Under, Chinese medicine flavin

Chapter 240 Bronchoscopy

Seeing Dr. Lai's gaffe, this can be regarded as a profound lesson for him, don't think that a certain doctor is the best in the world every day.

Before everyone returned to Aleph's bed, Flavin explained to Billie: "The patient is recovering well now. The next step in our drug treatment will focus on tonifying the kidney and filling the marrow. Given the good recovery of the patient's spinal cord, we will seek an orthopedic doctor. Come here and make a corrective surgery for the patient's spine."

"Doctor Huang, we all listen to you."

Seeing that his son's condition was improving day by day, Billieger agreed with joy on his face.

Five years later, I finally saw hope for my son's healing.

黄素对身后的何慧说道：“何慧记方，巴戟天15g、仙灵脾15g、菟丝子20g、鹿角胶12g、龟版胶12g、炙黄芪30g、枸杞子30g、全当归15g、赤芍药6g、大川芎6g、紫丹参12g、熟地黄15g、肉苁蓉30g、川续断20g、桑寄生20g、川牛膝20g、金毛狗脊15g、太子参15g、嫩桂枝12g、鸡血藤30g。”

After taking the prescription handed over by He Hui, the flavin check was correct and handed it over to Li Yan and instructed: "Drink one dose of this medicine every day; decoct each dose twice, and make a total of 400 ml together, twice a day, Two hundred milliliters each time orally."

Li Yan took the prescription in Huang Su's hand, added it to the patient's treatment file, and updated the original prescription.

Seeing that the matter here has been explained clearly, Huang Su walked up to Dr. Lai and asked, "Expert Lai, do you still want to continue rounds with us?"

Cough!

Dr. Lai coughed twice, straightened his back, and said confidently: "Of course, I am in charge of the assessment of the business of traditional Chinese medicine, and ward rounds are also one of the assessment items. Naturally, I will follow you to continue the ward rounds."

Where did he look like he was just hit, and he regained his arrogant look. If a certain doctor did not have this shameless energy, he would not have been able to steal the credit of others in [-]. After the development of the self-media in [-], everyone knew it. They don't want to blatantly steal credit when they know it, but they still don't give up, they keep doing nasty things, they do their best to pour dirty water behind their backs, and they send small videos, slander, and slander. making movies.

"Expert Lai, since it is a matter of hospital rating and inspection, our Chinese medicine department has the right to cooperate." Huang Su said slightly sideways: "Expert Lai, please."

During the subsequent ward rounds, Dr. Lai seemed to have really entered the role of an evaluation expert. After entering the ward, he did not say a word, but took out his notebook and quickly recorded some things.

Liang Anguo's ward This is the last ward checked today.

Walking into the ward, he saw Liang Anguo lying on the hospital bed wearing a hospital gown, and Chen Huixiu by the side of the hospital bed, peeling an apple in his hand.

During the consultation yesterday, Huang Su didn't pay attention to Liang Anguo's stomach because he was wearing thick clothes.

Now, Liang Anguo was wearing a hospital gown to block the bed, without a quilt, and he could clearly see his bloated belly, as if he was five months pregnant, swelled as if half a basketball was stuffed into it, and the hospital gown was stretched round. .

Seeing Huang Su and his party coming in, Chen Huixiu put down the apple and fruit knife in her hand, got up and asked, "Director Huang, you're here, sit down!"

Saying that, he stretched out his hand and placed the chair he had just sat on beside Huang Su.

"I don't want to sit, you can continue to sit." Huang Su declined Chen Huixiu's politeness and asked, "I prescribed the Chinese medicine, has the patient drink it now?"

"I have already drank it. After going through the hospitalization procedures yesterday, the nurse has already decocted the medicine. I drank it once yesterday, once this morning, and I have drank it twice."

As she spoke, Chen Huixiu showed a hesitant look on her face.

Seeing Chen Huixiu wanting to stop talking, Huang Su asked, "Family, if you have any questions or doubts, just say them."

Then Chen Huixiu said cautiously: "Director Huang, it's not that I don't believe you, but since I took the medicine you prescribed, my husband has been going to the toilet all the time. Since the first time I took the medicine yesterday, I've been urinating for more than 20 minutes. Once again, if I pee now, nothing will happen to my husband, right?"

After finishing speaking, Chen Huixiu stared at Huang Su's eyes nervously, for fear that Huang Su would say some bad news, and her husband could no longer stand the torment under the torture of illness.

Huang Su explained with a smile: "Don't be nervous, family members, it is a good thing for patients to urinate more, and more urine is to remove excess water from the body under the action of drugs."

"Given your husband's current physical condition, he can't bear the harm of chemotherapy, so we must first restore the patient's righteousness and improve his physical condition. To improve his physical condition, we must first treat the patient's pleural effusion. There are Chinese medicines for treating pleural and ascites and dampness and diuresis added to the sub, and your husband's current condition shows that the medicines have begun to take effect."

