"The new patient in bed 1, one month after colon cancer surgery, has a left colostomy. This time, he requested hospitalization mainly because of general discomfort."
The doctor who reported the case looked at the description of the patient's physical signs on the iron medical record folder and couldn't help but be amazed.
Good guy, he got such a difficult patient right at the beginning of the rounds,
And he also felt uncomfortable all over?
What disease is this?
"Okay, I know."
Xiao Chenguang waved his hand to stop the doctor who was flipping through the medical records and wanted to continue reporting.
Uh?
Why can't he say it?
The doctors, nurses, patients and their families who followed Xiao Chenguang in the rounds were all stunned for a moment.
According to the previous rounds mode, isn't it that the subordinates will report, the director will ask about the patient's relevant indicators, and then ask questions and leave in style?
Why is this round a little different today?
Just when everyone was puzzled, Xiao Chenguang came directly to the patient's bedside.
"Uncle, did you eat this morning?"
Faced with the question, the uncle sitting on the bed was confused.
Because he was often hospitalized, he was very familiar with the process of doctor's rounds.
But most of the time, they just stood at the door, looked into the room, said a few simple words, and left.
Few people would ask him about the specific situation, and no one would ask him about eating, drinking, defecating and urinating during the rounds.
"Ah... I ate... But I have no appetite recently, and I always feel uncomfortable all over, so I want to come to the hospital for a check-up." The patient answered truthfully.
"Well, it's right that I have no appetite." Xiao Chenguang nodded, with a thoughtful look in his eyes.
Patient: "???"
Xiao Chenguang continued: "You should have more than just gastrointestinal discomfort, don't you also feel weak all over, belching constantly, and the amount of intestinal fistula is more than usual."
"How do you know?!"
The patient was shocked.
He had just been admitted to the hospital today, and had not had time to tell the attending doctor many things. Most of the information in the admission medical record was about his colon surgery history. Only he knew about personal signs that were not very important.
"Of course I saw it."
Xiao Chenguang pointed to the patient's swollen eyelids and said, "You are weak all over and have gastrointestinal discomfort. It was originally caused by increased fluid loss and water and sodium retention at the colostomy."
"But you saw that you were swollen and thought it was caused by too much daily intake. Since the past half month, you have been limiting water and food privately. As a result, you found that the symptoms were getting worse and worse, so you came to the hospital."
Patient: "!!!"
He really didn't expect that the doctor in front of him could tell him clearly about the changes in his disease course in the past half month.
Could this person have opened his eyes and could know the past and the future?
Otherwise, how could he know his condition clearly? You know, this is the first time they met.
However, what Xiao Chenguang said next was a bombshell, which almost exploded in the patient's heart.
"Uncle, you are now suffering from prerenal AKI caused by decreased GFR, which is what we often call acute kidney injury caused by decreased glomerular filtration rate."
When these words came out, not only the patient was stunned, but also the medical staff who were making rounds were all stunned.
What?
The patient was feeling unwell all over, was it because of kidney problems?
This is not right.
The patient was admitted to the hospital after colon cancer surgery. If there were any complications, it would be gastrointestinal problems at most.
How come the kidneys are gone now?
"Doctor, are you telling the truth? My kidneys have always been very good and I can bend and stretch them normally. How could there be any problem?"
The patient looked incredulous.
No wonder, even the medical staff on the scene looked unconvinced when they heard Xiao Chenguang's diagnosis.
"Believe it or not, look at your feet."
After that, Xiao Chenguang pointed to the end of the patient's bed. Seeing this, the family members beside him quickly lifted the quilt.
Suddenly, there was a sound of cold air being sucked in.
"My feet...what's wrong?!"
The patient looked down and was immediately shocked.
His feet were obviously swollen, especially from the instep to the ankle joint. The skin had become crystal clear due to edema, and even a slight touch might break water.
The patient's calves also began to swell. Xiao Chenguang just pressed it with his fingers, and a dent immediately appeared, which could not recover for a long time.
"When I was admitted to the hospital today, I didn't notice the swelling. How come it has become like this in such a short time?"
The patient was obviously scared. No matter who it happened to, they would be at a loss.
"Bed 1's kidney is really in trouble."
"My goodness, why is this foot swollen like a fermented steamed bun? At first, I was a little skeptical of Dr. Xiao's diagnosis, but I didn't expect him to see the problem at a glance."
"But how did Dr. Xiao see it?"At this time, the medical staff were all confused.
The patient might not understand, but the medical staff present were all professionally trained. Seeing the patient's symptoms at this time, they completely agreed with Xiao Chenguang's diagnosis.
I didn't expect that Xiao Chenguang could make a diagnosis based on the most basic visual, audio-visual and percussion. Such diagnostic ability made everyone envious.
No wonder Director Wang directly appointed Xiao Chenguang as the chief resident of the department at the morning meeting. He must have seen Xiao Chenguang's ability to treat patients.
At this moment, the door of the ward was pushed open.
The nurse who received the critical value report from the laboratory took a test sheet and immediately reported the condition of the patient in bed 1 to everyone present.
[Renal function: creatinine 666umol/L, urea nitrogen 10.2mmol/L, glomerular filtration rate 10ml/min]
Basically, every value is seriously exceeded, which reflects that the patient's renal function is in the acute failure stage.
The bright data further confirmed Xiao Chenguang's diagnosis.
After hearing this, the patient was almost shocked.
He didn't expect that his discomfort was so serious.
He looked terrified, grabbed a corner of Xiao Chenguang's white coat, and asked hurriedly: "Doctor, since you can see my illness at a glance, there must be treatment measures."
The patient had just experienced a serious illness, and now he suffered this disaster. He didn't want to die, so he regarded Xiao Chenguang as his last straw.
"If blood filtration can be done, it is estimated that the patient will be able to recover in three to five days."
But Xiao Chenguang knew that in 1999, it was not like the later generations, where even township health centers had blood filtration machines.
In this era, everything was just starting, and hospitals that could develop blood filtration technology probably had to go to the provincial capital.
But he was at least four or five hours away from the provincial capital by car. Even if the patient could finally endure the bumpy road, there might not be a blood filtration machine available in the provincial capital hospital.
After all, there are many patients with more serious conditions than him, with renal necrosis, uremia, and everyone is waiting for the machine. Whoever gets the first chance to survive, how could he easily give it to others?
Seeing Xiao Chenguang fall into deep thought, the patient felt dizzy, his eyes went black, and he almost fainted.
Just when the patient thought he was going to die, Xiao Chenguang's voice sounded again in the ward.
"Don't worry, your disease can be cured."
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