Chapter 1363

"Come on, do a physical examination!" Zhang Fan has not been obsessed with this problem. He is very clear. When he finds this problem, when the ward round is over, the Department will not go through the medical records of the past five years, but at least the medical records of the past two years.

In the early days, medical records were records of the occurrence, development, prognosis, examination, diagnosis, treatment and other medical activities of patients. When it was simple, the medical records were wonderful.

Doctors will write their own conjectures or their own views on the future development of the disease. A medical record is a doctor's depth of understanding of the disease. Later, medical records played a new role and became the legal basis for disputes.

Then the medical records are not much to read. They are all the same. They are full of possibilities, maybe and No. let alone write their own opinions. Even the treatment can be signed by the superior doctors and their families.

Therefore, the current medical record is to look at the examination pasted on it. As for others, they fit perfectly, you can't see anything useful.

The patient is a young man, thin and fit for ordinary people. He is like a broad monk's robe, but the color of blue and white makes him feel like a T-Bag in prison break.

Cheekbones are raised, eye sockets are deep, eyes are open, and white eyes are more benevolent than black eyes. Obvious malnutrition.

"Why are you not feeling well?" Zhang Fan started physical examination while asking.

"It's just a stomachache! I don't want to eat. " Zhang Fan nodded his head, matched his hands, turned the knife with four fingers, and began to touch his finger belly counterclockwise.

"Does it hurt?"

"No pain!"

One lap down, from left to right, I didn't find any pain points.

Zhang Fan looked up at the patient's expression, no pain, and then looked at the tube bed doctor.

It means that there is no pain in the whole abdomen. What you wrote is suspected appendicitis. You invited a general practitioner to come for consultation. You want a general practitioner to operate. How did you learn this diagnosis? Did the biochemistry teacher give you a diagnosis class?

"He has paroxysmal pain. There is no abnormality when he is not in pain, but his position is passive when he is in pain. When the general foreign doctor came, he was well. When the general foreign doctor left, he began to hurt. Now he is well again! "

The doctor in charge of the bed pursed his lips and looked like he was dying of injustice. To tell the truth, the department director is afraid of Zhang Fan, but the little doctor is not afraid of Zhang Fan. Not only are you not afraid of Zhang Fan, but also you have the ability not to ask me.

The profession of doctor is very wonderful. If a person who wants to be a part-time official in the hospital is very easy to manage and doesn't need your management, he will work hard to get close to the organization. He is afraid of this kind of person who doesn't ask for merit but no fault.

Anyway, I'm just a little doctor. If I don't get close to you, don't worry about me. Just give me the salary and bonus on time. I don't want your front guard or your guard with a knife.

Moreover, Zhang Fan is a surgeon and young. He is a young internal medicine doctor. In fact, he is quite unconvinced. No matter how awesome your operation is, it's also surgical and doesn't understand anything.

Really, it's no exaggeration. It's obvious that doctors have this experience when doing medical treatment. Surgeons suppress physicians in income, and physicians always surpass surgeons in spirit.

But to be honest, the digestive department of internal medicine is a little similar to the general surgery of surgery. The disease is complex and difficult to diagnose. This department is difficult to do.

In detail, this thing is too difficult. First of all, the feedback of abdominal pain is not accurate. For example, a comatose patient was sent to the outside of God first. The doctor said that there was no organic change in the brain and respiratory failure. This is a matter of the respiratory department.

Then the patient came to the respiratory department. The doctor in the respiratory department looked, "quickly transfer to the digestive department. This is a willingly encephalopathy."

After being sent to the gastroenterology department, the doctor said, "come on, check it first." The family members were unhappy and scolded the digestive doctor. If you don't do anything, you have to have an examination. How do you become a doctor.

Digestion is also very wronged.

Gastroenterology is very similar to general surgery. General surgery can also have an exploratory laparotomy, while gastroenterology can only see the doctor's technology.

It's hard to guess the heart, and so is the disease. Moreover, when you think about it carefully, the tissues and organs in the abdomen are a little like Yan Laoxi in those days. They are self-contained. They usually seem very honest and listen to the orders of their superiors, but when this thing comes to a critical moment, it doesn't listen to the orders of the brain.

Not only don't you listen to the command of the brain, you may have to send troops to turn over the brain first. For example, in patients with liver coma, this is the ammonia from the liver into the brain and turn over the brain. This is not what sending troops is.

Zhang Fan looked at the grievance of the bed doctor with a complaining face, looked at the slightly embarrassed director of the digestive department, and smiled gently.

It's not much to say. Technical units often have wishful thinking if they want to convince each other verbally, unless they lie down with their identity, but Zhang Fan won't. It's too technical.

