The road to the rise of great doctors

Chapter 55 Grapes
It may also be a "hydatidiform mole".
In a normal pregnancy, embryonic tissue is formed and gradually develops into a fetus.

A hydatidiform mole means that normal embryonic tissue does not form after pregnancy, but abnormal tissue similar to grape shape is formed.It is also called a "blister-like fetal mass". After pregnancy, the placental villous trophoblasts proliferate and the interstitial edema forms blisters of different sizes. The blisters are connected in clusters by pedicles and look like bunches of grapes, hence the name.

Liu Dong chatted with Xiaomei, while dispelling the uneasiness that she had concealed but could not stop overflowing, hoping that she could accept examination and treatment with peace of mind; on the other hand, he was also constantly collecting medical history information.He is now an expert at asking questions about medical history. Even if the patient takes a roundabout way, he can still bring the topic to the medical history.

Maybe Xiaomei's boyfriend is a medical student, and she has a high degree of favorability and cooperation with medical students.She seems to have a cheerful personality herself.I was hospitalized alone, and my boyfriend was "heavy with schoolwork" and couldn't come to stay with me, but he didn't seem particularly panicked.

Liu Dong asked, "When will your family come over? If you want to talk about the surgery, your family members need to talk and sign."

Xiaomei looked a little unnatural and replied, "I didn't tell my family. I will sign for the operation."

"You are alone in the hospital now. It was okay to be alone before the operation, but you still need someone to take care of you after the operation. There must be someone at home. And you should also tell your family about the precautions after the operation."

Seeing her distraught expression, Liu Dong continued, "You're not married yet, and your boyfriend and his family can't make decisions for you yet. If your parents don't come, the surgery will have to wait."

After listening, Xiaomei didn't speak, she looked a little troubled, and after a few minutes, she said, "I'll tell the family. You can arrange for the examination as usual. You have to go back to class after it's cured."

Liu Dong returned to the office and wrote down medical records. He did not participate in the family gossip.But the voice in my ears still came through.

"Today's men are so unreliable that they don't take care of others even when they get pregnant."

"That's right, men are never good."

"You can't say that. Girls should keep themselves clean."

"You have reached your age, do you still have to guard it?"

"If you ask me, this is life. It's a blessing, not a curse. We can't avoid it."

"I think these are nothing. What's important is that you don't plan to have children, and you need to take appropriate contraceptive measures. Contraception during safe periods is not reliable."

"What flavor do you like, strawberry or peach?"

"I do not understand what you're saying"

"Oh, it's really bad to have a department with many women." The classmate next to Liu Dong sighed with emotion.

Liu Dong was unmoved and quickly wrote down the medical records, disease course, ward rounds, etc., and also maintained the pre-operation template.There were no new patients or new tasks. He looked over the conditions of the patients in his group again and wrote them down in his little notebook so that he knew what he was doing.In the obstetrics department, the main hospital admissions are people related to pregnancy, and cannot be said to be "patients".

In the gynecology department, patients are basically all patients. The main diseases include tumors (ovarian cancer, uterine tumors, vulvar malignant tumors, cervical tumors), gestational trophoblastic disease, endometriosis, and pelvic floor organ prolapse. Wait.The main treatment method is surgery, and drug treatment is also an important component.

Obstetrics and gynecology are divided according to organs, mainly the organs located in the pelvic cavity, next to the bladder and ureter under the jurisdiction of the Department of Urology. Special attention needs to be paid to the anatomy of these during surgery.In the medical field, this can be regarded as a "family department" that often helps each other.

At noon, Liu Dong went to check the results of Xiaomei's vital signs. Blood pressure, heart rate, breathing, etc. were all normal, and there were no external manifestations of anemia.Dr. Zong, the superior doctor, came to the outpatient clinic and came to the ward to see the patient. She led Liu Dong to complete a specialist physical examination. Dr. Zong told Liu Dong that the physical examination found that the uterus was larger than a normal pregnant uterus during menopausal months, and the right appendage could be touched. to the lump.

afternoon.Liu Dong looked at Xiaomei's newly reported test results and found that the blood HCG level was abnormally elevated, and the discharge from the lower body that was submitted for testing looked like blister-like tissue discharge.Routine blood tests, coagulation tests, and thyroid function tests were all normal.Under pelvic ultrasound, we saw that the uterine cavity was filled with honeycomb-like echoes, with a large range and a "falling snow shape", and there was a cystic echo in the right appendage.

Liu Dong looked through the textbook of "Obstetrics and Gynecology" and found that it was very consistent with the diagnosis of hydatidiform mole: women of childbearing age, irregular vaginal bleeding after menopause, positive urine pregnancy test, abnormally elevated blood HCG, and significant uterine enlargement on physical examination. , blister-like tissue was seen in the lower discharge, and the ultrasound performance also supported this diagnosis.

He checked the preoperative examination report and found that the results were basically complete and there were no contraindications.So, I silently continued to prepare the preoperative informed consent form, power of attorney and other materials, printed out the medical records, pasted the examination sheets neatly, and waited for Dr. Zong to have a preoperative conversation.

Xiaomei's parents finally came. A rough estimate of the distance and time revealed that they arrived quite quickly.Moreover, her boyfriend did not come, but her boyfriend's parents came with him.

Both parents met for the first time in the hospital, even in the absence of the boy.

Instead of tearing or complaining, he came to the office and calmly waited for the doctor's talk.

Liu Dong discovered that while waiting, the man's mother had been trying to talk to the woman's parents, and seemed to fall silent as soon as she stopped.The woman's parents also responded indifferently. Although it could be seen that they were a little sad, the overall reaction was not that violent.

Dr. Zong checked the materials prepared by Liu Dong, and nodded with his approval.Then he turned to the two couples and said, "Come and sit down. Who are the woman's parents? Come here, and sign the power of attorney first. Because there are some things that are not convenient to speak directly to the patient, she also agrees to authorize you , then it’s the same with you. I also understand the love for my daughter.”

"However, the diagnosis is basically clear. So the most recommended treatment for this disease is ultrasound-guided uterine curettage. The aspirated tissue will be sent for pathological examination. The subsequent treatment and follow-up plan will be determined based on the pathological examination results. "

"The operation process is like this because the uterus is large and soft, with a lot of bleeding and easy perforation, so you need to be prepared for blood transfusion, but if the bleeding is small, you will not use this preparation. Blood transfusion also has risks, mainly allergies, Infectious diseases, etc.”

"Fortunately, the child came to the doctor in time now. He is still a month old. If the uterus is cured, it can be cured in one go. If he comes late and is a month old, he may need a second visit. But the specifics also need to be determined by the operation process and postoperative review. It’s up to you to decide, it’s different for everyone.”

Xiaomei's mother held her father's hand tightly. After Dr. Zong finished speaking, she couldn't wait to ask, "Is the surgery traumatic? Will it affect having children in the future?"

(End of this chapter)