Chapter 268

As a doctor, to treat people, the most important thing is to learn to see the essence through the phenomenon

For a patient with stomachache, do you know exactly where the pain is? Then we can judge the cause by the location.

for example, when Xu Ze has found that the patient has obvious gallstones through color Doppler ultrasound, and the gallbladder also has swelling, it can be basically determined that the patient's abdominal pain is mainly caused by this gallstone.

But doctors are not so easy to be a profession, and it is not so simple to see a doctor. Xu Zefang just wanted to cope with the examination, but he forgot what was very important to a doctor.

That is, in addition to the main diseases, we have to identify and analyze other diseases, because such abdominal pain can be caused by gallstones, gastritis and even pancreatitis.

At present, Xu Ze has been able to confirm that the main gallstones, but also to exclude the corresponding other possible diseases Although the possibility of merging other diseases is small, but as a doctor, we should not ignore it because of the small possibility; because many times, we just don't pay attention to a little problem, which leads to serious consequences

Now Xu Ze suddenly thinks of this problem. Although there should be no big problem, for him who has always been cautious and is always responsible for the patients, it is a problem that can not be ignored.

So he calmed down again, started color B ultrasound, and scanned the patient's stomach and pancreas.

Color B ultrasound can effectively judge the overall changes of pancreas and stomach, through this examination, we can roughly judge whether there are abnormalities.

Color B ultrasound scan results let him a little lower heart, the patient's stomach did not find any major problems, and the pancreas is also very smooth, it seems that there is no abnormal situation.

Xu Ze at this time is almost at ease, but think of the recent three levels of system function in the new blood amylase function, then also smoothly for the patient to do.

This blood amylase test is the most standard test to exclude whether there is pancreatitis. As long as this determination is made, it can completely confirm whether there is a problem. It is more accurate than simple color B-ultrasound scanning.

With his order, he quickly ejected a fine needle of cow hair from the ring of the right index finger of the patient's pulse, and gently pricked the wrist of the patient. Before the patient knew it, he took a little blood for test.

"1200ul" Xu Ze frowned at the red value displayed on his glasses, and his blood amylase obviously exceeded the standard. The patient was actually complicated with pancreatitis!

however, the main diagnosis was gallstones, and the second diagnosis was pancreatitis. In terms of traditional Chinese medicine diagnosis, there should be no problem in the diagnosis of cholelithiasis.

Then he stood up slowly, nodded to the elders who were already impatient, and then said, "Mr. Guo, I have finished my examination..."

Listening to Xu Ze's words, all the predecessors also nodded slowly. Wang Laoguo was relieved to see that Xu Ze's face was serious but still confident.

At first, Wang saw Xu Ze's hesitation and hesitation. He saw that Xu Ze was weaker than some other rookies in traditional Chinese medicine. He was worried about whether Xu Ze could pass the test smoothly. But now, although Xu Ze spent more time, he seemed to have enough confidence. Naturally, he put down his heart a little.

Wang laoguoshou now for Xu Ze failed to pass, on his reputation is not too concerned, he is concerned about the young man is really very good, if you can not pass the examination to get a license, it is really a pity.

Old president Guo looked at the young man with a solemn face, then nodded gently and said, "OK Now that the diagnosis has been completed, Xu Ze, please answer the diagnosis basis and treatment plan of this patient... "

"The main manifestations of the patient are epigastric pain, bitter mouth and anorexia of oil Western medicine physical examination showed mild tenderness in the right upper abdomen and positive Murphy's sign Therefore, TCM diagnosis considered: cholelithiasis, liver qi stagnation type, treatment principle for soothing liver and regulating qi, prescription selection: Chaihu Shugan San Acupuncture and Moxibustion: take the points of Riyue, Qimen and gallbladder, match Zusanli and Zhongwan... "

Speaking of this, Xu Ze couldn't help but squint his eyes and looked at the expressions of the first few senior Chinese players See Wang Laoguo hand smile gently nod, the bottom of my heart this is a big sigh of relief, as long as this is not wrong, then I don't worry about

