Chapter 1979

"Huh?" Su Yun blew a very impolite cigarette on Yu Zong's face, "it sounds like something big."

Zheng Ren is also curious.

"The patient's eldest son is a friend of director Liu. He lives in the special needs ward now." President Yu said, "so the patient belongs to me."

This is the rhythm of other professors. Director Miao has an accident and changes the director. It is estimated that there will be a fight in private.

Director Liu has just come up, and his foundation is not stable. If you think about it carefully, you can think about it all day.

However, Zheng Ren has no interest in these things. What he cares about is what kind of hematuria will make Yu worry.

Hematuria is usually caused by stones or tumors.

It must not be so simple to make Yu always difficult. As for some common factors, Zheng Ren did not consider them. It's supposed to be complicated. Maybe it's caused by some rare diseases.

"Tell me about the situation." Su Yun asked.

"The patient has no positive signs. The old man is still taking care of the daily work of a listed company before he is hospitalized."

"Oh? Quite rich. Listed companies, tut tut." Su Yun praised.

"Ask the medical history. Concentrate." Lin Yuandao.

"Why don't I concentrate? It's part of past history." Su Yun said contemptuously, "do you know how many people you need to see every day to take care of a listed company? How much wine you drink a month? Do listed companies directly queue up for listing or buy a shell for listing?"

“……”

"Don't make trouble. Listen to Yu." Zheng Ren feels a little annoyed. Su Yun's grinding is not enough. Now he has an opponent who is not his opponent and talks more.

"The patient complained about hematuria for half a month and was admitted to the hospital. Routine urine examination in the outpatient department: occult blood (+ + +), protein (+ + +); abdominal ultrasound: large liver, dilated right hepatic vein, large spleen and a small amount of peritoneal effusion. Urinary ultrasound: benign prostatic hyperplasia with stones."

"At that time, it was considered whether there was nephrotic syndrome or urinary tuberculosis."

"Urinary protein is more than 3.5g/d and plasma albumin is less than 30g / L. there are no two points." Lin Yuan asked.

"Listen to the medical history and don't interrupt." Su Yun said contemptuously.

Zheng Ren feels a little headache.

"Well, none. Tuberculosis is also considered negative." President Yu carefully replied that he didn't know the origin of the new long legged beauty from the medical group.

Dare to quarrel with Brother Yun, which is not what ordinary people can do.

"Mr. Yu continued, leave them alone." Zheng Ren pondered.

"Serum tumor markers: normal range; multiple urine cleaning smears for acid fast bacteria: negative; chest X-ray film: right pleural thickening and calcification; ECG: sinus rhythm and normal ECG; lower abdominal CT: whole process and branch expansion of inferior vena cava, branch limited expansion of hepatic vein; a small amount of ascites."

"Wait a minute, does the chest film have pleural thickening? Does the patient have a past history?" Zheng Ren stopped Yu Zong.

"No, I asked in detail. I also thought there was something wrong with the chest film, so I gave the patient a CT. According to the chest CT, the pleural thickening, adhesion and calcification, and the pericardial wall was slightly thickened."

"See the film later." Zheng Rendao.

"What do you suspect?" Su Yun didn't quarrel with Lin Yuan either. He calmed down and asked.

"I don't know. Hematuria needs to check whether it is congestive heart failure, but only a small amount of calcification will not lead to heart failure. Moreover, from the general description, I can guess that the old man is in good health and won't have such a serious problem as congestive heart failure." Zheng Ren analyzed.

"Well, boss Zheng is right. The patient is in good health." President Yu said: "before admission, it is said that he can play table tennis for two hours."

"I'll go..." Su Yun was surprised. "How old is the patient?"

“72。”

It must not be congestive heart failure, Zheng Ren concluded.

Heart failure is due to low ventricular pumping or filling function, cardiac output can not meet the needs of body metabolism, insufficient blood perfusion of tissues and organs, and congestion of pulmonary circulation or systemic circulation. It is a clinical syndrome in which various heart diseases develop to a serious stage.

Generally, this situation occurs, and the patients have reached the time when they are terminally ill.

But playing table tennis for two hours the day before yesterday can't consider congestive heart failure.

"Take a look at the film first." Zheng Rendao.

"I'll find it." President Yu turns on the computer in his duty room and starts looking for the patient's film.

Zheng Ren thought about the patient's situation in his mind. It's not a tumor, it's not a stone, it's not... What's that?

"Mr. Yu, what do you think it is?" Su Yun asked.

"I see the old man every day, but when I went to see him yesterday and today, I always thought he was pretending to be ill." Without hesitation, Mr. Yu directly said his most real thoughts.

"Hematuria?" Su Yun and Lin Yuan asked suspiciously at the same time.

"It may be oral drugs that cause hematuria." Zheng Ren said, "since President Yu has no disease to consider for the time being, this one should also be added."

"As for?" Lin Yuan asked.

"Haven't you seen anyone cheat on insurance?" Su Yun looked at Lin Yuan contemptuously and saw her face at a loss. He knew that this was a rookie. He only knew that he had not evolved to consider human nature from the analysis of his condition.

President Yu transferred out the film and gave up his seat.

Zheng Ren was also welcome. He sat down and began to roll the mouse pulley.

Watching films frame by frame and pondering bit by bit, Zheng Ren became more and more confused.

The imaging data of the patient is just like what president Yu just introduced. There is not much to see. It's definitely not a tumor. There's a little problem with the liver. The portal pressure is not very high depending on the situation.

Normally, there will be no continuous hematuria.

"Mr. Yu, why do you suspect that the old man is pretending to be ill?" Zheng Ren asked.

"I'm in good health. I can't find a reasonable explanation." President Yu said: "once when I went to the ward round, the old man went to the bathroom. I wanted to see the urination. He washed it away directly by the water."

"Personal hygiene, what's good about it?" Lin Yuan asked suspiciously, "if you want to see it, just check a urine routine and you'll know soon."

"Lin Yuan, not so." Zheng Ren said lightly, "what president Yu said is still reasonable, but president Yu, have you found aminopyrine, phenytoin sodium, rifampicin, phenol red and other drugs around the patient?"

Yu always shook his head.

"It's also wrong. If it is caused by oral drugs, how can there be red blood cells in urine routine." Lin Yuan caught a flaw and asked.

"Just get some fingertip blood. It's the kind to measure blood sugar. It's very simple to want red blood cells in urine." Zheng Ren is still watching the film, light and shadow skip, so focused.

Lin Yuan was stunned.

Is it really going to be so complicated? Also fingertip blood drops in the urine of routine urine examination... But think about it, it's really possible.

Except for the serious patients in ICU, the urine was left by the patients themselves. If you want to do something, you have a lot of opportunities.