The current X-ray of the patient shows that the condition of the lungs is generally normal, but there is some pulmonary fibrosis. The county hospital has some basis for suspecting that the pneumonia has not healed, but it needs to be carefully distinguished. Without a CT machine, the diagnosis can only go so far.
Now, if conditions permit, clinicians can make further judgments based on CT scans. The lung tissue texture is thickened and blurred, the bronchial wall is thickened, and fibrosis is evident in some parts. Bronchial inflammation is present, which is consistent with Chang Jiawei's previous judgment.
Consistent.
Seeing this, Xie Wanying had to admire that Teacher Chang could see very accurately even though she was not a cardiopulmonary doctor.
Beside her, classmate Geng was heard asking the monitor why some people suspected that his brother had tuberculosis.
The features of tuberculosis on the lung films are temporarily absent.
Before Fu Xinheng and Chang Jiawei arrived, the only one who suspected that the patient had tuberculosis was Teacher Ren or Dr. Guo. If specified, Teacher Ren was not a clinician who would not express his opinion but came to understand the situation. It could only be that
Dr. Guo is suspicious.
After hearing what the students were talking about behind him, Fu Xinheng, who had just arrived in the future and had time to get a full picture of the patient's condition, asked Dr. Guo: "Why do you suspect he has tuberculosis?"
Anyway, as a cardiothoracic surgeon, he can guarantee that these films cannot confirm that the patient has tuberculosis.
Dr. Guo wiped his palms carefully in the face of the superior teacher's doubts and answered his medical reasoning path: "It's not clear from the film for now. But I have learned about the patient's medical history before. It is said that the patient's family has a grandfather who smokes all year round and often coughs.
, we cannot rule out that this old man has a history of tuberculosis. Tuberculosis is just a type of tuberculosis, Mr. Fu."
Gu YanMost tuberculosis bacteria invade the lungs, so it is commonly known as pulmonary tuberculosis. When most people talk about tuberculosis, they habitually equate it with pulmonary tuberculosis, which is wrong. Tuberculosis refers to the infection of the human body by Mycobacterium tuberculosis. According to the site where the bacteria invade
It can be divided into different types: pulmonary tuberculosis, digestive tract tuberculosis, lymph node tuberculosis, etc., but the latter are clinically uncommon and are rare cases, the same as spinal tuberculosis.
One thing that is different about spinal tuberculosis is that most spinal tuberculosis seems to be secondary tuberculosis rather than primary disease. The so-called secondary means that, like tumor metastasis, the Mycobacterium tuberculosis does not directly invade the spine but spreads from pulmonary tuberculosis to digestive tract tuberculosis.
Wait for other primary tuberculosis lesions to reach the spine through blood circulation.
Dr. Guo's suspicion of tuberculosis was definitely not from the featureless lung films, but from the spine films.
Spinal X-rays include anteroposterior and lateral radiographs. The anteroposterior radiograph shows that the lesion area is in the middle of several vertebrae of the patient. It seems that the soft tissue has been invaded and the bone has signs of destruction. It happens that clinically, there is a difference between spinal tuberculosis and spinal cord tumors.
The big difference may be at this point.
Mycobacterium tuberculosis is not like a tumor. It is jokingly called a bully by medical experts. It only dares to attack the soft tissues of the human body first, which is tantamount to bullying. Tumors are exactly the opposite. They like to attack the human body head-on. Tumors are more common in clinical practice.
It will directly destroy the bone tissue like an army pressing in, and it is a bit disdainful to the soft tissue of the human body. The typical difference between the two is that when ordinary doctors see soft tissue destruction on the film, they will first check whether it is tuberculosis.
question mark.
Of course, every patient has his or her own individual differences. Some patients have special bodies and may have symptoms that are reversed. These are all factors that doctors must consider.