Chapter 2376

After explaining the surgical image, Zheng Ren dropped a stone to the ground.

This cardiac X syndrome is not uncommon, but it is particularly easy to ignore. After all, noninvasive examination is difficult to find out. It is normal for patients to travel to countless hospitals without a definite diagnosis.

"Ah ah!" Su Yun was suddenly stunned and then said, "I forgot one thing!"

"Ah? What's the matter?" Zheng Ren asked in surprise.

"Just now, Mr. Wang came to you." Su Yun said, "he asked me if you had time. When you came out, you saw a patient with heart X syndrome..."

"Oh, what does Mr. Wang want from me?" Zheng Ren asked.

"Said there was a patient who had difficulty breathing and fainted when walking. There was no good diagnosis. I want you to take a look." Su Yun said, "Haicheng is preparing for the whole hospital consultation. It's off duty. I don't know if the consultation is finished."

"Oh?" Zheng Ren asked, "do they judge whether it is emphysema or vertigo?"

"Boss, do you want to charge for consultation in the future? Why are we all experts in the imperial capital? It's like asking us to consult like a big girl." Su Yun didn't answer Zheng Ren's words, but nagged about other things.

"Don't be so ugly." Zheng Ren smiled, "has the information come?"

"No, he just asked to see if you were interested." Su yundao.

"Have a look. If you don't understand, let the patient come over." Zheng Ren said casually.

"What are you doing here?"

"..." Zheng Ren was stunned for a moment and then said, "look, touch, listen, look, smell, ask, and see the patient. Do you think remote consultation can solve all difficult and miscellaneous diseases?"

"Boss, why is it like being trampled on the tail all of a sudden?" Su Yun asked with a smile. He just asked casually, but he didn't expect his boss to be so serious.

However, Su Yun didn't care. He just habitually hated his boss and gave it up.

"Don't talk nonsense. Ask Mr. Wang for information." Zheng Rendao.

Su Yun took out his mobile phone, and his hands almost flashed back and forth on the mobile phone screen with remnants.

The whole hospital consultation is not over yet. It seems to be very troublesome, Zheng Ren judged. Whether it's the patient's condition or the patient's family, there will be trouble.

Soon, President Wang sent the patient's information.

The patient complained of general weakness, fatigue and dyspnea for three months.

He doesn't smoke or drink. He doesn't have a pet at home. He usually eats normally. There has been no special change recently. There is no history of previous disease, no family history, etc. Working as a bank clerk, there is no chance of exposure to dust and other metal substances.

But suddenly, this situation will not heal for a long time, and neither the patient nor the doctor can do anything.

At the first visit a few months ago, a chest film was made, diagnosed as lower respiratory tract infection, and targeted treatment was carried out.

After anti-inflammatory and symptomatic treatment, his symptoms improved at the beginning, but recurred again a month later. What's more strange is that his X-ray didn't seem to have any problems after the second time.

All the tests were done, but there was still no problem with the patient.

Just looking at the examination results, this is a very healthy person. However, according to President Wang's description, the patient's condition is very serious. Now he can't go up the stairs. He walks on the flat ground and trembles. He has to take a rest after taking a few steps.

Looking at the patient's condition profile, Zheng Ren sat on the chair in Zhou Litao's duty room and began to think about it.

"Brief introduction to medical treatment, such as serious cor pulmonale, but there is no problem with chest film and lung CT display." Su yundao.

Zheng Ren clicks the mouse to enlarge the chest film image.

"Do you want raw data?" Su Yun asked.

"No, I can see it clearly." Zheng Ren said, "there is no wheezing sound in the medical record. Su Yun, do you think asthma can be ruled out?"

"In the early stage, it can be seen that the permeability of both lungs increases during the attack of asthma, showing an over inflated state. There is no on the film, but there are also reasons why the film is not in the attack of asthma." Su Yun continued: "but I don't think about it. I didn't mention wheezing at all. I don't think this obvious symptom should be overlooked."

With that, Su Yun smiled, "no matter how it is, it is a third-class hospital. If you can't hear the roar, President Xiao can take the blame and resign."

"Well, and when asthma doesn't attack, it doesn't consider the symptoms of limb weakness." Zheng Ren added, ruling out the possibility of asthma.

"There's nothing wrong with the heart check. The 24-hour ambulatory ECG was also checked. The patient is very healthy."

"Epilepsy?" Su Yun asked.

"It's possible. It's possible that the patient complained about his symptoms and kept the diagnosis of convulsions... It's not right. If his limbs are weak... Although it's unlikely, it's possible." Zheng Ren said in a deep voice.

Su Yun recorded the diagnosis of epilepsy on A4 paper. If you want to make a clear diagnosis, you can give the patient an EEG examination when the attack occurs.

