Chapter 137 Lumbar Puncture

"Grindler Syndrome. Hearing Xu Ze's words, a gleam of light flashed through Zhai Ren Xu Xing's eyes under the fetal tent mirror. He fixed a glance at Xu Ze, but said in surprise: "You Also know this disease? "

Xu Ze was overjoyed seeing Director Huo's rhetorical question. Secretly thought that Director Zhai knew it, so there was no need for him to waste his time talking.

He nodded slightly at the moment, then handed over the medical record at hand to Ranwen Novel.com, and said to Director Huo, "Director, take a look at this patient."

He could see that the medical record that Xu Ze handed over was the patient who had seen fatigue Cha Yin. Director Zhai couldn't help being taken aback, and after taking a deep look at Xu Ze, he finally took over the medical records and read them.

Director Zhai looked at it very carefully, flipped through the pages of Ranwen Novels.com, and thought for a long time. He also went to see this patient today, but there were too many patients at that time, so he did some examinations and heard about Qian Xuebin. After the report, he agreed with his diagnosis. At that time, this disease was not considered.

However, according to the information I read last time, in retrospect, some symptoms are quite similar, which seems to be more suitable than the diagnosis of neurogenic myasthenia gravis.

Director Cheng thought for a long time before looking up at Xu Ze, and said slowly, "Have you also read the latest information?"

Xu Ze nodded, then looked at Director Zhai and said, "Director, I have conducted a detailed consultation and physical examination on the patient just now, which is slightly more detailed than the medical history recorded by Doctor Qian. A history of infection, and a history of pain in the limbs and neck and back before the disease!"

After hearing Xu Ze's explanation, Director Zhai's eyes gradually brightened, and he motioned for Xu Ze to continue.

"Physical examination, in addition to the decline and disappearance of limb muscle strength and disappearance of tendon reflexes, I also felt that the patient had shallow sensory disturbance in the lower limbs. Although it was only mild, it did exist..."

Xu Ze paused for a while, seeing that Director Zhai was looking at him and listening carefully, he continued: "The current medical treatment by Dr. Qian is not sure of the patient's effect, it only temporarily prevents the disease from progressing." Further aggravation did not achieve tangible results, indicating that the diagnosis of neurogenic muscle weakness is still questionable."

"So based on the current medical history and physical examination analysis, the possibility of Guillain-Barre Syndrome is extremely high," he said. Xu Ze looked at Director Zhai steadily, waiting for his reaction.

After listening to Xu Ze's analysis, Director Cheng nodded slowly, looked at Xu Ze approvingly and said, "That's right, you are only at this age, but you can have such a wide range of knowledge, and you can be so careful, it's very good."

"good,

But the diagnosis of this disease, we must be careful, after all, it is a new disease, and there are not many reports about it in China." Director Zhai stood up, picked up the stethoscope and percussion hammer, looked at Xu Ze and said solemnly: "Go "Let's go check it out together!"

Seeing that Director Que didn't object to his opinion, nor did he agree easily, but insisted on checking and confirming together again, Xu Ze couldn't help but secretly nodded. This is the prudence that a medical expert with high professional quality should have. Without any hesitation, the two of them headed directly towards the ward.

After watching Director Que chat with his new disciple for a while, they went out together. Zhang Yan next to him looked up in surprise, and then continued to write his own progress record.

The two pushed open the door of the ward and walked to the bedside of the fatigued Chayin patient. The family members and patients next to him had seen Director Zhai this morning, and knew that he was a professor and the director of the attached one. , Dr. Qian accompanied the examination respectfully.

At this time, Director Zhai came in. The family member was feeding the patient porridge, so he quickly stood up happily and said, "Director Zhai, hello!"

Director Cheng smiled and nodded, and then said to the patient: "There are too many patients this morning, and things are too busy, so I didn't give you a detailed examination. Now Dr. Xu and I will give you a careful examination!"

"Ah, okay, I'm really sorry to bother you and Dr. Xu!" The patient looked at Director Zhai and Xu Ze beside him, and thanked him excitedly and politely.

Director Zhai smiled and asked about the medical history again. Hearing Director Que's inquiry, the patient was curious. How could Director Que, like the little doctor Xu before him, like to ask some inexplicable irrelevant things.

Hearing that what Xu Ze said was exactly what Xu Ze said, Director Zhai nodded, and then conducted a careful physical examination. The final result was indeed as Xu Ze said. Except for the disappearance of lower limb muscle strength and tendon reflexes, the patient , and mild lower extremity shallow sensory disturbance.

After the examination, Director Zhai nodded to Xu Ze, and the two left the ward.

Looking at Qian Xuebin's medical records, Director Zhai couldn't help frowning and shaking his head, secretly wondering why Qian Xuebin didn't ask about his illness more carefully. If he asked carefully, he wouldn't have almost missed this disease today.

