Chapter 365

There must be a key point in diagnosing a disease!

Only when we can find this key point can we make a clear diagnosis in the real sense.

This is what modern medicine says: the gold standard of diagnosis!

For example, tuberculosis diagnosis can detect Mycobacterium tuberculosis in sputum culture, such as cancer diagnosis, finding cancer cells in tissues and so on

But!

Many diseases have no gold standard.

This requires finding a main clue that can help diagnose the disease!

Once you find this, you can help diagnose the disease.

Chen Cang took a deep breath and looked at the old man again. His eyes were full of awe.

Chen Cang nodded slightly to express his thanks!

The old man just smiled faintly, nodded and didn't speak.

……

……

The old man is powerful, right here.

However, the most powerful is not only here.

The most powerful thing is the philosophy of dealing with people.

He knows that Wu Yushu has a problem. Maybe the problem is not small, but he won't say it directly.

He knows this is a hospital and needs to listen to the doctor.

Even if the old man is a famous doctor and a powerful doctor, he will not exceed his authority, let alone tell Chen Cang what to do.

However, as a doctor, seeing the patient's diagnosis encounter something, his heart does not allow him to stand idly by.

At this time, Chen Cang's operation of "measuring blood pressure" appears to have high Eq.

If the old man asked Chen Cang to make a chest film, an electrocardiogram, or even a color Doppler ultrasound, would the patient be willing?

What does the patient think?

Your doctor won't give a diagnosis and ask others to help?

Patients will not think that doctors are quacks!

I won't even follow the advice to check.

And taking blood pressure is from the patient's point of view, do you think? Take a blood pressure, what a simple thing. Anyway, it doesn't cost money. It's just a simple examination.

First, the patient did not reject the heart and listened to the suggestions.

Second, doctors can also get a lot of useful clues.

It can be said that the problem was solved when the clouds were light and the wind was light, which is very powerful.

Never underestimate the sphygmomanometer. It seems simple.

However, this blood pressure test can also find a lot of things.

This is the deep place.

Odd pulse refers to the phenomenon that the pulse weakens or even disappears obviously when inhaling, and appears or returns to its original state when exhaling. Observing odd pulse with sphygmomanometer is more intuitive and obvious than palpation with fingers.

Experienced doctors can feel the same thing for the first mock exam.

The principle of odd pulse is that the increase of pericardial pressure limits the diastolic filling of the ventricle, the return of systemic vein during inhalation is limited, and the blood volume discharged from the right ventricle into the pulmonary circulation is reduced, while the pulmonary circulation is affected by respiratory negative pressure and the pulmonary vessels are dilated, resulting in the decrease of the blood volume of pulmonary vein flowing back into the left heart and the decrease of left cardiac output, resulting in the weakening or even disappearance of the pulse.

The occurrence of odd pulse is common in right heart failure, pericardial effusion, constrictive pericarditis, and severe asthma.

With this diagnosis, what Chen Cang needs to do next is simple and clear.

The auscultation sound of the heart just now matches the strange pulse at this time. Chen Cang now knows about Wu Yushu.

Nine times out of ten is constrictive pericarditis!

However, if you want to make a diagnosis, you must have a basis. Thinking of this, Chen Cang observed carefully. With Wu Yushu's breathing, the anger of the jugular vein in the neck can be seen vaguely, but it is not very obvious because he is fat.

Chen Cang thought of Wu Yushu's saying that he had a bloated stomach, indigestion, poor appetite and so on.

"I'll touch your stomach," he said

Wu Yushu is very cooperative in raising his legs.

After Chen Cang's abdominal percussion, he was slightly silent. There may be effusion in the abdominal cavity, accompanied by large liver.

At this time, Chen Cang can already judge 7788.

Thinking of this, Chen Cang asked about the disease history and inducing factors in detail.

After that, Chen Cang looked at Wu Yushu: "your current performance and my examination of you just now, I feel that you are more like a constrictive pericarditis."

When Wu Yushu heard this, his eyelids jumped and he was startled by the professional term.

He has heard of pneumonia and rhinitis, but it is the first time he has heard of pericarditis!

Thinking of this, Wu Yushu's face changed: "what is this pericarditis? What does it mean?"

Chen Cang explained: "constrictive pericarditis is a disease caused by chronic pericardial inflammation, which acts on the human body for a long time, resulting in pericardial thickening, adhesion and even calcification, limiting cardiac relaxation and contraction, reducing cardiac function and causing systemic blood circulation disorder."

"Your breathing pain, chest pain, including abdominal distension are directly related to this!"

Wu Yushu was frightened to tell the truth.

He can't be sick

This is the key.

The heavy burden is on him. How dare he get sick?

Dare not rest, let alone get sick?

Thinking of this, Wu Yushu quickly asked, "doctor, is this serious?"

It's really hard to say whether it's serious or not, but when Chen Cang saw Wu Yushu, he had to tell the truth:

"To tell the truth, it is not a simple disease, because long-term development will not only affect the cardiovascular system, but also accumulate diseases of the liver, lungs and other systemic systems."

Wu Yushu's heart clicked: "this... Do I need to be hospitalized? Or should I take some anti-inflammatory drugs?"

In Wu Yushu's heart, you should take some anti-inflammatory drugs, right?

But... The inflammation in his heart made him feel at a loss.

Hearing Chen Cang's explanation, Wu Yushu seemed very serious and was immediately afraid.

Chen Cang couldn't help shaking his head: "if constrictive pericarditis, it is mainly surgical treatment, supplemented by drug treatment, and the sooner the better. Moreover, the effusion in your abdominal cavity still needs to be extracted. My suggestion is to arrange hospitalization as soon as possible."

"After hospitalization, improve the relevant examinations, and then make specific diagnosis and treatment."

Chen Cang said everything he should say.

He could see that Wu Yushu seemed to resist the inspection for two reasons: economic pressure and time delay.

But when the disease comes, it should be treated.

However, the examination can be done after hospitalization.

In this way, you can go to medical insurance and reimburse a large part of the inspection expenses.

This is Chen Cang's greatest effort.

Therefore, Chen Cangcai did not ask Wu Yushu to have an examination in the clinic as soon as possible, but hoped that he could be hospitalized as soon as possible.

When Wu Yushu heard Chen Cang's words, he was a little silent. He sat there and didn't say a word.

At this time, Chen Cang received the old man.

Seeing the old man, Chen Cang didn't know what to say. After thinking about it, he said, "old man, what can I do for you?"

The old man handed over the emergency registration: "give me an ECG, a little flustered."

Chen Cang's eyes shrank when he saw the old man's name!

Perhaps most people don't understand this name.

However, in the medical field of Dongyang Province, or in the field of traditional Chinese medicine, this represents a very different meaning.

Chen Cang also learned the name by chance. Unexpectedly, he could see the big man!

National Medical Master: Zheng Sanshui!

PS: Hey hey, it's the third watch, actually

Qimai is actually a very interesting thing. I really met it.

Finally... Brazenly ask for a ticket, cough!