Chapter 147 Controversy, Part 1

Okay, this method is good...let's have a debate, to determine the ownership of this patient and the subject!" Hearing Zhang Lide's proposal, Dean Ou also frowned, secretly thinking that this move will win, and the loser Naturally, he had nothing to say, and saved his family a great deal of trouble, so he couldn't help but smiled and nodded in agreement as if relieved from a heavy burden. Vice President Qian and Minister Sun next to him couldn't help sighing softly when they heard President Ou's words With a sound, it seems that it has been decided in this way, I am afraid that the emergency department is almost doomed this time, and secretly sighed: "Old Qu, it's not that we don't help you, it is really only this far, if you If you lose, there is nothing you can do. "Looking at Zhang Lide's proud appearance, Director Qu also sighed. Now that the matter has come to this point, there is no need to say more. Let's debate." It seems that we can only do our best. In case something goes wrong, We can only admit it... Thinking of this, I turned my head and looked at the subordinates behind me. Seeing that they also had a gloomy expression on their faces, I couldn't help but forced a smile, and encouraged Wu Yue and Xu Ze, "Since Zhang The director proposed a debate, so although our emergency department is not as large and experienced as the internal medicine department, we can only accept it... everyone should be energetic and study hard with the seniors..." Hearing that Director Qu said that he was right Encouraging him, but he was mocking himself and others, bullying the young with the old, Zhang Lide and the directors of internal medicine couldn't help but blushed, and coughed twice to cover up their embarrassment. Minister Sun, at this time, he also showed disdain, indeed... four old fellows at the chief physician level, one chief physician, two attending physicians, and two general doctors, oh... and one who didn't even have a certificate. Physicians' debate... It's really thanks to them that they have the nerve to say it, they are obviously bullying... But Zhang Lide can be the director of the internal medicine department, he is naturally thick-skinned, and he wants to let Director Qu continue to be sarcastic, so he coughed dryly Said: "Okay... Since everyone does not object, let's start now!"

A round of doctors who don't even have a certificate to debate... It's really thanks to them that they have the nerve to say it, they are obviously bullying... But Zhang Lide can be the director of the internal medicine department, naturally he has a thick face, so why would he continue to let Director Qu continue to sarcasm , and immediately coughed dryly and said: "Okay... since everyone has no objection, let's start now!" After that, he looked at Director Qu, who had a very unsightly face, and smiled and said, "Director Qu, since You have been taking care of this Guillain-Barre syndrome patient, and you are the first to be diagnosed with this disease, so you must be very clear about this disease, so let’s ask first, and you explain? Then we can do it the other way around , Debate and debate, everyone should show their strengths and decide the outcome, how about it?" Director Qu was already prepared for the possibility of losing at this time, and after hearing Zhang Lide's words, he snorted coldly: " It doesn't matter, anyway, no matter how you come here, the young and old in the emergency department will continue..." "Okay...then let's raise a polemic question!" Zhang Lide was ridiculed, but at this time his face was a little bit After saying the beginning, he turned his head and nodded towards Li Huaming, the director of Neurology Department who was sitting not far behind him. "Everyone knows that Guillain-Barre Syndrome is caused by infection, so may I ask if it has other causes? Is there a season of proneness! What is its pathology-mainly?" Li Huaming asked with a chuckle. Hearing Li Huaming's question, everyone in the emergency department frowned. It's only been two days since I came into contact with the first case, so I can't analyze it so clearly.

However, Director Qu, as an experienced chief physician, was a little annoyed when he heard this question, but he was not afraid. After all, he had carefully analyzed this case for two days.

In the past two days, I have also checked a lot of information. After combining the two sides, I have also found out some things, but there is no definite basis, but I have not come up with it. After pondering for a while, he said in a deep voice: "Guillain-Barré Syndrome is a newly discovered disease, and the main cause at present is the delayed hypersensitivity reaction caused by the history of non-specific infection before the onset. Immune disease, its main lesion is the extensive inflammation of peripheral nerve. It mostly has history of upper respiratory tract infection in 1-4 weeks before the onset. According to this situation, generally speaking, the disease can occur in four seasons; and country A also discovered the disease recently. It shows that there must be more cases of this disease in the near future, so that it can show a certain specificity to confirm the emergence of this new disease, so I think it should be more in summer and autumn. Hearing Director Qu's analysis, everyone listened He had to nod frequently, thinking that the analysis was reasonable, but Wu Yue and the others also breathed a sigh of relief, saying: "The director is the director... Sure enough, we have more experience than us, so we can analyze it. "Xu Ze nodded secretly at the back at this time, admiring Director Qu very much, the things he analyzed were not far from the conceptual knowledge he had learned from the knife... only one or two things were missing