"So that's the case, I'm relieved when you say that."

After listening to Huang Su's explanation, Chen Huixiu let out a long sigh of relief, and the anxiety and nervousness were relieved.

Huang Su walked to the side of the hospital bed and said to Liang Guoan, "I'll check the condition of your pleural effusion."

Seeing Liang Guoan nodded slowly, Huang Su reached out and unbuttoned the patient's hospital gown.

I saw that from the patient's chest, the thoracic cavity and abdominal cavity had been propped up round, the blue blood vessels were propped up on the stomach, twisted like a centipede, and the navel was also protruded by the effusion in the thoracic and abdominal cavity.

Looking at the position of the patient's right chest to below the clavicle, many small bumps with irregular shapes protrude, like bunches of grapes, layer upon layer, with a diameter of about three or four centimeters.

Huang Su reached out and stroked gently, the surface was extremely hard.

Risong also walked to Huang Su's side and carefully observed Liang Anguo's situation.

Huang Su has been watching the recent changes in Na Risong. It seems that he is serious about specializing in TCM tumors this time.

Flavin pointed to the tumor that bulged on the right chest and explained to Na Risong: "Lung cancer is very easy to metastasize to lymph nodes, but the tumor that bulges from the patient only stops in the right chest, which means that the patient has not metastasized yet. For lateral metastasis, surgery should be considered first, and after surgery, consolidation treatment with traditional Chinese medicine and curative effects should be carried out.”

Speaking of flavin, he explained the various situations of lung cancer metastasis to Na Risong in detail.

The first lymph node metastasis of lung cancer is the ipsilateral hilar lymph node. For example, lung cancer in the right lung may be transferred to the right hilar lymph node. If only the ipsilateral hilar lymph node is transferred, surgery can be performed.

However, if the lung cancer metastasizes to the contralateral hilar lymph nodes or to the mediastinal lymph nodes, or to the supraclavicular lymph nodes, or even further to the axillary lymph nodes, it means that distant metastases have occurred, and such patients may undergo surgery. It is very difficult. If surgery is not possible, the effect of chemotherapy and targeted drug treatment will be greatly reduced. It is best to carry out TCM treatment and chemotherapy at the same time, use TCM to consolidate the body, and then perform multiple chemotherapy to achieve the desired effect.

That day Song also took out a notebook and recorded it seriously.

Seeing that Risong was so serious, Flavin continued: "In addition, the lymph node metastasis of lung cancer is also related to the type of lung cancer itself. If it is small cell lung cancer, the degree of malignancy is very high. Even if there is very little lymph node metastasis, follow-up It will be very difficult to achieve the therapeutic effect of non-small cell lung cancer. Even if there is lymph node metastasis on the same side of the lung, if a radical lung cancer resection is performed, the effect is still very satisfactory if supplemented by traditional Chinese medicine, chemotherapy or targeted therapy after surgery. ."

After the inspection, when Chen Huixiu buttoned Liang Anguo, Huang Su said, "Go downstairs together and have a fiberoptic bronchoscopy."

Fiberoptic bronchoscopy is a tumor of lung cancer, trachea, and bronchi. The performance of trachea and bronchial mucosa, as well as the degree of stenosis, tumor size and shape, can be directly observed through fiberoptic bronchoscopy.

Fiberoptic bronchoscopy can not only directly observe the pathological structure, but also carry out tumor cell biopsy sampling through the bronchoscope attached to the biopsy sampling structure to obtain the basis for the pathological diagnosis of the tumor.

Flavin asked Liang Anguo to do fiberoptic bronchoscopy, first to see the structure of the patient's lung cancer, and second to do biopsy sampling.

Because flavin did not see the biopsy report in the patient's medical record, I don't know whether it was not done or lost.

Huang Su's group and the patient came to the inspection team of the research group.

Walking into the office, all the inspection instruments are available here.The Prairie City People's Hospital purchased a batch of the most advanced inspection equipment for the new building, and this batch of equipment was composed of a person who used it.

Director Mei saw that Huang Su brought a group of people in, and said jokingly: "Isn't this Director Huang, what kind of wind blows you, a busy person."

Huang Su explained: "Yesterday, a new lung cancer patient was received, and I came to take him for a fiberoptic bronchoscopy, and a biopsy was also done casually."

Saying that, Flavin looked around the examination room.

Seeing Huang Su looking for someone, Director Mei asked, "Director Huang, what are you looking for?"

Huang Su said, "Where's Dr. Liu?"

Dr. Liu is the lead doctor of the inspection team of the research group.

Director Mei pretended to be angry and said, "Why, Director Huang, you don't believe me, you insist on Doctor Liu."