The following diagnosis and treatment of Western medicine, for Xu Ze, it is no longer simple. Xu Ze, in a relaxed mood, continued with a light smile: "western medicine diagnosis considers: acute cholecystitis, gallstones; does not rule out the possibility of acute pancreatitis It is suggested that liver and gallbladder color Doppler ultrasound, blood routine examination and blood amylase examination should be carried out. In terms of treatment, Cefradine and ofloxacin should be used for anti infection treatment, and cimetidine for acid suppression and 6542 for spasmolysis and pain relief

"If gallstones are confirmed by relevant examinations, the patient's physical condition is acceptable. It is recommended that surgical treatment be carried out under the condition of effective anti infection and inhibition of gastric acid to protect the pancreas..."

After listening to Xu Ze, old president Guo frowned slightly. Although he has gradually accepted Western medicine in recent years, he is still very resistant to the surgery that western medicine is good at.Because in his opinion, if conservative treatment can be carried out and traditional Chinese medicine is used to assist in stone removal, it will naturally be the last thing. After all, western medicine surgery, although simple, is after all a matter of killing the enemy 3000 and losing 800, which is not in line with the way of traditional Chinese medicine.

However, at this time, although he was not satisfied with the treatment proposed by Xu Ze, the operation belonged to the category of Western medicine after all. Naturally, he could not easily deny it. He turned to the two professors of Capital Medical University and waited for their judgment.

Old president Guo looked at Professor Tang Wuyou and Professor Jiang Lingyun, but found that they were looking at Xu Ze, and there was a trace of surprise in their eyes.

Professor Guo was stunned and puzzled at the two professors: "two professors, please comment..."

Tang Wuyou and Jiang Lingyun looked at each other, then Jiang Lingyun nodded and said with a smile: "old Guo This son examines dialectically extremely closely The diagnosis of acute cholecystitis and gallstones is very clear, and the treatment plan is clear. "

Hearing Professor Jiang's words, old president Guo was stunned. Did Xu Ze's young man really have such a high level of Western medicine?

And Wang Laoguo hand next to him is also gently jaw first smile, Xu Ze finally did not let him down

However, several new comers, especially Guo Yujian, looked at Xu Ze with a trace of admiration in their eyes. They all studied traditional Chinese medicine, but western medicine could reach this level. Naturally, they could not match it

Guo Yujian, in particular, was also restrained by his arrogance.

just as he was surprised, he heard Professor Jiang suddenly say, "it's just..."

"But what?" Mr. Guo was stunned again, but he didn't find it strange. Although Xu Ze seems to be very skilled in western medicine, he is still too young after all. It is likely that there will be some places with poor heat.

At the moment, he was also a little happy. If Xu Ze had no problems in this round of examination, he would have been able to participate in the examination of Chinese medicine rookies as a student of Western medicine. If he could be so good-looking, then the faces of all the people present were not good-looking.

Moreover, his grandson Guo Yujian was already the first one today, and had a lot of face with him. However, if Xu Ze can achieve such good results in this round, he can keep pace with his grandson who has been carefully cultivated for more than ten years Naturally, he was not very comfortable in his heart

At the moment, it seems that there are still some omissions in Xu Ze's answer. He is a little relieved and said with a smile: "Professor Jiang is in charge of the assessment today. He should have his own words, but it's OK to say so If there is something wrong with Xu Ze's diagnosis, it should be pointed out by Professor Jiang. "

Jiang Lingyun nodded with a smile, but then he asked with a curious smile at Xu Ze: "is doctor Xu..."

"Professor Jiang I'm Xu Ze! " Xu Ze looked at Jiang Lingyun like this, but also followed a Leng, in the bottom of his heart secretly generated doubts, is he wrong?

"Dr. Xu The basis of your diagnosis of acute cholecystitis and gallstones is very clear, and the diagnosis is very good. But how can you be sure that he has the possibility of acute pancreatitis? " Professor Jiang looked at Xu Ze and asked curiously.

