Is this true? The symptoms of clinical patients are complicated. It is impossible to simply and easily classify the causes. If it were possible, it would not be said that the patient was suddenly discharged from the hospital after being hospitalized for three weeks.
Xie Wanying chose this time to listen to the patient's heart. Thinking about it carefully, there are many strange things about Yangyang's mother's case that deserve further scrutiny.
For example, the patient's jaundice is relatively mild, the hepatitis B indicator is positive but the transaminase is generally normal, cirrhosis usually means the liver shrinks, but the opposite is true for the positive patient, which is hepatosplenomegaly.
The patient's chest X-ray appears to be normal, except for the slightly thickened texture on the left side of both lungs, the mediastinum is normal, and the heart shadow is generally normal.
In the B-ultrasound, there is substantial diffuse damage to both kidneys, which is consistent with the symptoms of ascites in the late stage of cirrhosis. The liver shows widening of the portal vein. Due to the ascites, the B-ultrasound doctor's field of view is unclear and he cannot see clearly whether there is obstruction in the inferior vena cava.
, but the B-ultrasound doctor suspected it based on his own experience.
With such a result, it is estimated that Budd-Chiari syndrome needs to be ruled out. Budd-Chiari syndrome is a type of posthepatic hypertension, and the main cause is obstruction of the hepatic vein and the inferior vena cava. Why did the patient not
For further examination of the inferior vena cava, you need to ask Dr. Gong the reason.
"Take a deep breath." Xie Wanying said to the patient.
Yangyang's mother took a deep breath and exhaled a long breath.
After listening to the patient's breath sounds from both lungs, Xie Wanying found that the patient's left lung's breath sounds were thickened, indicating some inflammation.
Listen carefully to the patient's heart. There is a systolic murmur in the mitral valve area at the apex of the heart, but it is relatively weak. In terms of classification, it is estimated to be only grade two, which is far from the standard of structural heart disease.
In fact, the effect of removing ascites for patients like this is average. Therefore, the treatment plan was later adjusted to salt restriction, water restriction and diuresis, that is, the latter was treated based on the overflow theory, and the effect was quite good. This is all that can be done in the hospital.
Therefore, the patient's condition improved and he was discharged from the hospital first.
Even so, after listening to the patient's heart, Xie Wanying took the stethoscope and continued to think about it. She felt that this case could be considered more carefully. Now she will pay more attention to her medical intuition, mainly because of Li Yaxi's case in bed 21 next door.
She sounded the alarm.
Yangyang's mother raised her head as if she wanted to talk to her.
Xie Wanying put her ear to it.
Yangyang's mother whispered to her: "The girl next door can't sleep at night and is very scared."
Even though Yangyang's mother is seriously ill, she never forgets to care about the patients in the same ward. Maybe in Yangyang's mother's eyes, a young and beautiful female college student living in the hospital is a pity.
The medical staff knew Li Yaxi's fear, so the nurse specially drew a curtain between beds 20 and 21 to block the patient's view. But it was useless, fearing that it would become ingrained in some patients in this environment.
If the patient himself is not strong, like Li Yaxi, he will feel like he is having a nightmare every night and day.
"What disease does she have?" Yangyang's mother asked the doctor, probably because she wanted to help the patient.
Xie Wanying said to the patient: "No matter what kind of disease you have, the doctors will do their best to treat you when you enter the hospital."
Xie Wanying is confident about Li Yaxi's illness, because Senior Brother Tao has arranged for Dr. Song to take care of it, and there will definitely be a breakthrough.
Yangyang's mother felt a little relieved after hearing what she said.
"I'll discuss it with Dr. Gong when I get back and see if I can do another check-up on you." Xie Wanying said to Yangyang's mother, "If the check-up is clearer, the medicines prescribed in the future will be more targeted and the effect will be better."