Sleepless Doctor

"Ma department... Dean Ma, I'm really embarrassed." Director Song saw Ma Xiude coming in and immediately stood up and said.

"It's okay, this is Director Zhou Guohuizhou of the Department of Neurology of the Imperial Capital Hospital." Matthew De introduced.

"I know." Director Song said quickly, "Director Zhou who held the academic conference gave a lecture."

Zhou Guohui nodded slightly, as a greeting. He doesn't care much about the doctors in the "primary" hospitals. They should know themselves, but there is no need for them to know them.

"Tell me about the patient's condition. You were rescued just now."

"The patient is now diagnosed with upper gastrointestinal bleeding and has been given symptomatic treatment. The condition is not very serious." Song Yabin said.

Upper gastrointestinal bleeding? This one is more bizarre than the other. The patient was only a 21-year-old young man with a stroke and stomach bleeding.

Zhou Guohui sat down seriously and asked, "I look at the medical records."

Immediately a little doctor came over and called up the patient's medical record page.

The patient was a 21-year-old male who presented to the hospital with sudden dysarthria, mild left limb weakness, and ataxia. The NIHSS score at the time of admission was 6 points, and there were no obvious vascular risk factors.

Previously, the patient had a history of psychotic depression and asthma and was taking sertraline and risperidone to treat depression.

The patient was initially diagnosed with a posterior circulation stroke. CT scan of the brain showed a dense shadow of the right posterior cerebral artery.

It is clear that ischemic stroke is accompanied by cerebral infarction.

Zhou Guohui checked the doctor's advice again. The doctor in the second hospital gave the patient a single dose of 300mg of aspirin and then 75mg of clopidogrel orally once a day.

Because he was given anticoagulant drugs, he was always observing for upper gastrointestinal bleeding during hospitalization.

Unexpectedly, patients who have been recovering well during the hospitalization had an accident while going through the discharge procedures.

Before he had time to write the record of the course of the disease after the emergency treatment, Zhou Guohui turned to the last page and asked, "How is the patient's current condition."

"Vital signs are stable, blood oxygen saturation is low, 92%." Director Song said, "The blood gas analysis report of the emergency check showed an oxygen partial pressure of 10.7, a carbon dioxide partial pressure of 5.0, and a pH of 7.38, confirming that the patient is hypoxic."

Zhou Guohui looked at the computer screen, thinking about the specific situation in his mind.

After thinking for two minutes, Zhou Guohui said solemnly, "Look at the patient first."

"Director Zhou, please." Song Yabin opened the door politely and bowed to let Zhou Guohui go out first. Then she walked quickly to Zhou Guohui and led the way to the ward.

Zhou Guohui took a look at the neurology ward of the Second Hospital of Medical University, and found that the layout should be a ward that can accommodate about 50 patients. There is no extra bed in the corridor.

He knew that it was not that there were no patients, but that the top three hospitals did not allow extra beds, and many patients lined up outside waiting for hospitalization.

The patient in front of me should actually be observed for another two days, but it involves assessment indicators such as bed turnover rate...

These are all non-medical factors, Zhou Guohui doesn't care very much, just a habit of passing thoughts.

When he came to the ward, Director Song opened the door and introduced to Zhou Guohui, "This is a patient."

Later, she and the patient's family said, "This is Director Zhou of the Department of Neurology of the Imperial Capital Hospital. We invite the patient to consult."

Zhou Guohui glanced at the patient, and his eyebrows wrinkled.

The patient is weird.

His face was pale, probably due to blood loss. Generally speaking, pale lips and pale eyelids after blood loss are normal.

But a few capillaries "crawled" on the patient's lips, as if a few small bugs were lying on his mouth.

"The patient has telangiectasia?" Zhou Guohui asked.

"Uh..." Director Song Yabin was taken aback and nodded.

Zhou Guohui didn't say much in the ward. After all, he was only here for the consultation, especially in the ward to scold other doctors.

Not only that, even in the own hospital or scolding lower-level doctors in the ward, it will have extremely bad effects. This involves the patient's trust in lower-level doctors, which will have extremely bad negative effects.

Zhou Guohui inquired about the medical history in detail, and then had a physical examination. It took a full 20 minutes for one set to come down.

Back at the office, Zhou Guohui said slightly sternly, "Why is telangiectasia not reflected in the medical record? Have you taken a physical examination?"

"..." Song Yabin concluded.

"I just asked the patient. The patient had a history of nosebleeds since childhood. This is not reflected in the medical record." Zhou Guohui talked about the patient, when it came to the medical history, his aura was full. "Director Song, I don't think the physical examination can be sloppy."

"Yes, yes." Song Yabin replied sullenly.

"Give me the imaging data."

Immediately a little doctor brought the film over, with CT and NMR.

Zhou Guohui watched the film one by one in front of the reader in chronological order. He watched it carefully, and it took him 30 minutes to "pass" the film.

Director Song and his doctors waited for Zhou Guohui to make a conclusion, but they didn't expect him to pick up two of the films, insert them into the reader, and look carefully.

It's the chest~www.readwn.com~ Two films, one is the lung window and the other is the mediastinal window.

The little doctors looked at Zhou Guohui in surprise. They didn't understand why a patient with ischemic stroke did not look at the head film, the color Doppler of the blood vessels of the neck, and the blood supply image of the vertebral artery. Why should he look at the lung CT.

Zhou Guohui didn't explain, instead, he reviewed the CT images of his lungs little by little, as if there was some treasure in it.

He watched the two films for twenty minutes.

There was no sound in the office, and everyone seemed to feel that there was a dark cloud covering their heads, the humidity increased, and it was difficult to breathe.

The silence was finally broken by Zhou Guohui.

"Mayuan, can you ask when Teacher Wu will come."

"Director Zhou, have you found anything?" Dean Ma asked.

"The lung CT is a bit wrong. I don't have enough level. I think the patient needs 64-slice enhanced CT. It's better to take a look at the film after Mr. Wu comes." Zhou Guohui casually admitted that his level is not enough, and there is not a hint of embarrassment.

"Okay, I'll urge Teacher Wu again." Matthew De said.

Although he didn't understand why Zhou Guohui wanted to see a chest radiograph of a patient with ischemic stroke, this is clearly a different analysis. But Matthew De had already cultivated to perfection, so naturally he wouldn't ask at this stall. Director Zhou must have his reason.

"Mr. Wu, hello, Director Zhou Guohui said that there is something wrong with the CT of the patient's lungs, and there is no diagnosis at the moment. I would like to invite you to take a look at the film."

"Okay, okay, I'll get in touch now."

Hanging up the phone, Matthew De said, "Mr. Wu will be there in about an hour. He said that he will do a 64-row 3D CT for the patient's chest."

"..." Song Yabin was dumb, this was really simple and rude.

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