At this time, Li Huaming also had a flash of admiration in his eyes, but he continued to smile and said: "About this question, do Director Qu and colleagues in the emergency department have anything to add?" Director Qu frowned, and carefully After thinking about it, he finally shook his head and said: "No, based on the current information, I can only analyze this..." Wu Yue and others also shook their heads. Director Qu analyzed it in such detail. If there is any new opinion, Xu Ze in the back is still calm at this time, smiling lightly and watching without making a sound. "Well, Director Qu is really experienced and able to analyze so much..." Seeing everyone shaking their heads, Li Huaming laughed, but then smiled complacently: "I have something to add to this..." The invited Li Huaming said so complacently , Director Qu's eyes flashed, and a gloomy look flashed across his face, secretly thinking that the internal medicine department really came, and there were supplements... "As Director Qu said, Guillain-Barré Syndrome is a kind of Delayed hypersensitivity immune disease, so besides non-specific infection, there is another obvious possibility, that is vaccination..." "Vaccination?" Hearing this, Director Qu was taken aback, and then But he smiled wryly. After analyzing so much, he forgot this item. Hey...it's a pity...but Xu Ze was also stunned at this moment, and then sighed. Wu's hospital, it really is Crouching Tiger, Hidden Dragon, he Man even analyzed this point. Wu Yue and the others, when they heard this, were stunned for a moment, and their faces darkened. This question. But it was only a little bit close, and the result was still lost... Dean Ou was very happy when he heard the doctors under him at this time, and the analysis made sense, one was better than the other, and nodded: "Okay, the first question Internal medicine wins, and the next question will be given by the emergency department..." Just now, I have already lost one question, but this one is absolutely unavoidable. Director Qu took a deep breath, thought about it for a while, and secretly thought that the current Guillain-Barre Syndrome The patient is the first case in our hospital, and only people in our emergency department have been in contact with it, so some subtle changes in signs, this internal medicine is always a little unclear'''

Immediately smiled, and then said: "Since we have talked about the etiology and principle just now, let's talk about the symptoms and signs of Guillain-Barre Syndrome... Hearing Director Qu's question, Li Huaming and Zhang Li The two men looked at each other, a smug smile flashed in their eyes, and then nodded to Li Qijiang, the director of general internal medicine next to him. Li Qijiang smiled and nodded at Director Qu: "Since Director Qu asked, then I Just come to answer the previous answer, and I would like to ask Director Qu to give me some advice!" Seeing Li Qijiang's confident and casual appearance, Director Qu's heart felt a little "thumping", and he thought to himself that they even figured out this in detail?" Green Barry The clinical features of the syndrome are after infectious diseases (severe nerve root pain occurs suddenly within 3 weeks, mostly in the neck, shoulders, waist and lower limbs), acute progressive symmetrical limb flaccidity, subjective sensory disturbance, and weakened or disappeared tendon reflexes. Main symptoms. "" Its specific manifestation is movement disorder: muscle paralysis of limbs and trunk is the main symptom of this disease. Generally, it starts from the lower limbs and gradually spreads to the trunk muscles, upper limbs and cranial nerves, from one side to the other. Paralysis is generally more proximal than distal, with hypotonia. If breathing, swallowing and pronunciation are involved, it can cause spontaneous breathing paralysis, difficulty swallowing and pronunciation, and be life-threatening. 2) Sensory impairment: generally mild, mostly mild and superficial sensory impairment. 3) Reflex disorders: limb tendon reflexes are mostly symmetrically weakened or disappeared. "Speaking of this, Li Qijiang looked at Director Qu with a light smile, and said with a smile: "Director Qu, do you think there is anything else to add? "After hearing Li Qijiang finished speaking, Director Qu's face was so gloomy that he could drip water, because what Li Qijiang said was something that the emergency department had explored in the past two days, and it was not bad at all... It seems that it is as imagined first. In that way, they have already figured out all the cards in their hands, no wonder they stabbed themselves so confidently... Our emergency department is really stumped this time,'·Seeing Director Qu's face With the gloomy expression and the dejected appearance of the emergency doctors behind him, everyone in the internal medicine department understood that the emergency department had no power to resist under the blow that he and others had accumulated for a long time. I'm afraid they're about to admit defeat. They all looked at Director Qu and the others proudly, and then Li Qijiang also smiled at Director Qu and asked, "Director Qu, do you have anything to add. ?

Director Qu raised his head, looked at the internal medicine staff, and shook his head expressionlessly. Seeing Director Qu shaking his head, Li Qijiang secretly rejoiced, thinking to himself that we have already won two victories, and the emergency department has no power to turn around now, right? Now I asked Wu Yue and the others a symbolic question, and after seeing the four doctors shake their heads dejectedly, they couldn't help laughing, and said, "Director Qu, if you don't add anything, the emergency department is already dead." There are two questions, there is no need to continue this debate!" Director Qu sighed lightly, knowing that today he might be hopeless, but he looked at the roof and did not speak. Seeing Director Qu's helpless look, Zhang Lide laughed and said, "Since Director Qu didn't add anything, then our internal medicine department will win...According to the agreement in advance, this patient and subject will belong to our internal medicine department!" At this time, Qian The dean and Minister Sun looked at each other, and then sighed. These old fritters in the internal medicine department are too good, and the emergency department really lost. At this time, Dean Ou also thought that the overall situation was settled, so he planned to speak, but behind the doctors in the emergency department, there was a clear voice: "I'm sorry, can I add something?" PS: Finally, at two o'clock Going forward to this chapter, although it has surpassed the sixteenth place, but the monthly tickets behind are chasing fiercely. Please vote for more monthly tickets. As long as you are not particularly busy, Tiannan will definitely add more today! Of course, the premise is that It can't be less than yesterday's Zhang. "If there are too many monthly tickets, Tiannan, yes. I'll go all out and add more according to the situation! Give Tiannan a little encouragement, and give yourself a little pressure. Thank you."