He couldn't help but looked at Xu Ze happily and said, "According to this situation, it really looks like Guillain-Barré Syndrome, but there is no official information in China yet, and our diagnosis is still not sure,"

Xu Ze smiled lightly and said, "Director, there is a characteristic of Guillain-Barré syndrome, which is the separation of protein cells in the cerebrospinal fluid. We only need to do a lumbar puncture,

"Separation of protein cells?" Director Zhai frowned and recalled the document he had read. It seemed that there was such a statement on it. I didn't remember it very clearly, but it seemed that what it said was not very certain. He couldn't help but looked at Xu Ze and said, "Xu Ze, are you sure?"

"I remember that the treatment of Guillain-Barré syndrome and this kind of neurogenic myasthenia is almost completely different. You must be cautious about this!" Director Zhai looked at Xu Ze and said seriously.

Xu Ze nodded with a smile. He is absolutely sure that what he just said is correct, because future medical technology has already proved this.

"Okay, let's do a waist piercing now, don't delay!" Director Guan stood up resolutely and said.

Seeing that Director Que was so impatient, Xu Ze couldn't help asking in a daze, "Don't we have to wait for Doctor Qian?"

"Don't wait now, he should be ready for lunch now, he will take over at noon, let's do it first, and make a diagnosis as soon as possible," Director Zhai said decisively.

Seeing Director Zhai's affirmation, Xu Ze no longer hesitated, nodded, and said, "Then I'll prepare the equipment!"

Although Xu Ze is not very familiar with the emergency department, with the help of the little nurse Hu Xia, he quickly prepared all the equipment for waist piercing.

Director Zhai went to call the patient's family members in person, and told about the new situation and the necessity of the lumbar puncture.

The family members heard Director Zhai's words, and remembered that Dr. Xu came for an examination first, and then asked about the situation, and then Director Huo came to ask again before considering this question. But he couldn't help feeling grateful to Xu Ze secretly. If it wasn't for Dr. Xiao Xu who discovered the problem and told Director Zhai very responsibly, he probably couldn't find the possible reason.

Immediately, he quickly signed the consent form for waist piercing, and asked Director Huo to be more considerate. Xu Ze who was waiting came in with the waistband. The family members saw Xu Ze with great enthusiasm, which made Xu Ze feel a little unaccustomed to it.

Seeing that Xu Ze was ready, Director Zhai took Xu Ze and the two of them went straight to the ward with their things.

At this time, the patient had already known the situation from his family members, and he was going to have such an examination, but the way he looked at Xu Ze was very different from the way he was before, and his eyes were full of gratitude.

Director Zhai pushed his glasses and watched Xu Ze skillfully position the patient in a side-lying and tuck-knee position. At that moment, he was curious again, and said inwardly, "Could it be that Xu Ze still does lumbar puncture? Is it impossible? It is impossible for the clinic to perform this lumbar puncture!"

However, out of an inexplicable confidence in the surprise that Xu Ze gave him today, after Xu Ze made preparations for himself, he looked at Xu Ze and asked tentatively, "Xu Ze, can you do it?"

Hearing Director Que's question, Xu Ze was taken aback for a moment, but answered honestly: "Yes."

"Yes?" A strange light flashed in Director Zhai's eyes, as well as a hint of surprise, and he immediately smiled and said, "Okay, then you can do it!"

"Oh, good!" Xu Ze was very excited to be able to perform a lumbar puncture by himself. After all, he had only performed simulated operations in empty space before, although these simulated operations were different from real operations. Not much, but Xu Ze was extremely excited when he actually did it.

Lumbar puncture is also a small operation that is not low in difficulty. Many doctors rarely succeed the first time they perform it, but Xu Ze still has confidence in himself.

At that moment, in order to achieve a successful puncture, Xu Ze adjusted the patient's position again. Make the patient's back perpendicular to the bed surface, bend the head forward to the chest, hug the knees with both hands and cling to the abdomen, make the trunk arched, and make the patient's spine protrude as much as possible to increase the width of the intervertebral space and facilitate needle insertion.

Then he began to select the puncture position. He stretched out his hands and determined the puncture point at the intersection of the posterior superior spine of the pelvis and the posterior midline of the spine. This is the position of the spinous process space of the first lumbar vertebra and the best place a location.

Then take out the complexed iodine cotton swab, and routinely disinfect the skin at the puncture point, then wear a sterile waist puncture bag, and spread a sterile hole towel on the patient...

Director Cheng watched Xu Ze's actions with satisfaction. Xu Ze performed these procedures extremely skillfully, completely following the procedure of aseptic operation, and did not make a single step wrong, just like a veteran.

Director Cheng couldn't help being amazed by this, Xu Ze really gave him too many surprises today, I really don't know where he learned this from? How can a third-year student do this?

At this time, seeing that Xu Ze had already laid out the disinfection hole towel and took up the syringe, Director Huo suppressed his surprise, took out a lidocaine from the plate, opened it, and moved it in front of Xu Ze, waiting for Xu Ze to draw the medicine , to fulfill the duties of an assistant.

At this time, Zhang Suo, who had been in the office all the time, also followed curiously. At this time, he saw that Director Zhai was actually working as an assistant for Xu Ze. He couldn't help being surprised at the moment. Man is one. Novice, if this is said, who can believe it?

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