Sun Lien made his own diagnosis for the first time and was very confident in this diagnosis.
But this kind of diagnosis... there is absolutely no way to convince Zhou Jun, who has always been strict.
In fact, based only on the analysis of the existing medical history data and the symptoms displayed by the patients, the simultaneous outbreak of syphilitic encephalopathy and syphilitic liver disease is not even in the list of "possible types of diseases". If there is not a status column as a basis, Sun Lien
Even I would not believe that a patient with tertiary syphilis would show symptoms of both encephalopathy and liver disease at the same time. This does not conform to the "common principles" of diagnosing the disease. At least all other possibilities should be eliminated first before extending to syphilis.
On the body.
"First do a blood routine, five liver function tests and bacterial culture." Zhou Jun made a prompt decision and began to give diagnostic instructions. "As soon as the liver failure is confirmed, start polyene phospholipids. Give him two slow doses first to see the effect."
Enphosphorus refers to the commonly used hepatoprotective drug polyene phosphatidylcholine injection. Most of the names of Western medicines are long and difficult to pronounce. Doctors often use the conventional abbreviation to call them. This name is used in every hospital and even every department.
There is a difference.
"By the way, let's check the liver function and do a brain CT to make sure there is no bleeding in his brain." Zhou Jun continued to add, and he suddenly said to Sun Li'en who was recording the money, "What other examination items do you think are needed?"
"I think..." Sun Lien thought for a while, "Let's do a lumbar puncture to rule out other neurological diseases."
"Well..." Zhou Jun nodded thoughtfully, "There are enough medical reasons, and it is very uncomfortable to do." He smiled at Sun Lien, "I like this idea."
This is not part of the revenge... Sun Lien smiled bitterly and nodded.
Deputy Director Liu still hasn't come back. He probably continued to supervise Lin Lan's operation in the operating room. Jiang Lun, who was called over by Sun Lien on the phone, acted very quickly. He had just finished drawing Zheng Xiaoyu's blood when he appeared.
In the emergency room.
"There are not many opportunities for our department to be called for consultation." Jiang Lun smiled and shook hands with Zhou Jun, walked to the bed and looked at Zheng Xiaoyu, "Oh no, it's this turtle son."
"Why did he come to see you for outpatient consultation?" Sun Lien's eyes lit up, "What are the symptoms?"
"This turtle son said he had ulcers on his body." Jiang Lun recalled the scene at that time, "but he said that he was usually busy with work and had time to see it today. The ulcers on his body had healed and there were only some scars. No visible scars.
what is the problem."
Special-shaped ulcers are one of the manifestations of tertiary syphilis. After the syphilis rash gradually expands, the center will begin to soften and break, and discharge pus-like secretions. However, this kind of ulcer will not get better quickly. If it is not treated, it will rarely
They said it would take half a year to heal on its own.
"The patient himself denied the history of syphilis." The history of syphilis is the medical name for "high-risk sexual experience." Jiang Lun seemed to have guessed Sun Lien's thoughts, but his views on syphilis were as conservative as other doctors. "If you say this
The turtle son suddenly fainted because of syphilis. The course of his disease must be at least more than 10 years, and he has not been cured during this period." Dr. Jiang shrugged, "It's the 21st century, and penicillin is no longer called penicillin.
Can it take ten years to cure syphilis? Impossible."
This man was able to delay seeing a doctor for more than half a year after he contracted syphilis. He must be delaying the late stage of cancer. Sun Lien sighed, "Does he have other symptoms?"
"I guess his ears don't work very well." Jiang Lun suddenly slapped his thigh, "I asked him if he had any history of drug allergies, and it took him five or six times to understand."
That's not a hearing problem... The symptoms of tertiary syphilis matched up again, and this one was a manifestation of paralytic dementia. Sun Lien silently checked another check mark on the mental checklist.
"Generally speaking, I think this may be a lunatic." Jiang Lun gave his own opinion, "If you are worried, then you can also do the five infectious diseases."
Jiang Lun left with his hands behind his back, and Sun Lien also got what he wanted.
"Doctor Jiang suggested that we do five infectious diseases." Sun Lien used chicken feathers as arrows and began to fool his instructor. "He said that the patient had strongly denied his history of travel."
For doctors in the Department of Dermatology and Venereology, strongly denying it is basically equivalent to having something evil inside. The five items of infectious diseases include the syphilis spiral antibody test. As long as Zheng Xiaoyu is confirmed to have syphilis after taking this test, Zhou Jun will definitely realize that he is having syphilis.
Faced with a very difficult case of compound tertiary syphilis.
Zheng Xiaoyu here was clearly arranged by Sun Lien. The high school student who had been protected by Sun Lien was also pushed out of the CT room. The results of the enhanced angiography were very clear, this was another cerebrovascular accident.
He did not suffer a brain aneurysm bleeding due to a fall, but the aneurysm bleeding caused him to lose control of his body and fall into a coma. Fortunately among the misfortunes, this high school student still has some sense of self-safety.
He was wearing a helmet on his head. Otherwise, the sidewalk stone that cracked his helmet would have killed him.
"Hang up a bottle of mannitol first and ask for a consultation from the neurologist." A ruptured brain aneurysm is a very dangerous disease. Zhou Jun, who took the initiative to take the case, threw himself into intense work. The cerebral hematoma caused by the ruptured aneurysm will compress the patient's body.
Brain tissue, depending on the location of compression, may cause different neurological disease symptoms. If the brain stem is compressed, it may even inhibit the patient's heartbeat and breathing. And excessive intracranial pressure may even cause the already fragile
Brain tissue squeezes into other locations, causing brain herniation.
Mannitol is one of the drugs commonly stocked in the emergency room. As a good diuretic, it can effectively act on various organs of the human body, increase plasma osmotic pressure, and rapidly dehydrate the organs. In short, it can shrink the brain.
The shrunken brain frees up more space to reduce intracranial pressure, which can reduce the possibility of cerebral herniation in the case of cerebral hematoma. The fatality rate of cerebral hemorrhage is 30%, while the fatality rate of cerebral herniation is 30%.
As high as 80%. Although the shrinking brain after dehydration may cause the originally compressed blood vessels to lose pressure and bleed again, the principle of two evils meeting the lesser is exactly the same in medical decision-making.
The weather is getting colder, and more and more patients with cardiovascular and cerebrovascular accidents have begun to appear in the emergency room of the Fourth Central Hospital. The Fourth Central Hospital, which is responsible for both the stroke center and the chest pain center, has become busy.