombophlebitis.

Those that have been clinically verified include gastric cancer, pancreatic cancer, lung cancer, etc.

The examination of this patient was clearly inadequate.

At present, I have only done some basic examinations and color ultrasound examinations.

"Director Lin, I think this patient is very likely to have migrating thrombophlebitis. There are many similarities. It's just that there are many causes of this disease, and the most common one is tumors. Considering the patient's busy work and life The patient is under great pressure, and he smokes and drinks a lot. Should we further conduct an abdominal CT to check the condition?"

Li Jingsheng put forward his own diagnosis.

Diagnosing such difficult cases is really not an easy task.

Some relevant in-depth inspections must be done.

The diagnostic clues currently available are extremely limited.

Who would have thought that a venous thrombosis caused by a fall might lead to malignant tumors? (End of chapter)