Chapter 544: Using medicine like a god!
Although she is a hepatobiliary doctor, she still knows about various types of edema.
The mechanism of hepatic edema is that albumin decreases, resulting in a decrease in plasma colloidal osmotic pressure, so water will enter tissue cells from blood vessels, causing swelling.
The treatment measure is very simple, supplement albumin.
Edema can be quickly controlled.
Nephrogenic edema is also similar.
However, cardiogenic edema is caused by weakened myocardial contractility, which leads to increased venous pressure and capillary pressure and reduced cardiac output. To control edema, diuretics, cardiotonic, vasodilation, etc. are needed.
Edema is slow to eliminate, and it must wait until heart failure is relieved and heart function is restored before edema can be eliminated.
"Is it hepatic edema..." Mo Wan hesitated.
If so, it will be relieved without albumin?
But if not, it is generally difficult to see the effect of cardiogenic edema within a few hours.
"Do you remember Wei Ding?" Xu Qiu asked.
Mo Wan nodded subconsciously, and suddenly she opened her eyes, as if she remembered something, and said excitedly: "You mean...congested liver?!"
If it is liver congestion caused by heart failure, which leads to liver damage, and then develops into hepatic edema.
Then, as long as the impact of heart failure is reduced and the venous return obstruction is relieved, the liver function can be quickly restored, and the edema will naturally be eliminated quickly.
It is still cardiogenic edema in essence, but there is an extra twist in it, and it is linked to liver damage caused by congested liver.
"It turns out to be like this!"
After figuring it out, Mo Wan's breathing became a little faster, and joy flashed in her eyes.
"No, no..."
Suddenly, she shook her head again and said: "In this case, the diagnosis of hereditary liver disease is completely denied. If congested liver is established, then the liver damage of mother and child has no connection?"
Obviously, congested liver caused by heart failure is not a genetic disease.
In this case, the two cannot be linked, and the child's disease must be considered from other angles.
Xu Qiu said as a matter of course: "They are two unrelated diseases."
Mo Wan turned his head suddenly and said in surprise: "Do you have an idea?"
"It shouldn't be a big problem."
After that, he said to Shi Lian: "Arrange for the child and the biological parents to do a thalassemia gene test."
The office was silent immediately.
Mo Wan's breathing became rapid, and his eyes flickered several times: "Thalassemia, do you suspect it is thalassemia?"
...
At the same time.
Obstetrics and gynecology office.
Li Xue was showing the medical records of Yuan Yu and the child.
Kong Huixia said: "This patient was admitted by Dr. Xu. It is very challenging. You can learn from him and actively express your opinions."
"It's Dr. Xu!"
"It's Dr. Xu's patient..."
"That's troublesome. The diagnosis process of Dr. Xu's patients is like solving a case, one link after another. Most people can't keep up with his clinical thinking!"
"Looking at the medical records, it seems to be hereditary liver disease? But think about it carefully, it seems that there is no special indication."
Obstetricians and gynecologists talked about it.
But in the end, no reasonable diagnosis was made.
"Director, what do you think?" The deputy director of obstetrics and gynecology had no idea either, and she looked at Kong Huixia.
Kong Huixia stared at the copy of the medical record in her hand, frowning.
After a moment, she raised her head in some pain, "Dr. Xu's patient... I'm not sure either."
The most reliable way is actually whole-genome sequencing.
However, this test is too expensive. If a doctor wants to do this, it will cost more than 9,000 yuan, and it will take at least three days.
If there were the results of the prenatal and marital examinations as a reference, it would not be so troublesome now.
The discussion lasted for more than half an hour. Everyone went around in circles on various common diseases of young children, and finally returned to hereditary liver disease.
"Maybe it's a rare genetic disease?"
"Mother and child suffer from it, so it's very likely to be a genetic disease!"
"How is the biological father of the child? Is his liver good? Does he have a history of chronic hepatitis such as hepatitis B?"
While everyone was arguing, Li Xue's cell phone rang.
She glanced at the message, her face changed slightly, and her cold voice resounded throughout the conference room: "Everyone, Dr. Xu has given the child a new medical order. The next step is to do a genetic test for thalassemia..."
Ding——
Kong Huixia and others turned around, their expressions full of astonishment and confusion.
Thalassemia? !
They discussed hereditary liver disease for more than half an hour, but they didn't even touch the subject!
"Doctor Xu's diagnosis?" Kong Huixia confirmed.
Li Xue nodded, "The cardiotonic and diuretic measures given by Dr. Xu this morning have very good effects, and the patient's edema has been eliminated."
"How could it be so fast!"
Kong Huixia's expression was exactly the same as Mo Wan's.
After Li Xue's explanation, the conference room of the Department of Obstetrics and Gynecology was left with silence.
Gurgle.
I don't know who swallowed.
They carefully recalled the symptoms of thalassemia.
Not to mention babies with severe thalassemia, such babies usually miscarry.
If the baby is born by force, the fetus may not have symptoms in the first few days, but will develop progressive anemia, hepatosplenomegaly, and jaundice within a few days after birth, and the condition will become more and more serious over time.
Very likely to die.
The survival rate of children with mild and moderate thalassemia is relatively much higher.
"The child had a history of bronchitis before... If it is thalassemia, one of the special manifestations of the patient is that he is prone to bronchitis or pneumonia!"
"There is also an enlarged head and widened eyes, which are also consistent with the face of thalassemia."
"So it is not a hereditary liver disease at all, but thalassemia causing liver damage?!"
At this moment, the obstetrician and gynecologist felt as if he had suddenly realized something.
He quickly fell silent again.
Shame on you...
A group of gynecologists and pediatricians are not as professional as Dr. Xu who focuses on other departments!
Kong Huixia breathed a sigh of relief, broke the silence, and said with a little emotion: "It is worthy of being Dr. Xu, who uses medicine like a god."
She read the medical records again and summarized the information of the child's biological parents. Her brows just relaxed, but suddenly frowned again.
"If it is really thalassemia, I am afraid it is not good news..." She sighed.
Everyone looked over immediately.
It has been confirmed, how can it not be good news?
Is there any hidden secret!
……
Ward
The nursing department and the laboratory department came to the scene in person to draw blood for urgent testing of the thalassemia gene.
It would take almost two days for the results to come out.
During this period, Xu Qiulai arranged the hospital affairs after the business trip.
Including surgery arrangements, outpatient transfers, etc.
Today's clinical medicine is full of talents, and the senior management includes Joseph, Noah, Academician Dai and others. In theory, they will not participate in the hospital's diagnosis and treatment, surgery, etc., but with various high-tech surgeries in front of them, they can't restrain their hands.