Seeing Director Mei's confident look, Huang Su gave a thumbs up and said, "Director Mei is amazing! You are the first doctor in our city hospital who can perform fiberoptic bronchoscopy."

Seeing Huang Su making fun of himself, Director Mei gently patted Huang Su's arm and joked: "I am also thanks to you Director Huang, I have treated several lung cancer patients, and I learned this under the guidance of Dr. Liu. already."

Prairie City People's Hospital, as a second-class hospital, used to have no fiberoptic bronchoscope equipment, and now it is added for the evaluation of third-class hospitals.

Huang Su continued to ask: "Director Mei, you are the only person in our hospital who can use this equipment. You will not be transferred to the Department of Respiratory Medicine in the future. You are the director of the Ultrasound Diagnostic Department!"

Bronchoscopy belongs to the department of respiratory medicine, which is a branch of internal medicine.

Director Mei rolled his eyes at Huang Su and said, "You can't expect me to order it, can't you set up a medical imaging department!"

Looking at Director Mei's determined attitude, Huang Su knew that this matter was a certainty.

Huang Su cupped his hands and said, "Then I'm here to congratulate Director Mei!"

Director Mei smiled and said: "I am not thankful for you, Director Huang, I have learned not only bronchoscopy, but also other imaging equipment."

While the two were chatting, Liang Anguo was already lying on the hospital bed.

Seeing that the patient was already in place, Huang Su said, "I have seen the superb skills of Director Mei Da."

Director Mei rolled his eyes at Huang Su again and walked to the clinic bed.

Seeing that Liang Anguo was already lying down, he first disinfected the camera lens of the equipment.

Afterwards, Director Mei stood at Liang Anguo's head, holding the control part of the mirror body with his left hand, and controlling the adjustment knob with his thumb.The right hand feeds the lens into the nasal cavity.

The screen instantly showed the structure of Liang Anguo's nose, and every nose hair was clearly visible.

Director Mei continued to operate the machine while staring at the display screen, allowing the camera to continuously protrude into the nasal cavity. This nasal feeding is a rationale.

When the catheter has been inserted about fifteen centimeters, a leaf-like object appeared on the display, which is an important part of the throat - the epiglottis.

The epiglottis is the leaf-like structure on the upper front of the larynx composed of the epiglottis cartilage and mucous membranes.

When speaking or breathing, the epiglottis is upward, opening the larynx, and when swallowing, the epiglottis is downward, covering the trachea, so that food or water cannot enter the trachea.

Prevents food and liquids from entering the windpipe when swallowed.When swallowing, the epiglottis descends to cover the top of the larynx and trachea, and the larynx simultaneously produces an upward reflex movement, thereby effectively closing the entrance to the trachea.

When he saw the epiglottis, Director Mei became very focused, because any small mistake would likely insert the lens into the esophagus, which would lead to failure and make the patient suffer again.

Director Mei was operating the machine steadily with his left hand, staring at the monitor, and saw the camera slowly inserting from under the epiglottis cartilage.

When he saw the glottis, Director Mei told Liang Anguo, "Keep breathing steadily."

Director Mei quickly inserted the mirror end into the trachea from the back of the glottis when the glottis opened.

Watching the camera on the monitor enter the trachea, Director Mei exhaled softly.

After the trachea is successfully inserted, it is easy to handle, and you can check along the bronchus in turn.

Flavin stared at the monitor. After seeing the camera inserted into the air tube, he said to Director Mei: "The patient's cancer cells are in the right lung, and the specific location should be in the middle lobe of the right lung."

The order of bronchoscopy is generally right first, then left, upper lobe, middle lobe, and lower lobe first.

If the lesion site is known, check the healthy side first, then the diseased side, and finally focus on the diseased site.If the patient is frail, only the affected side can be examined.

Director Mei checked according to the inspection order, and sure enough, he saw dense granulation-like tissue at the opening of the middle lobe of the right lung. If people with dense phobia see the images on the monitor, they will definitely feel extremely uncomfortable.

Flavin stared at the monitor, carefully observing the state of the cancer cells, and said to Director Mei, "Take a sample of the patient's cell biopsy."

After examining the patient, Director Mei said to Huang Su, "Come and get the biopsy report in two days."

Under normal circumstances, it takes 5-7 working days to issue a biopsy report. However, the inspection team of the research group only serves the research group, and the report will be issued faster. Generally, the biopsy report can be obtained within 1-2 working days.

"Director Mei, trouble you!"

After greeting Director Mei, Huang Su and his party left the inspection team's office together.

It didn't take long for the group to walk out of the inspection team's office.

Huang Suyi's cell phone rang in his pocket, and when he took it out, he saw that it was actually a call from Briggood.

(End of this chapter)