When I spit out these two inspection items on Monday.
Liu Jing and Su Quan on the side were both startled.
Generally speaking, ordinary CT and X-ray examinations are performed in the emergency department.
The principles of X-ray examination and CT are similar.
They are all based on the high penetrability of X-rays.
The inventor is the famous Roentgen, also known as Roentgen rays.
This thing is simply a milestone invention of modern Western medicine, allowing humans to see the "essence" through the eyes.
Roentgen may have won the Nobel Prize in Physics for this discovery.
This shows its importance.
The difference between CT and X-ray examination is that CT is a product of recent decades.
The principle is the same, but the function is more powerful. It assists computer imaging and can scan a certain thickness of a certain part of the human body.
But this does not mean that x-ray examination is outdated.
X-ray examination has advantages in bone examination and other aspects, and the price is also cheap.
CT is better at examining internal organs and intracranial organs. It is more expensive.
Enhanced CT is based on CT, injecting contrast agent into the vein of the subject, usually an iodine-containing preparation, which can better image blood vessels.
MRI is the latest imaging examination equipment, which has better imaging effects on soft tissues. Even tiny blood vessels can be seen clearly.
Of course, the fees for these four types of inspections are also different.
The cheapest X-ray examination is about 100 yuan, and the CT examination is several hundred yuan.
Enhanced CT is of course more expensive.
The most expensive one is nuclear magnetic resonance, which is almost twice as much as CT scan, costing nearly a thousand yuan each time.
CT examination, that is, ordinary plain scan, can already detect symptoms such as intracranial hemorrhage.
Therefore, in emergencies, this examination is generally prescribed.
Enhanced CT and MRI are expensive and generally not an option in emergency rooms.
It will only be considered when some specialties require more detailed examination, or when CT examination cannot achieve the expected results.
Neither Liu Jing nor Su Quan understood why Zhou Yisheng directly performed these two examinations on the patient.
The middle-aged man lying on the hospital bed was conscious at the moment.
He heard everything Zhou Sheng said.
He didn't know what enhanced CT was, but anyone with a little common sense about MRI would know it.
That thing is a ring-shaped cabin, with people lying on the platform and being sent into the cabin, just like the scenes in science fiction movies.
This stuff isn't cheap.
And for common diseases, that is rarely used.
In his mind, an Internet joke that he had seen before suddenly came to mind. It was about a person who had a cold and went to the hospital for a check-up worth several thousand dollars. When the time came, he was prescribed medicine worth only a few dozen dollars.
People who see a doctor should not only have the first purpose of seeing a doctor, but to treat them well.
The second concern is the price.
Although this middle-aged man has a headache.
But I feel pretty good about myself.
He had to spend thousands of dollars for a check-up, and he felt a little sick.
He said to Zhou Sheng without hesitation: "What about MRI, enhanced CT, headache, can't we just do a normal CT?"
Patients, sometimes, like to be their own doctors.
However, today's situation is a bit special. Even Liu Jing and Su Quan thought that a normal CT scan would be enough.
Of course Zhou Sheng is not one of the few doctors in the joke who likes to perform random examinations.
He has his own reasons.
Sudden headache and drooping eyelids.
These symptoms are most likely early symptoms of cerebral aneurysm bleeding.
Cerebral aneurysm is a cerebrovascular disease.
Ordinary plain CT scans are very poor for vascular imaging.
If you want to know the location and status of blood vessel lesions, it is better to use enhanced CT and MRI.
Face patients' questions.
Of course Zhou Sheng has to answer.
Zhou Shengsheng answered the question immediately, and Liu Jing and Su Quan also understood.
Liu Jing also discovered at this time that the patient also had stiffness in the neck and discomfort in moving.
It is very consistent with the symptoms of subarachnoid hemorrhage.
Subarachnoid hemorrhage is most likely caused by cerebral aneurysm.
Without enhanced CT, it is difficult to judge.
Su Quan does not have rich clinical experience.
It's hard to judge.
It's just that he has great faith in his brother.
When the patient heard this, he didn't believe it.
Is my brain bleeding? Or is it most likely a brain aneurysm?
The cerebral hemorrhage was so serious that I just had a little headache. Maybe I just didn't get enough rest.
It's already very good to have a CT scan.
Also do enhanced CT? MRI?
Then I am not taken advantage of.
He yelled that he didn't need it.
Liu Jing and Su Quan were of course standing by Zhou Sheng's side.
They persuaded the patient to follow the examination prescribed by Zhou Sheng.
The patient refused to do it.
Zhou Sheng was also quite helpless.
Forget it, give him an A-level auxiliary scan first.
Based on experience, Zhou Shengsheng had already judged that this middle-aged man had a high probability of bleeding from a cerebral aneurysm.
But he couldn't judge the future development.
A-level auxiliary scans will also provide judgment on subsequent changes in condition.
If the condition is not serious, follow this guy's advice and do a plain CT scan first.
He will have to do other tests later.
no way.
In order to avoid unnecessary disputes, doctors can only give advice.
Su Quan and Liu Jing were still persuading.
Zhou Sheng remained silent and turned on the auxiliary scan.
A few minutes later.
The scan results come out.
Patient's condition: Cerebral aneurysm bleeding, current condition is grade II.
It is expected that ten minutes later, the second bleeding will occur and the condition will progress to grade III.
It is expected that four hours later, the third bleeding will occur and the condition will progress to grade IV.
It is expected that twenty hours later, the fourth bleeding will occur and the condition will progress to level V.
See the results on Monday.
His eyebrows were furrowed.
The Roman numerals ii, iii, iv, and v in the system are the internationally accepted grading methods for primary subarachnoid hemorrhage.
As long as the doctor sees the numbers, he will know the patient's current condition.
This is graded as level five.
Grade 1, asymptomatic or mild headache and mild cervical stiffness.
Grade 2, moderate to severe headache. Neck stiffness, oculomotor nerve and other cranial nerve palsies.
The patient is now in level 2 status.
Level 3, confusion, restlessness and mild cerebral symptoms.
Grade 4, stupor, semi-coma, hemiplegia, early decerebrate tonicity and autonomic nervous system disorder.
Level 5, deep coma, decerebrate ankylosing, near-death state
Generally speaking, cerebral aneurysm bleeds if there is no secondary bleeding.
If the symptoms are not particularly severe, they can be treated conservatively.
But if bleeding occurs again and the condition progresses, surgical treatment is the best option.
It is best to perform surgery within 4 hours after bleeding.
If it occurs three times and bleeding occurs everywhere, the condition will enter level 4 or 5.
Even if the operation is successful.
Even if you save your life, there is a high probability that there will be sequelae.
The bleeding symptoms are so severe.
Bleeding occurred three times within three hours.
It seems that surgery is not possible.
The persuasive voices of Su Quan and Liu Jing.
This attracted Liu Zhengqing, who happened to be passing by the observation room.
Liu Zhengqing saw that there were actually three doctors gathered around a patient.
Don't know what happened.
As the temporary acting team leader, he is too lazy to take care of things.
But since you are the team leader, you still have to show up sometimes.
Otherwise, if something happened, it would be difficult for him to deal with him.