Those who engage in technology are those who don't see the coffin and don't shed tears. You can't convince her technically. You can't press her out of breath with technology. She will always raise her mouth and say: that's it? I've seen bigger!

Therefore, Zhang Fan smiled gently and seemed to say: it's time to show real technology.

"Fold your legs, bend your knees, take a deep breath, breathe out, and spit out clean air. That's it. Do it again."

The young and thin patient was squeezed by Zhang Fan's hands like a doll.

"What are you doing? Increase the amount of exercise and cause symptoms? " The bed doctor looked at his director slightly incomprehensibly.

The director glanced at her as if to say, "no learning, no skill!"

Of course, Ren Li, Yan Xiaoyu and Ouyang all understand.

Zhang Fan wants to do a deep abdominal physical examination.

When CT, MRI and Dr dominate the medical field, not to mention the deep physical examination method, even the ordinary physical examination is almost lonely.

Few people can see the deep physical examination now, because it is not only difficult to operate, but also prone to accidents.

With advanced instruments, who needs NIMA to take risks.

So, let alone patients, some young doctors have heard of it and haven't seen it.

Ordinary examination is quite exquisite. Four fingers and finger abdomen scratch the skin, rising and falling, like a couple. The girl first says to take a bath, then seduces the boy, pouts her mouth, and four fingers gently scratch the boy's eight abdominal muscles.

Well, how amorous it is.

The in-depth examination is more rude. In a vulgar way, a man with big cheeks hasn't seen the opposite sex for more than ten years, and then suddenly gave him a opposite sex.

Hands together!

The hands are folded together, just like artificial respiration, and then in the patient's abdominal cavity, the depth fluctuates. For patients who don't have much muscle fat, the abdomen is like a flattened and bulging watermelon.

It's frightening to look at it. I'm afraid that the patient's stomach will be crushed by carelessness.

"Breathe, breathe! Hoo, come on, spit, spit desperately, come on! " I don't know. I thought NIMA was doing something.

Thin patients, the eyes pressed by Zhang fan are almost protruding. It's really no exaggeration. Not only the eyes were coming out, but also the tongue was being pressed out, and the patient was a little frightened. If so many doctors were not around, he would definitely think Zhang Fan was going to murder him.

It's really difficult to press your hands across your belly to a depth of about 10 cm and touch your organs. You can't feel like you can read a novel, and then you can experiment with your girlfriend in bed at night.

Don't let your girlfriend pull a bed instead of doing a physical examination. Making a pool of stool is the lightest. If it is not done well, it is a matter of human life. When it comes to substantive organs, it is massive bleeding, and when it comes to hollow organs, it is rupture and infection.

Zhang Fan's in-depth physical examination shows that in the early stage of exertion, he should sink quickly and vigorously with the moment the patient exhales, and when he comes near the organs, he should recover his strength quickly.

How to say, it's like a bull galloping at high speed. I thought it would destroy the woman in front of the bull. As a result, in front of the bull, the bull brake quickly and kissed the woman's lips gently. The light woman can't even feel kissing!

This is the requirement, and Zhang Fan should not only touch the organs, but also feel the abnormalities of the organs. Therefore, this kind of physical examination is too difficult.

Up and down,

Up and down,

The patient's frightened expression showed his eyes open.

Then, under Zhang Fan's deep pressure for more than a dozen times, the patient finally shouted: "it's here, it's here, it's here!"

The sweat of Zhang Fan's head. This thing is individual work.

When the patient shouted, Zhang Fan stopped the action for the first time, determined the position, and then made a nail mark on the skin.

The female doctors in charge of the bed are stupid. Not only the female doctors in charge of the bed, but also Yan Xiaoyu.

Really, for many years, few people have used this way of physical examination, but today I finally see it, and it's still so popular.

Yan Xiaoyu looks at technology, and the female doctor in charge of bed is like watching a small film for the first time. It's not why the female number one is not dressed, but whether the male number one is full of gas.

Tanima is amazing.

Up and down, she even worried that the patient's liver would be crushed by Zhang Fan.

"CT and MRI couldn't find the lesion, but the body was found!" Yan Xiaoyu muttered to herself.

"Can it be diagnosed now?" Zhang Fan asked the bed doctor. The bed doctor was not convinced and changed.

Like a little white rabbit seeing a big tiger, he began to politely say, "Dean, Dean seems to be colonic diverticulitis!"

Um! Zhang fan can't say.

"After three days in hospital, there is no way to diagnose. Not only do I not think of a way, but also prevaricate the patient. Director Li, is this OK? Today, I checked out this disease. If another one can't be diagnosed tomorrow, do you want me to have a physical examination?

Am I going to be the director? "

Zhang Fan doesn't talk about the bed doctor, but he can't let go of the director.

The director's sweat is flowing down, as if he did the operation just up and down!