Chapter 536: The patient with an out-of-body experience

"Xu Qiu, do you have a new surgery?" Shen Hua asked excitedly.

The other end of the phone was quiet.

Xu Qiu was silent.

Although he was a master, he couldn't come up with a new surgery in a month...

Moreover, the various surgeries in neurosurgery that have not been created yet are basically related to life-forbidden areas. The patient may lose his breath if he moves a little, or he may have severe blood pressure disorders and abnormal heart function. How can it be so easy?

Xu Qiu said: "No new surgery."

"Oh." Shen Hua could not hide his disappointment.

"However, I plan to hold an academic lecture again in the near future."

"Really?!" Shen Hua immediately became excited again.

Creating new surgeries can enhance the international status of Daxia neurosurgery.

But it is Xu Qiu's lectures that can benefit patients the fastest!

At the Jinghai People's Hospital, after Xu Qiu's lecture, the level of doctors in the hospital improved a lot, and the comprehensive score of the department directly increased by five points, which is very competitive.

If Xu Qiu can visit neurosurgery hospitals across the country, he may be able to improve the average level of domestic neurosurgeons!

"Really."

Xu Qiu took out the list of the hepatobiliary expert group and marked it on the map, saying: "However, you have to follow my schedule, first go to Hunan Province, then Jiangxi Province..."

He planned to complete the academic lecture and the expert group signature at the same time.

Shen Hua agreed, "I will notify the qualified hospitals in each province, and they will definitely welcome your arrival."

After hanging up the phone, Xu Qiu started to worry about Linyi again.

This business trip may last for a few weeks or even a month.

If everything goes well, when he returns, Gan Anning will be at the forefront of the storm and will be listed as a banned drug banned nationwide.

During his absence, he also has to arrange the affairs of the hospital.

After all, Linyi now has several national key projects that are operated with Xu Qiu as the core, including the brain surgery talent training base and the advanced training courses of various departments, and Noah, Joseph and others are willing to stay in Linhai because of Xu Qiu.

……

The next day, during the morning handover, the patient Yuan Yu who was admitted yesterday was mentioned.

The emergency doctors are not unfamiliar with this name.

Abdominal rectus muscle separation, this sign is not mentioned in undergraduate textbooks. After that, whether continuing to study or entering the clinic, many people, except for gynecologists and obstetricians, have never seen it with their own eyes.

And Yuan Yu, the phenomenon of abdominal rectus muscle separation with upper muscle and lower fat, has been a personal experience for all emergency doctors, leaving an indelible impression in this life.

In this sense, she is a teacher to many people present...

The nurse Yang Meng, who was on duty, said: "The results of the liver function test this morning showed that the patient's serum transaminase was elevated, cholinesterase was reduced, and bile pigment metabolism was abnormal..."

Mo Wan looked at Xu Qiu in surprise.

There is really a problem?

She is also a good hand in hepatobiliary surgery, and is very keen on diagnosing various liver diseases, but she didn't realize that Yuan Yu had a problem...

Xu Qiu only glanced at the other party during the rescue and concluded that the other party's liver was damaged. This kind of clinical intuition and experience is too terrible!

After the report, Xu Qiu said: "Do a comprehensive examination to confirm the specific cause of the disease."

There are too many causes of liver damage, such as hepatitis B, cirrhosis, fatty liver, etc., and the treatment methods and emphases are different.

For example, patients with pulmonary tuberculosis may have drug-induced liver damage. At this time, if they follow the drug treatment of conventional liver damage patients, it may aggravate the condition.

Some do not need treatment, such as transient increase in transaminase caused by strenuous exercise and extreme fatigue. In this case, they can recover by themselves after a few days of rest.

For abnormal liver function caused by active replication of HBV or HCV, antiviral treatment must be carried out as soon as possible.

At present, Yuan Yu only found a liver function, and the various causes are not clear, and further examination is needed.

…

Coincidentally, it is the turn of teaching rounds again today.

However, it is Xu Qiu who is responsible for teaching rounds this time.

After becoming the director, he, like Wang Ping and He Hai, also began to lead the team.

It's just that he is different from other directors, and it is not mandatory.

Moreover, when Xu Qiu was not the director, he had already led a team in the emergency department. Wang Fan, Yun Mei and others all followed Xu Qiu...

Now these people got what they wanted and were really assigned to Director Xu Qiu's team.

Among them, Wang Fan jumped from He Hai's team, and Yun Mei ran from Wang Ping's team. They pieced together and formed Xu Qiu's team.

"It's terrible, it's terrible!"

After checking a few patients, panicked cries came from the next ward.

Everyone immediately became interested and looked inside.

Xu Qiu's eyes also fell on the bed.

This is a middle-aged woman in her fifties, who he admitted a few days ago. She also has liver function problems.

Xu Qiu routinely checked the body.

Basic liver function test.

"Liver function tests mainly include liver protein metabolism, bilirubin and bile acid metabolism, enzymatic indicators, lipid metabolism function, liver excretion and detoxification function, etc...."

"In clinical practice, we mainly check alanine aminotransferase and aspartate aminotransferase. Alanine aminotransferase is more sensitive. These two indicators are used to reflect whether the liver parenchyma is damaged. In addition, the increase of aspartate aminotransferase often indicates that the liver parenchyma is seriously damaged and the chronicity is aggravated, so we need to be particularly vigilant..."

"In addition, when liver function is abnormal, an additional coagulation test is required. Everyone should know this very well. The liver can synthesize all coagulation factors except factor III and is the most important coagulation organ..."

While Xu Qiu was explaining, his hands were also moving fast.

Liver examination, like whole body examination, is also visual, palpable, and auscultatory.

Visual examination is to see whether the whole abdomen is bulging, whether there are varicose veins on the abdominal wall, whether jaundice, spider nevi, liver palms and other specific indicators can be seen. Experienced old doctors can even judge whether there is cirrhosis of the liver from the patient's complexion and body shape.

Palpation starts from the left lower abdomen farthest from the liver, and finally reaches the right upper abdomen. It is necessary to judge whether the body surface can be touched, the texture of the liver, whether the spleen is enlarged, etc.

Percussion mainly looks at ascites.

A large proportion of patients with liver problems will have ascites.

As for auscultation, it is not very meaningful. Generally, patients with liver disease can only hear ascites and weakened bowel sounds. Other signs are difficult to judge with a stethoscope...

"Typical signs of liver cirrhosis. If you are interested, you can come and check it out."

After Xu Qiu finished speaking, he looked at the patient.

"You just said it was terrible, what happened?" he asked.

The middle-aged woman on the bed looked terrified, her lips turned pale with fear, and she trembled and said, "I just... I just had an out-of-body experience!"