After all, it is a remote consultation. It is unlikely to check whether patients have other reactions during activities and make a clearer diagnosis.

"What about pneumonia?" Su Yun said, "the first X-ray can see a faint image of inflammation. Although it is not in the later stage, it can not be simply ruled out."

"Anatomically classified as lobar pneumonia, lobular pneumonia and interstitial pneumonia. According to the state of the patient, I think interstitial pneumonia is more likely."

"The etiology is divided into bacterial pneumonia, viral pneumonia, mycoplasma pneumonia, pneumonia caused by other pathogens, fungal pneumonia and pneumonia caused by other non infectious factors, such as radiation pneumonia, inhalation pneumonia and allergic pneumonia..."

Zheng Renhe and Su Yun checked all the way and began to make various differential diagnoses.

Zhou Litao watched silently in the back. The patient was only 34 years old. His limbs were weak and he had difficulty breathing. He did a lot of tests and did not make a clear diagnosis. It was strange to look at him.

The first thing he thought of was that the patient's age was wrong.

34! The patient looks 134 years old.

……

……

Haicheng, Municipal First Hospital.

Although they are off duty, the doctors are still working like worker ants.

President Wang is attending the hospital consultation.

As a support expert of the imperial capital, the first municipal hospital will ask him for help when consulting the whole hospital.

But this time, President Wang had no idea, so he had to use the ultimate skill - Summoning boss Zheng.

"The patient's family members are very dissatisfied. They haven't been diagnosed after so many tests." The perimeter of the medical office knocked on the table with his fingers and said in a deep voice, "if there is no clear diagnosis, the patient will be referred to the superior hospital."

The director of respiratory medicine nodded.

She had long wanted to transfer the patient away, but she was still worried because she was given symptomatic treatment for pneumonia diagnosed in respiratory medicine for the first time.

No one expected that an ordinary pneumonia patient would not heal for a long time, and finally became a huge trouble.

I just can't help it. I really can't understand it. If you don't go to the superior hospital, I'm afraid the patient's condition will be more and more serious.

According to the degree of dyspnea, it is not impossible to get on the ventilator in a few days.

In that case, once you enter the ICU

Director He of respiratory medicine has begun to think about patient referral. It's not important to fail to understand the disease. Who can guarantee that all diseases can be understood.

As long as the patient doesn't "hit" it in his own hand.

Director he began to think about how to communicate with the patient's family for a while. Would it be better to go to the provincial capital or the imperial capital? It seems that if it is a provincial capital, the patient's family members are more acceptable. After all, the road is closer.

But she didn't think the provincial capital could solve the case. Such a strange situation... Thinking, she was a little distracted.

The next few directors who came to the consultation also expressed their views, which were very simple, and they didn't have anything special to say.

Check what, what's normal, what to say.

It's all about wheels. It's totally meaningless.

President Wang repeatedly recalled the patient's illness, but he still had no clue. Autonomic nerve dysfunction? Or hysteria? It doesn't look like it.

It is quite difficult for a 34 year old man to be hysterical to the point where he is panting when walking.

Just thinking, the mobile phone vibrates.

President Wang glanced at Su Yun's phone. He smiled at director Zhou and went out to answer the phone with his head down.

Fortunately, this is not 912. Director Wei should sit here or preside over the consultation of the whole hospital. Is director Lin afraid of being scolded? As for director ye, President Wang didn't dare to think about it at all.

For ordinary doctors, director ye qingqiuye of the medical department is the governor of the royal guards. If he comes forward, he will be stripped even if he doesn't die.

The head of the Department shook his head and looked around at the directors of various relevant departments of the first municipal hospital. Seeing the expressions on their faces, he guessed one or two.

Everyone has no choice.

While handling the referral procedures, they were sent to the provincial capital by 120 ambulance. As for who the provincial capital contacts, director Zhou thinks it's better to let the patient's family members contact first.

If such things are done more, the patient's family will certainly think that there is a problem in the hospital diagnosis and treatment. If they are not justified, how can they be so attentive.

Among them, discretion mainly lies in a degree. How to grasp director Zhou has gradually become an eyebrow. Clinical work is really troublesome. Thinking about it, the head of the Department is bored. When can I go to logistics?

"That's settled. Director he, go and communicate with the patient's family members." Zhou chuchang said, "this disease..."

"Director Zhou." President Wang came back with his mobile phone and interrupted director Zhou.

"Mr. Wang, what do you think?" Asked the director.

"I just consulted boss Zheng. He said he suggested to check an EEG when the patient has difficulty breathing. In addition, I also need to check a lung enhancement CT." President Wang said very seriously.

He didn't change his expression because it was boss Zheng's consultation opinion, but calmly stated a fact.

Director Zhou was stunned. Zheng Ren? He suggested doing lung enhancement CT.