Chapter 366 Surprised to Meet the Boss!

To diagnose a disease, there must be a key point!

Only when this key point can be found can a true diagnosis be made.

That's what it's called in modern medicine: the gold standard for diagnosis!

For example, tuberculosis diagnosis can find Mycobacterium tuberculosis in sputum culture, such as cancer diagnosis to find cancer cells in tissue, etc.

but!

There is no gold standard for many diseases.

This requires finding a major clue that can help diagnose the disease!

Once you find this, follow the trail and help diagnose the disease.

Chen Cang took a deep breath and looked at the old man with awe in his eyes again.

Chen Cang nodded slightly and expressed his gratitude!

The old man just smiled lightly, nodded, and did not speak.

...

...

The old man is great, and he is great here.

However, the most powerful, but not only here.

The most powerful place is still the philosophy of dealing with people.

He knew that Wu Yushu had a problem, and it might not be a small problem, but he wouldn't say it directly.

He knew this was a hospital and he had to listen to the doctor.

Even if the old man is a famous doctor, how powerful he is, he will not overstep his authority, nor will he teach Chen Cang what to do.

However, as a doctor, seeing something happened to the patient's diagnosis, his heart does not allow him to stand by.

At this time, the operation of Chen Cang's "measurement of blood pressure" seems to be very emotional.

If the old man asks Chen Cang to do a chest X-ray, an electrocardiogram, or even a cardiac ultrasound, would the patient be willing?

What do patients think?

Your doctor won't give a diagnosis for others to help?

Will the patient feel that the doctor is a quack?

Won't even follow advice to get checked out.

The blood pressure measurement is from the patient's point of view, do you think? It's a simple matter to measure blood pressure. It doesn't cost money anyway, it's just a simple check.

First, the patient did not reject his heart and followed the advice.

Second, the doctor can also get a lot of useful clues from it.

It can be said that the problem is solved in a light and light time, which is very powerful.

Don't underestimate the sphygmomanometer, this thing seems simple.

However, this blood pressure test can find a lot of things.

This is the high place.

Paradoxical pulse refers to the phenomenon that the pulse weakens or even disappears when inhaling, and appears or returns to its original state when exhaling. Using a sphygmomanometer to observe paradoxical pulses is more intuitive and obvious than palpation with fingers.

An experienced doctor can feel a lot of things with a little bit of mold.

The principle of azygos pulse is that the pressure in the pericardial cavity increases, which limits the diastolic filling of the ventricle, and the systemic venous return during inspiration is limited, and the right ventricle discharges blood into the pulmonary circulation. , resulting in a decrease in the amount of blood returned to the left heart by the pulmonary veins, and a decrease in the output of the left heart, so that the pulse weakens or even disappears.

The occurrence of azygos is common in right heart failure, pericardial effusion and constrictive pericarditis, as well as severe asthma and other diseases.

With this diagnosis, what Chen Cang needs to do next is simple and clear.

The heart auscultation sound just now and the odd pulse at this time, Chen Cang now has a good understanding of Wu Yushu's situation.

Nine times out of ten it is constrictive pericarditis!

However, in order to make a diagnosis, there must be a basis. Thinking of this, Chen Cang carefully observed, accompanied by Wu Yushu's breathing, the jugular vein in the neck can be vaguely seen, but because he is fat, it is not very obvious.

Chen Cang recalled that Wu Yushu said that his stomach was bloated, indigestion, and poor appetite after he came.

Said, "I will touch your belly."

Wu Yushu raised his leg very cooperatively.

After Chen Cang's abdominal percussion, he was slightly silent. There may be fluid accumulation in the abdominal cavity, and it is accompanied by hepatomegaly.

At this time, Chen Cang was already able to make a judgment.

Thinking of this, Chen Cang asked in detail about the history of the disease and the predisposing factors.

Afterwards, Chen Cang looked at Wu Yushu: "Your performance now, and my examination of you just now, I feel that you are more like a constrictive pericarditis."

When Wu Yushu heard this, his eyelids jumped, and he was taken aback by this professional term.

He had heard of pneumonia and rhinitis, but it was the first time he had heard of pericarditis!

Thinking of this, Wu Yushu's face changed: "What kind of pericarditis is this? What does it mean?"

Chen Cang explained: "Constrictive pericarditis is caused by chronic inflammation of the pericardium, which acts on the human body for a long time, resulting in thickening, adhesion and even calcification of the pericardium, which limits the relaxation and contraction of the heart, reduces cardiac function, and causes systemic blood circulation disorders. a disease.”

"Your breathing difficulties, chest pains, and bloating are all directly related to this!"

When Wu Yushu heard this, to be honest, he was quite frightened.

He can't be sick...

This is the key.

With a heavy burden on him, how dare he get sick?

Don't dare to rest, let alone get sick?

Thinking of this, Wu Yushu hurriedly asked, "Doctor, am I serious?"

It's really hard to say whether it's serious or not, but when Chen Cang saw Wu Yushu's situation, he had to tell the truth:

"To be honest, it's not a simple disease, because long-term development will not only affect the cardiovascular system, but may also accumulate diseases of the liver, lungs, etc., systemic systems."

Wu Yushu groaned inwardly: "This...do I need to be hospitalized? Or should I just take some anti-inflammatory drugs?"

In Wu Yushu's heart, inflammation, should take some anti-inflammatory drugs, right?

But... the inflammation in his heart made him feel unsure.

When Wu Yushu heard Chen Cang's explanation, it seemed to be serious, and he was immediately scared.

Chen Cang couldn't help shaking his head: "In the case of constrictive pericarditis, surgery is the main treatment, supplemented by drug treatment, and the sooner the better, and the fluid in your abdominal cavity needs to be extracted, my suggestion. It is to arrange hospitalization as soon as possible.”

"After hospitalization, complete the relevant examinations, and then make a specific diagnosis and treatment."

Chen Cang said everything he had to say.

He could see that Wu Yushu seemed to be somewhat resistant to the inspection, for two reasons, one was economic pressure, and the other was time delay.

But when the disease comes, the treatment still needs to be treated.

However, the test can be done after hospitalization.

In this way, you can go to medical insurance and reimburse a large part of the cost of the examination.

This is already Chen Cang's best effort.

Therefore, Chen Cangcai did not ask Wu Yushu to have an examination in the outpatient clinic as soon as possible, but hoped that he could be hospitalized as soon as possible.

When Wu Yushu heard Chen Cang's words, he was a little silent, sitting there without saying a word.

At this time, Chen Cang treated the old man.

Seeing the old man, Chen Cang didn't know what to say. After thinking about it, he said, "Old man, what can I do to help you?"

The old man handed over the emergency registration: "Take an electrocardiogram for me, I'm a little flustered."

When Chen Cang saw the old man's name, his eyes shrank!

This name, perhaps most people do not understand.

However, in the medical field of Dongyang Province, or in the field of traditional Chinese medicine, the meaning of this is really different.

Chen Cang also came across this name by accident, but he never expected to meet this big guy!

Master of Traditional Chinese Medicine: Zheng Sanshui!

ps: Hey, it's three shifts for now, in fact

Qimai, in fact, is a very interesting thing, and I have actually encountered it.

Finally...be cheeky to ask for votes, ahem!