Chapter 135 Guillain-Barre Syndrome

Xiao Ze looked at the patients in front of him who were talking about progressive myasthenia, and heard Qian Xuezhi "Chuanma". A virtual patient he had treated in the virtual space appeared in his mind, that patient and Qian Xuebin The symptoms mentioned are very similar, and now I can't help being curious.

"After I received this patient, I first considered it to be a Zhouming paralysis, but through various blood tests, potassium ion and other tests, there was no abnormality. Later, I did a related nerve test... It is mainly the limbs that are involved, and there is no abnormality. Other nervous system abnormalities... and it was a progressive increase, and I considered it a neurogenic problem at the time"

Qian Xuebin said with some complacency: "This should be muscle weakness caused by neuromuscular origin. After half a month of treatment in Taoyuan City Hospital, there was no effect. When I was transferred to our hospital, abdominal muscles had already begun to accumulate, but I have passed Anticholinesterase drugs, and anti-slimming inhibitors have been cured, and now he has improved a little bit "and has not spread further. If we continue to treat, it should still be under control, and may even recover slowly. ! "

At this time, the patient and the family members beside him heard Qian Xuebin's words, but they said gratefully: "Thanks to Doctor Qian, not only did my treatment not get better, but it became more and more serious, and I can only control it here. Doctor Qian, please take care of me in the future!"

"Don't worry. Since we've arrived at our hospital, we will of course try our best to treat you!" Qian Xuebin nodded proudly, and then said again: "However, this disease is extremely troublesome, and the effect is relatively slow. And most of the time, it needs long-term treatment. For treatment, you must have a certain degree of psychological preparation.”

"That matter, of course, as long as it can be cured, we will listen to Dr. Qian!" The family member hurriedly thanked you.

"En." Seeing the respectful appearance of the family members, Qian Xuebin nodded in satisfaction.

Then he smiled at Xu Ze proudly and said, "Doctor Xu, do you want to check with him?"

Xu Ze smiled. He had some doubts about the patient at this moment, so of course he would not delay. Immediately nodded, and then began to examine the patient.

The patient was not very enthusiastic about Xu Ze. He looked at the doctor in his twenties. Although Dr. Qian was very polite to the little doctor, he seemed to be bringing an intern to study. He was just a normal student, so although he cooperated with Xu Ze's inspection, he was not very proactive.

But Xu Ze didn't take it seriously. When he was online at Huimin Clinic, didn't those patients do the same? When they beg you, their attitude will completely change, and it doesn't matter if you get used to it.

After a detailed examination of the patient. Xu Ze's eyes narrowed slightly, and this patient had a slight decrease in the superficial sensation of the lower limbs. It is not just the weakening and disappearance of muscle strength,

Such shallow hypoesthesia should be rare in purely neuromuscular myasthenia gravis.

At the moment, he smiled lightly and asked the patient: "Before you got sick, did you have any other bad conditions, such as a cold or other things?"

The patient listened to Xu Ze's words, although he was not very enthusiastic. But I still thought about it and said: "It seems that two weeks before the onset of the disease, I had a cough for a while, but it will be fine after some injections."

"Oh?" Knowing that there was a history of infectious diseases before the illness, Xu Ze raised his eyebrows lightly, and then asked with a smile: "Then before you got sick this time, didn't you have the feeling of feeling like you have a cold all over your body?"

"Well, it seems that I have. At that time, I just felt that my arm, neck and thigh were a little sore." But it will be fine in two days! "The patient thought about it, and said indifferently. From his point of view, his feet are weak. It has nothing to do with the pain in his arms and neck."

However, Xu Ze was affirmed now. This patient might not have some simple neuromuscular muscle weakness, but Guillain-Barre Syndrome.

This disease refers to an acute onset syndrome characterized by nerve root and peripheral nerve damage, accompanied by protein-cell separation in cerebrospinal fluid. Also known as Guillain-Barré Syndrome. Any age and men and women can get the disease, but it is more common in young men.

Its clinical features include acute and progressive symmetric limb softness, accompanied by shallow sensory disturbance, weakened or disappeared tendon reflexes, and sudden severe pain in the nerve roots in the perioperative period of the infectious disease. disease.

Although this kind of Guillain-Barré syndrome has already existed in the internal medicine of the small school, it has only recently been discovered in modern medicine. Know it.

Information on this disease has just been published in the National Journal of Medicine, and many people have not been exposed to this disease, and may not even have heard of it.

