When doctors have a simulated operating room

Chapter 691

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"Check?" The female patient stared at Zhang Yi, shaking her head without moving her face or eyes: "No, no, I don't have any other symptoms, just simple gum bleeding. I originally wanted to check I wonder if I have leukemia, but my friend said that my bleeding might be caused by gum atrophy, so I came to see the dentist. "

"You have been bleeding repeatedly for two years. Is this your first time to see a doctor?"

"Yes I originally wanted to go to the emergency department to see you, but they said that I didn’t have a serious illness and couldn’t go to the emergency department. Haha, I didn’t expect that I could see you even if I went to the stomatology department. Dr. Zhang, please help me. My friend said that my gums are shrinking. Do you think my gums are shrinking? "

Then the female patient immediately raised her head and bared her teeth at Zhang Yi.

The female patient was a bit fat. She was 160cm tall and weighed 150kg. About the weight of the 1.5-meter-high lipstick.

As soon as the bloody mouth opened, Zhang Yi quickly closed his eyes.

After taking a deep breath, I put on gloves and cotton swabs to do a simple oral examination.

The gums are indeed atrophied, at the upper right 8 and upper left 8, which are the positions of the back molars, which should be caused by dental calculus, but The atrophy is not serious.

It is not easy to brush the back molars, so it is easy for tartar to accumulate over the years.

After the tartar is washed away by teeth cleaning, the atrophied gums will be exposed and will naturally bleed.

Could it be true? Simple gum recession?

Just then, the results of blood and coagulation tests came out.

Prothrombin time: 16.10 seconds (10-14)

Prothrombin time activity: 61% (70-130)

The most important factor in coagulation The two indicators showed that this person really had a problem with blood coagulation.

Zhang Yi quickly turned his attention to another blood routine examination form.

This sight immediately made several doctors around him alarmed.

Wow! The indicators of white blood cells and platelets have all decreased!

There are several downward arrows on it, which makes it hard to ignore.

Several people understood and thought that this really cannot rule out leukemia.

However, they did not show it in front of the patient. What's wrong?

Sometimes when a doctor considers that it may be a serious disease, he must be more calm.

Zhang Yi silently closed the examination form and turned to ask the stomatologist to notify the hematologist to come for a consultation.

"What's wrong, doctor? ? Is my test result bad? "

The female patient was not stupid, although her eyes were almost squeezed into a slit by facial fat.

But bursts of light still burst out from the slit~

It was still clear that the doctors The difference between them~!

Zhang Yi didn't say it clearly, but explained: "At present, your blood coagulation function is not very good, and your white blood cells and platelets have also decreased, but you should not..."

"What??! Then do I have leukemia? Before I came I checked it out! They said that frequent bleeding that can't be stopped is leukemia, and leukemia means thrombocytopenia. I can't... can't it really be leukemia? ! ? "

The female patient was anxious and grabbed Zhang Yi's wrist They are all exerting force unconsciously.

"Don't worry, I haven't finished talking yet. The decrease of white blood cells and platelets does not necessarily mean leukemia. Some drugs can also cause the decrease of white blood cells and platelets, such as the That rat poison."

"Woo woo...but I was cured of that disease a long time ago, that was four years ago, don't lie to me... woo woo...I have leukemia! Oh my God, I have leukemia! I'm going to die..."

Good boy, Zhang Yi hasn't even started to make a diagnosis yet.

The patient had already started to cry for herself.

Zhang Yi pulled his hand away and did not rush to comfort her, letting her cry for a while and wait until she calmed down before talking to her.

"Who is her doctor?"

"Me."

" Let's do a drug concentration test later to see if there is any bromadiolone residue. "

The doctor nodded and agreed.

Sure enough, as soon as Zhang Yi finished speaking, the female patient really stopped crying. .

She looked at the doctors and asked with some concern:

"Doctor Zhang... am I suffering from leukemia? Don't scare me. I still have parents at home. They can't afford to send someone off. Ah..."

Zhang Yi raised a professional fake smile: "Haha, I haven't said a word that you have been diagnosed with leukemia from just now to now. You are scaring yourself. But you still have several tests to be completed. Do, between white

The cells and platelets have indeed decreased, so leukemia cannot be ruled out.

But don't worry too much, even if it is leukemia, there are treatments. Existing medical technology has several ways to treat leukemia, such as radiotherapy, chemotherapy, targeted drugs, and some patients can be cured by chemotherapy and radiotherapy without bone marrow transplantation. "

Zhang Yi's words hit her but also gave her hope.

"Really? Can it be cured without a transplant? ! ? "

"Well, the medical level is constantly improving, and there are indeed cases that have been successfully cured without bone marrow transplantation. ”

After Zhang Yi’s affirmative answer, the patient smiled again.

Although the smile was not deep, it was much better than the ghostly howling just now.

Just at this time, the doctor from the hematology department rushed over.

Just now, when the hematology department heard that it was Zhang Yi who called for a consultation, they immediately rushed over without stopping.

The doctor who came was the assistant director of their department.

Yao Guang, 38 years old, is preparing to take the deputy director exam next year.

He is also a very talented doctor, but the reason why he is so attentive is entirely because he wants to show off in front of Zhang Yi. Maybe he is willing to accept him as an apprentice?

"Zhang Yi, you called for a consultation?"

"Well, take a look at these examinations. The gums have been bleeding repeatedly for more than two years. This is blood coagulation. "

As he spoke, Zhang Yi handed him the list.

A few minutes later, Yao Guang raised his head with a serious expression: "This index is very similar to those of leukemia patients in our department. Leukemia cannot be ruled out. My suggestion is to do a bone marrow puncture and a drug test to see if there are any drug factors affecting it. Because white blood cells and thrombocytopenia are not only caused by leukemia, many drugs can also affect the values. "

"Well, that's what I meant. "Zhang Yi nodded.

After a while, the girl went to the examination with a dying look.

First, she did a drug test, and then went to the operating room for a puncture.

It happened that when the puncture was done, the results of the drug test came out.

Because she had a history of rat poison poisoning four years ago, this drug test mainly checked the blood concentration of rat poison.

Unexpectedly...

It was actually found!

Dalon: Not detected

Coumatetrade: Not detected

Difacoum: Not detected

Ratdeco: Not detected

Isofamoxan: Not detected