Listening to Professor Jiang's words, Xu Ze's heart was also free of a trace of color, secretly: "do these two professors do not know that patients have the possibility of acute pancreatitis?" Looking at Professor Jiang's appearance, Xu Ze had some knowledge. The two professors must have seen the patient in advance, but they did not carry out detailed examination and examination, so they did not confirm this conclusion.

However, Xu Ze of course is not to say that he did blood amylase for patients to determine Of course, he had his own preparation, and he had already thought of a way to defend himself.

At the moment, he said with a smile: "Professor Jiang, the patient reported that before the abdominal pain, he had a large amount of eating greasy fried rice and beer, and had abdominal pain in the rear. Although this kind of overeating and the abdominal pain after eating alcohol are one of the factors that can cause cholecystitis attack, there is also acute pancreatitis, which must be considered, because this situation is the first in internal medicine It has been mentioned that this kind of overeating and drinking liquor can lead to this kind of serious disease... "

"Therefore, I think that although we can judge the possibility of cholecystitis and cholecystolithiasis through the positive of Murphy's sign, this kind of situation can't be ruled out naturally, and the possibility is not small So, I proposed this complication... "

After listening to Xu Ze's analysis, Professor Jiang and Professor Tang Wuyou looked at each other in amazement, but they didn't expect that Xu Ze could remember such a small item in the book, and he could also analyze it so clearly

Even if he and he didn't pay attention to the situation in a short time, they can analyze it in a short time. This young man is really extraordinary

Thinking of this, Jiang Lingyun sighed and nodded to Xu Ze. Then he turned his head and looked at the side of the old president Guo and sighed: "old Guo You young people are amazing Even with such a simple means, we can diagnose such a complex situation It's not easy It's not easy... "

After listening to Professor Jiang's words, however, old president Guo's face was stagnant. Naturally, he didn't think that Professor Jiang's words were just Even two old experts in western medicine were so praisedAt present, he could only touch his beard with a dry smile and said: "look at the talent coming out in large numbers, we are also very pleased to see I'm so happy... "

Said, but only funny comment: "Xu Ze today excellent performance, evaluation for excellent All the rookies passed the test successfully Please let director Lin announce the overall situation of this assessment... "

Lin Zhikui, the deputy director of the national medical examination center, nodded with a smile. He was about to speak. Suddenly, an old man suddenly burst in with a smile: "Mr. Guo, just now Mr. Wang said that Xu Ze was very good at acupuncture and moxibustion. Today, we don't know if we can have a look What do you think? "

Listening to the old man's words, Xu Ze frowned in his heart. It seems that one of his major students in western medicine came to take part in the examination of the Rookies of traditional Chinese medicine, but he still made such good achievements. He stole the limelight of these new talents, and it was really a big catch

After all, Wang Yibo praised Xu Ze's acupuncture skills. If he didn't take a look at it today, it would be a pity.

moreover, this boy is better than most of the rookies in traditional Chinese medicine Ability, also be regarded as a little pressure on him, also let oneself these old guys also unapt too shameless

See everybody agree, Wang Laoguo hand also see helplessly wry smile, not good to oppose everybody to take a test of Xu Ze again

At this time, old president Guo also looked at Xu Ze with a smile and said, "Xu Ze Brother Wang is very appreciative of your acupuncture and moxibustion skills. We are also very curious. Why don't you show it on this patient today? "

Looking at all the old men looking at a smile, but not against the appearance, Xu Ze had to smile bitterly, but his certificate is still in your hands, can he not agree?

At the moment, I had to nod my head and say, "since you senior teachers want to test me, I will naturally comply with..."

The old men heard that Xu Ze's words were not angry, but they did not dare to oppose it. The people laughed at each other and said, "of course it is good So let's start... "

Xu Ze gently took a breath, knowing that if he didn't show his skill today, I'm afraid it's not easy to explain. In front of him, these are all senior national players, and he doesn't give them a little face At the moment, he felt out the silver needle that he had always carried with him, and he was ready to start (to be continued, please visit www.qidian.com , more chapters, support authors, support legitimate reading! )

www.novelhall.com , the fastest update of the webnovel!