Chapter 997 The end of the department, the doctor's life and death!

Soon after, the doctor from the psychiatric emergency department arrived at the scene.

At this time, Hu Jingying's condition further deteriorated.

She was no longer a harmless mushroom, but became like a big mushroom, constantly talking nonsense, and frequently spitting saliva around.

If it was just an ordinary patient, it would be nothing more than a little dirty and isolated.

But she was a syphilis patient...

Although syphilis is only highly contagious in the early stage, and the probability of infection will become smaller and smaller as it develops, and the probability of saliva transmission is very small, there is no need to be too cautious.

But even medical staff such as Liu Susu could not get over this hurdle in their hearts.

After all, once infected with this thing, TPHA may be positive for life, and any work that requires physical examination of infectious diseases is probably impossible.

At the critical moment, Bi Guang's cousin stood up.

He was already an infected person and had close contact with Hu Jingying. At this time, he did not have much disgust and rushed up to control Hu Jingying.

The latter was quickly subdued by Bi Guang's cousin, and her voice suddenly became shrill, and she kept struggling.

Liu Susu quickly sent diazepam.

After the injection of sedatives, Hu Jingying gradually calmed down and was then admitted to the emergency intensive care unit.

It must be mentioned that Hu Jingying's mental state was very unstable at the moment, and she could not communicate normally, so even the psychiatrist could only give symptomatic medication first.

"In addition to the peeling, the patient may be mentally traumatized after stress..."

The psychiatrist analyzed: "However, the patient's cognition of himself has a huge obstacle, which is not very consistent with post-traumatic stress syndrome.

Compared with this, the patient is more like wolf-like delusion."

This disease is an extension of the legendary wolf legend. Patients with this disease often imagine themselves to be wolves and have the instincts and habits of wolves.

In the final analysis, it is actually a mental disorder of imagining that they are wild beasts or other animals and plants, and the cause of the formation is much more complicated.

Of course, everything is just speculation at present.

To get a more accurate answer, we can only wait for the patient's condition to stabilize, conduct a more detailed medical history inquiry, physical examination, etc.

However, Xu Qiu added a few additional tests.

One is a blood routine test, and the other is a cerebrospinal fluid routine test.

Although Hu Jingying had done these two tests before, it was before the onset of the disease.

Now that there is a new disease, these two indicators may have new changes.

"Director Xu has a direction?" asked the psychiatrist.

Xu Qiu did not hide it. If mental illness is caused by organic lesions, then there is indeed a relatively common disease.

"Anti-N-methyl-D-aspartate receptor encephalitis." Xu Qiu said seriously.

In short, it is anti-NMDAR encephalitis.

This disease is a central nervous system disease with neurological and psychiatric symptoms as the main manifestations. It is quite difficult to diagnose it.

We can only use blood routine and cerebrospinal fluid routine to confirm the general direction. After the results are consistent with the manifestations of anti-NMDAR encephalitis, further examinations can be performed.

"The age and gender are quite suitable." The psychiatrist analyzed.

He was not familiar with the diseases of neurosurgery, but anti-NMDAR encephalitis was an exception. After all, almost all patients with this disease showed mental and behavioral abnormalities.

The most common patients with anti-NMDAR encephalitis are young women.

…

After the injection of diazepam, Hu Jingying became much quieter, but it was not suitable for consultation at the moment.

Seeing that the situation had stabilized, Xu Qiu did not stay any longer and turned to Bi Guang's ward.

The latter was the original purpose of this trip.

Unlike hand surgery, which is not painful, hemipelvic amputation does not require any functional testing.

After all, both lower limbs and half of the pelvis are gone, and there is no room for functional testing. The postoperative situation can only be reflected through various indicators.

All the patient can do is to carry out rehabilitation training according to the doctor's requirements to reduce sequelae and complications as much as possible.

Grunting——

As soon as he entered the ward, Xu Qiu heard the movement inside.