Qian Xuebin next to him frowned when he heard Xu Ze asking about such a situation. He didn't know what Xu Ze meant, because he thought about it according to Xu Ze's questions, but he didn't expect to read about the symptoms and tears. What is the relationship between this disease?※

He is very confident in himself, and it is not fake to attach the name of a representative figure of the new generation. Basically, he has studied and studied most of the diseases in internal medicine. He is also familiar with most of the new developments, and his knowledge is even more comprehensive than many senior doctors with high qualifications.

And the few questions Xu Ze is asking now are at least within his current knowledge. There should be no impression of this. So Qian Xuebin also smiled lightly, Xu Ze was probably fine and asked something. Is it possible that you, a doctor who graduated from the Internet, can see what is wrong?

Xu Ze also smiled lightly at this moment, he did not express his judgment lightly. After all, overturning other people's diagnosis, unless it is a superior doctor, otherwise it is a very taboo thing, and even though he has a round doctor now brand, but it is still much worse than that of a doctor like Qian Xuebin who formally manages patients alone.

such a situation. If the two have a good relationship, they can remind them in private, but Xu Ze is confident that he has no relationship with Qian Xuebin. If he reminds him hastily, he may think that he is sincerely trying to tear things apart, and Qian Xuebin probably doesn't know the existence of this disease. , I'm afraid it's useless to say it. So Xu Ze hid this thought in his heart and didn't show it rashly.

After asking these questions, Xu Ze nodded with a smile and said, "Dr. Qian, let's go see the next patient."

Seeing that Xu Ze didn't raise any questions, Qian Xuebin didn't take it seriously at this time, and secretly laughed that Xu Ze also likes to pretend to be unpredictable. Immediately he smiled and said, "Okay, let's go see the next patient!" After finishing speaking, he led Xu Ze out of the ward and headed for the next ward.

But when the two of them walked out, they heard Director Zhai shout: "Xu Ze" is a patient, come and have a look..."

"Okay!" Xu Ze quickly responded, then smiled apologetically at Qian Xuebin and walked towards Director Zhai.

Qian Xuebin looked at Xu Ze's whereabouts, but the enthusiasm on his face was about to fade, showing a faint sneer, and then followed Xu Ze and walked over.

Xu Ze walked to the ward where Director Zhai was, and saw a new patient who was panting and lying on his side on the hospital bed, and the nurse was busy administering oxygen to the patient.

When Director Zhai saw Xu Ze come in, he wanted to know what Xu Ze's real level was. Although it was recommended by the old man, at least he had to have a good idea in his heart, so he smiled at Xu Ze and asked tentatively: "Xu Ze Ze. How about you take care of this patient?"

Hearing Director Zhai's words, Xu Ze understood Director Zhai's meaning very well. If he was not confident, he could tell him directly, and if he was sure, he could take over the treatment of this patient.

Naturally, he nodded with a light smile. Xu Ze has seen many patients like this. In the virtual space, he also saw them in the Huimin Clinic, but the patients he saw in the virtual space were much more serious than this.

Seeing Xu Ze nodded confidently in agreement. However, Director Zhai was also a little relieved. Since Xu Ze dared to take over, it meant that he still had some foundation, so he shouldn't have to work too hard in the next two months.

Xu Ze walked forward with a stethoscope, and then asked the family members beside him about their medical history, after a brief questioning. Xu Ze had a general understanding of the condition, and looked at the patient who was half lying on the hospital bed, breathing hard with his mouth open, and his lips were cyanotic.

Then through a systematic examination of the patient's heart and lungs, there is no need to cooperate with other examinations such as electrocardiograms. Based on experience alone, Xu Ze can basically confirm what kind of disease it is at this time.

I have a history of coronary heart disease, and I am prone to shortness of breath after a little activity. This time, I caught a cold a few days ago, and then the shortness of breath gradually worsened. Up to now, I can’t sleep and can only sit on the bed every day. pant.

No obvious jugular vein changes were found in the physical examination, but small moist rales at the lung bases could be heard clearly, and the oral examination revealed that the heart was dilated, and the heart rate was extremely fast, reaching nearly 120 times Per minute.

"Coronary heart disease, heart enlargement, and three grades of cardiac function Xu Bei got the following judgments. However, in order to clarify his diagnosis and reassure Director Zhai, Xu Ze took the electrocardiogram aside, quickly put electrodes on the patient, and began to do the electrocardiogram .

Director Zhai at the side saw Xu Ze's skillful physical examination and electrocardiogram, so he couldn't help but secretly nodded and said, "This kid is not bad, at least he shouldn't be the kind of fool I'm worried about. Wait to see how his diagnosis is, if it's good, then I can rest assured!"

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