Looking at Zhang Peiyi and Hou Liang who hurriedly arrived, and others.
Chen Cang knew.
Nodded one after another: "Director Zhang, Director Hou!"
Zhang Peiyi quickly said: "Professor Chen, what's going on?"
Chen Cang took a deep breath and looked a little dignified, but instead of directly talking about the diagnosis, he asked: "Did the patient eat aspirin recently?"
"Yes!" Hou Liang nodded directly. He looked at the medical record and it read!
After Chen Cang heard it, he nodded directly: "That's right!"
"What do you mean?" Everyone asked, staring at Chen Cang.
Where do they know the impact of eating aspirin!
Even the patients are a little ignorant!
I ... what's wrong with me?
Chen Cang directly took out the patient's checklist.
"When the patient was admitted to the hospital, the diagnosis was mainly platelets as high as 723, which was scary, and the flu, infectious diseases, liver and kidney function were normal, but these simply cannot explain the tenderness of the liver area of the patient."
"I saw the patient's B-mode ultrasound, fatty liver is not enough to cause these abnormalities, there must be acute liver injury."
"And what is the reason? I analyzed the patient's condition, he had obvious lymphadenopathy, and had acute fever and mild macules before admission. Although these are insignificant, they are indeed the key factors!
After talking, Chen Cang stared at the man and said, "Go to bed and lie down!"
The patient was unconscious and had to go to bed to lie down.
Chen Cang started a physical examination: "Look, the bilateral conjunctiva is somewhat hyperemia, there is no exudate, the neck lymph nodes are large, and there are spots on her body!"
"According to Japan's diagnostic criteria for Kawasaki disease, fever with the above symptoms can already be diagnosed as Kawasaki disease!"
Chen Cang's words directly cooled everyone's back!
Zhang Peiyi and Hou Liang looked at each other, and saw the uneasiness and fear in each other's eyes!
Bean big sweat beads keep seeping out!
Even the look was a bit panic.
"The most important thing is that the patient's elevated platelets are both the cause of angina pectoris and the result of Kawasaki disease!"
"However, it is still not the case that firmed my mind!"
"It's aspirin that you give the patient by mouth!"
This sentence froze everyone's words!
Chen Cang is perfect for clinical analysis of emergency medicine and drug poisoning!
He directly said: "One meta analysis clearly pointed out that aspirin is easy to cause serious liver damage during the treatment of Kawasaki disease!"
"So, you need to check the function now!"
After hearing Chen Cang's analysis, everyone was stunned!
Fortunately, Zhang Peiyi responded quickly and quickly called the head nurse to quickly draw blood!
During the waiting period, they also hurriedly performed physical examination on the patients.
During this inspection, they found that ... things may really be moving closer to Chen Cang!
And the patient is also blinded!
In fact, all this cannot blame the medical staff.
It was the patient who concealed the relevant condition because of some details.
It is not important to avoid talking about fever.
In fact, the diagnosis process is often based on many insignificant details.
The patient was really scared at this time: "Professor Chen ... Then why did you just say I need surgery!"
The directors around also stared at Chen Cang, not knowing why!
Does Kawasaki disease need surgery?
Chen Cang couldn't help saying: "Look at this picture!"
During the speech, Chen Cang picked up the chest radiograph and CT.
"Look, although the patient didn't have a complete examination for CTA angiography, but! Look at these two films."
"Actually, it seems that there is not much difference, but join you to see the basic disease of Kawasaki disease, you see here!"
During the speech, Chen Cang pointed to the patient ’s large blood vessels in the chest and could n’t help but ask, “Do n’t you think there is a slight change in size?”
"And here ..."
During his speech, Chen Cang began to point out every slight change.
As Chen Cang pointed out, everyone was low-skinned.
Because ... this is a bit scary, right?
"Professor Chen ... what do you mean?" Xu Aiming asked directly!
Chen Cang nodded: "Aura dissection aura performance!"
After Chen Cang made the answer clear, everyone was silent!
Aortic dissection ...
Chen Cang explained: "Well, Kawasaki disease has the most damage to coronary arteries, followed by aorta, abdominal aorta, carotid artery, and pulmonary artery!
"We can see some shadows through CT of the lungs, and we can judge that the patient may have nodular arteritis and thickened vascular intima. Here ... and here ..."
"I judge that the patient is still very dangerous at this time!"
"Slightly leads to coronary thrombosis, leading to myocardial infarction!"
"The intima ruptures and the aorta ruptures directly, causing the patient to die!"
"I now judge that the patient's condition of scraping the endometrium is very bad, it is best to operate as soon as possible!"
After Chen Cang finished speaking, he frowned!
After the patient heard Chen Cang's words, the entire face was scared green!
Is it so scary?
Thinking of this, the patient looked at Chen Cang: "You scared me, are you? Professor Chen?"
Chen Cang took a deep breath: "I hope my judgment is wrong!"
The patient nodded quickly: "Well, I hope ..."
Ignoring the silent echo: "I wish ..."
However, the voice did not fall, this time the laboratory called.
"Patient Wang now has alanine aminotransferase up to 941, and aspartate aminotransferase 819!"
With the appearance of the two indicators, everyone's face suddenly changed!
This evidence may prove that Chen Cang's reasoning is correct!
Chen Cang's face was low and he said, "Hurry up to be a CTA!"
Afterwards, he said to the patient: "Hurry up with your family and tell them that you need to prepare for surgery as soon as possible!"
Hearing this, the patient forced himself to calm down.
It's really not a time for panic, but ...
It is fake to not panic!
Soon, the patient's CTA angiography came out. At this moment, the inner wall of the patient's aorta and pulmonary artery is damaged, and it is likely that a vascular dissection is formed, and because of the presence of Kawasaki disease, the patient may directly skip the dissection Blood vessel rupture!
For a while!
Tensions of busy and deployment work began throughout the office. UU reading www.uukanshu. com
No one dares to relax.
Hou Liang frowned at this time and said, "Professor Chen, we do not have the ability to perform aortic replacement surgery! And there are so many arteries ..."
In a word, say what Zhang Peiyi and others have said!
At this time, Chen Cang nodded and said, "I'm coming!"
Everyone immediately turned to stare at Chen Cang.
Full of excitement!
Professor Chen really can bring hope in despair!
...
ps: sorry, late update.
When the meeting ends on the 12th, I will probably resume the normal update on the 13th, like six chapters a day ...