He looked over and happened to see Bi Guang lying on his back on the bed, with his lower limbs straightened, even though he had no legs.

Then, Bi Guang used all his strength to tense up, and relaxed after a while. He repeated this cycle several times, and his head was already sweating profusely.

"How do you feel?" Xu Qiu walked in.

At this time, Bi Guang noticed someone coming in. The latter had no time to wipe the sweat, and a grateful look appeared on his face. He said: "Doctor Xu, I can do leg raises now."

Bi Guang had previously done isometric contraction training of the quadriceps.

Generally speaking, patients start to do passive exercises with the CPM machine on the day after surgery, and also start quadriceps contraction training.

Five days after surgery, you can do supine leg raises.

However, Bi Guang's recovery speed exceeded everyone's expectations. He was able to raise his legs on the second day after surgery. After the drainage tube was removed, he started full-day activities and kept adapting to the extension and flexion of the hip and knee joints.

For general patients, due to pain, bad mood, fatigue and other factors after surgery, they often stay in bed for a long time.

Immediately afterwards, metabolic function was affected, physiological function was suppressed, and problems such as muscle atrophy and joint stiffness followed.

The only thing to be thankful for is that there is no need to worry about deep vein thrombosis in the lower limbs... Of course, this joke is hellish.

Bi Guang, on the other hand, did not need to worry about the nursing team at all. The nurse even told Bi Guang many times to be patient. This was a major surgery comparable to a hemitomy, so at least give him some respect.

After all, Bi Guang's posture forced his recovery into a fitness posture... and he was able to practice it.

"Just do two or three sets a day, and you can partially bear weight at other times." Xu Qiu did a simple physical check-up and gave a routine reminder after confirming that everything was developing in a good direction.

Bi Guang agreed and then asked: "Doctor Xu, when can I be discharged from the hospital?"

"If the situation doesn't get worse in the next few days, it will take about a week." Xu Qiu said after thinking.

It stands to reason that a patient like Bi Guang would need to stay at the hospital for at least three or four weeks, and even be cared for until he can walk independently with the help of a wheelchair.

However, recently, DRGs have been fully implemented, and the national medical industry has ushered in major changes.

The legend of golden orthopedics and silver surgery in the past no longer exists, and has become the hardest hit area everywhere, but the degree of misery varies in each department.

The main problem is that the current DRGs focus on a single main diagnosis and a single main operation for settlement, and then there are hundreds or thousands of situations in real clinical practice.

This will inevitably lead to the fact that all experience in the originally mature clinical diagnosis and treatment system is no longer applicable.

If cost is used as the guiding standard for treatment, how can the treatment effect be guaranteed?

But conversely, if the effect is the main focus, the cost will definitely exceed the average range of DRGs.

Especially in departments such as vascular surgery and interventional surgery, where new technologies and procedures are emerging one after another, DRGs still use the charging standards from decades ago.

This means that either doctors use technology from decades ago to treat the disease.

Either adopt new technologies, and the price is that doctors pay the price difference for patients out of their own pockets... Faced with a dilemma, small disciplines such as vascular surgery are already facing a life-or-death situation.

For example, in Linhai City, some hospitals have canceled the vascular surgery department and directly merged it with the cardiac surgery department. Almost all patients in the city who need vascular surgery are sent to the clinical hospital.

Only the clinical doctor in charge of Xu Qiu can afford so many patients who are destined to be severely deducted by DRGs...

However, even here, it cannot be said that there is no impact at all.

For example, for Bi Guang, his DRGs reimbursement amount has actually exceeded the standard. Now every extra day of stay and an extra medicine is equivalent to a free gift from the hospital.

Letting him stay for more than a week is already the limit.

After all, his condition is indeed stable, and the money should be reserved for the next patient who is not welcomed by the DRGs.

Moreover, the scariest thing about DRGs that are rushing to be put on the shelves right now is another point...