It was already completely bright, and there were many people wearing white coats or hospital gowns waiting in line at the entrance of the hospital cafeteria. On the other side of the cafeteria, a dozen tightly wrapped insulated boxes were being pushed by the cafeteria staff.
Slowly enter the inpatient building. These are breakfasts delivered to patients who have ordered meals.
As for doctors... they don't have such good treatment. They have to queue up to eat, order takeaways or go out to eat. The hospital canteens are also helpless. Their supply capacity is not enough to cover all hospital staff and inpatients.
The current stove equipment has reached its limit. Unless the canteen is dismantled and covered, it is absolutely impossible to meet everyone's dining needs.
Xu Yourong and Zhou Ce were eating in the cafeteria. They looked around, but did not see Sun Lien.
"Dr. Sun has gone back, hasn't he?" Zhou Ce joked to Xu Yourong, "Normally, I should have gotten off work long ago, but you stopped me and came back. Be careful that the boss will give you some shoes to wear in the future."
Xu Yourong wiped the traces of soy sauce on the corner of his mouth and replied calmly, "If he can learn to wear small shoes, then I don't have to worry about this treatment group being dismantled."
Zhou Ce heard the hidden meaning in Xu Yourong's words and couldn't help but asked in a low voice, "What's the news?"
"It's nothing special." Xu Yourong continued to eat rice rolls with his head down. The Hunan chef learned the Guangdong rice rolls from the boss in Jiangxi, and the taste was unexpectedly delicious. "Anyway, my boss is on top now, so the sky won't fall.
"
"Sooner or later, the sky will collapse for you if you try such a trick." Zhou Jun looked at Sun Li'en in front of him, furious.
After pondering for several hours in the small conference room, Sun Lien finally raised his hands and surrendered. He was just a doctor with regular training, not a professor and director specializing in nephrology. No matter how he thought about it, he could not treat Staphylococcus aureus pneumonia and chronic kidney disease.
associated with rapid exacerbation of glomerulonephritis.
But the biggest advantage of being a front-line doctor is that you have someone you can rely on. If you don’t understand something, you can ask your senior!
Then Sun Lien was scolded by Zhou Jun.
"Streptococcus infects both lungs, causing acute glomerulonephritis. What's wrong with this diagnosis?" Zhou Jun knocked on the table at Sun Lien, "This is not tuberculosis. It can also explain the patient's symptoms. Isn't it a good diagnosis?"
"However, the imaging findings are wrong." Sun Lien took out the CT examination report he had just received with a grimace. "The patient's lungs showed ground glass shadows, which does not meet the typical symptoms of Streptococcus pneumoniae pneumonia."
Zhou Jun took the CT report from Sun Lien's hand with a suspicious look on his face, frowned at it for a while, and said in deep thought, "Is it the result of inflammatory changes or alveolar hemorrhage? Considering his hemoptysis, this is diffuse alveolar disease.
Bleeding (dah).”
"Then I couldn't figure it out." Sun Lien said with a bitter face, "Streptococcus pneumoniae pneumonia cannot cause diffuse alveolar hemorrhage. The five infectious diseases that the patient was admitted to the hospital were negative, which can rule out Pneumocystis carinii pneumonia. Recently.
He has not been exposed to chemicals or toxic substances for a month. The tumor markers are all good, and the coagulation function is also normal..." Sun Lien sighed, "I really can't figure out what's wrong with him."
Zhou Jun glared at Sun Lien, "You knew he wasn't tuberculosis?" He seemed a little dissatisfied with Sun Lien's attitude in his words, "You, Sun Lien, can't just pour cold water on others, you have to find a way to figure out what's wrong with this person. Just do that.
What's the use of complaining? Can complaining tell you what disease he has, or can you simply cure him?"
Sun Lien nodded with a grimace to show that he heard Zhou Jun's criticism. He sighed and picked up the checklist and read it again as if he had accepted his fate.
"Brother Sun, the morning blood routine is out." While Sun Lien was struggling with the examination form, nurse Xiao Guo knocked on the door, holding a piece of paper in his hand and shaking it towards Sun Lien. "This is your patient's examination.
result."
Sun Lien took the checklist and thanked Xiao Guo. Then he lowered his head and read the report.
"The hb (hemoglobin) is only 80g/l?" Sun Lien frowned as he looked at the freshly released report. Holding the report in one hand, he began to look through the case records with the other hand. He flipped through the sorted examination reports all over the table.
Finally, he found the first routine blood test report done when the patient was admitted to the hospital about six hours ago.
Hemoglobin content, 88g/l. Within eight hours, the amount of hemoglobin in the patient's body dropped by 8g/l.
"The patient coughed up blood twice after being admitted to the hospital, and he coughed up about 150 ml of blood." Zhou Jun also came over, looked at the freshly released data, and said thoughtfully, "Calculating that he coughed up 200 ml of blood today, and all of it was
Suspended red blood cells are only 1u, and a reduction of 5g is huge. The reduction in hemoglobin is also too large."
Generally speaking, in the blood of normal adult men, the normal reference value of hemoglobin should be around 120~160g/l. Once it drops below 120g/l, it can be considered anemia. When the hemoglobin concentration drops to 90g/l
Sometimes, patients will suffer from asthma, fatigue and other hypoxic phenomena. When the hemoglobin concentration drops to 60~40g/l, the patient will suffer from acidosis due to insufficient circulation. Once it is lower than 40g/l, it is basically equivalent to a declaration of
patient's death.
According to Wang Lin's current rate of hemoglobin decline, his hemoglobin concentration will drop to the critical value of acidosis within about a day. After about 38 hours, his hemoglobin concentration will drop to the death line.
"Supplement two units of suspended red blood cells." Sun Lien responded immediately. Wang Lin's hemoglobin content could not drop any further and must be maintained at at least 70g/l. He called Xiao Guo in again and arranged,
"Increase the oxygen concentration to 98%."
"The cause of the disease must be found as soon as possible." Zhou Jun patted Sun Lien on the shoulder, "Communicate more with your team members. Brainstorming will help find the real cause."
"The hemoglobin concentration dropped rapidly. This is not a symptom of streptococcal infection." Returning to the conference room from the cafeteria, Zhou Ce rejected his diagnosis with some frustration. He was originally quite confident in his streptococcal diagnosis, but he just went to eat
After eating, I was slapped twice in the face by imaging and blood tests.
"Could it be an autoimmune disease? I think it might be SLE (systemic lupus erythematosus)." Dr. Pascal pondered for a moment and said, "SLE first acts on the kidneys, causing chronic glomerulonephritis, and then turns to attack
It hit his lungs, causing coughing and hemoptysis."
"The patient's WBC (white blood cell) count increased, indicating an infection." Xu Yourong shook his head, "It must be a symptom caused by some kind of infection. This is not SLE."
Yuan Pingan raised his head and asked in a low voice, "Could it be a tumor? Paraneoplastic syndrome may also cause this symptom." He himself had little confidence in this inference.
"There is too little information now, and it is meaningless to discuss it here." Sun Lien made the decision, "Perform a lung and kidney biopsy on the patient."