Chapter 264 Shocking Examination Results

As a doctor, heal people. The most important thing is to learn to see the essence through the phenomenon...

For a patient with stomach pain, you can tell where the pain is? Then judge the cause by the location;

For example, Xu Ze has found through color Doppler ultrasound that this patient has obvious gallstones, and when the gallbladder is also swollen, it can be basically confirmed that the patient's abdominal pain is mainly caused by the gallstones.

But being a doctor is not such an easy profession, and seeing a doctor is not such a simple matter. Xu Ze just wanted to cope with this assessment, but he forgot something very important to a doctor.

That is, in addition to the main symptoms, other diseases must be identified and analyzed, because such abdominal pain can be caused by gallstones, gastritis or even pancreatitis.

At present, Xu Ze has been able to confirm that it is mainly gallstones, but other possible diseases must be ruled out... Although the possibility of other diseases is relatively small, as a doctor, one should not refuse to go because the possibility is small. Ignore it; because in many cases, it is only a little problem that is not noticed, which leads to serious consequences...

Now Xu Ze suddenly remembered this problem. Although there shouldn't be any major problems, for him who has always been cautious and responsible for patients. This is a problem that cannot be ignored.

So he regained his composure, activated the color B-ultrasound, and scanned the patient's stomach and pancreas.

Color B-ultrasound can effectively judge the overall changes of the pancreas and stomach. Through this inspection, you can roughly judge whether there is any abnormality.

The results of the color B-ultrasound scan reassured him a little. No major problems were found in the patient's stomach, and the appearance of the pancreas was very smooth, and there seemed to be no abnormalities.

Xu Ze was almost relieved at this time, but remembering the new function of blood amylase among the functions of the tripolar system recently, he also did it for the patient smoothly.

This blood amylase test is the most standard test to rule out whether there is pancreatitis. As long as this test is done, it can completely confirm whether there is a problem, which is much more accurate than a simple color B-ultrasound scan.

Following his order, he quickly popped out a fine hair needle from the ring on the index finger of his right hand holding the patient's veins, and lightly pricked the patient's wrist. Before the patient knew it, he extracted the A small amount of blood was tested.

"1200UL" Xu Ze looked at the red value displayed on the glasses, and couldn't help frowning. The blood amylase obviously exceeded the standard, and this patient actually had pancreatitis!

but,

The main diagnosis is still gallstones, and the second diagnosis is pancreatitis; in terms of TCM diagnosis, there should be no problem with the diagnosis of cholelithiasis.

Immediately, he stood up slowly, and nodded to the senior national players who were already a little impatient. Then he said: "President Guo, I have finished the examination..."

Hearing Xu Ze's words, all the senior national players also nodded slowly, and the old national player Wang was relieved to see the serious but still confident expression on Xu Ze's face.

Seeing Xu Ze's hesitation and hesitation at first, Wang Lao Guo saw that Xu Ze was indeed weaker than the other rookies in Chinese medicine, and he was worried about whether Xu Ze could pass the test smoothly; It took some time, but it seemed that he was still full of confidence, so he was naturally relieved a little.

Wang Lao Guoshou is not too concerned about Xu Ze's failure to pass the test, and he doesn't care much about the impact on his reputation. What he cares about is that the young man in front of him is indeed very good. It's such a pity.

Old Dean Guo looked at the young man with a serious face on the opposite side, then nodded lightly, and said, "Okay... Now that the examination has been completed, Xu Ze, please answer the patient's diagnosis basis and treatment plan. ..."

"The patient mainly presents with epigastric pain, bitter taste and oily mouth, thin yellow tongue coating, and stringy pulse...We can see mild tenderness in the right upper quadrant and positive Murphy's sign on physical examination of Western medicine...So the diagnosis of traditional Chinese medicine is considered: cholelithiasis. Liver depression and qi stagnation type , the treatment principle is to soothe the liver and regulate qi, and the prescription is selected: Bupleurum Shugan Powder... Acupuncture and moxibustion: take the points of Riyue, Qimen, and Gallbladder, and combine them with Zusanli and Zhongwan..."

Speaking of this, Xu Ze couldn't help narrowing his eyes slightly, and looked at the expressions of the senior national players above... Seeing Wang Lao Guoshou smiling and nodding lightly, he was relieved from the bottom of his heart. As long as there is nothing wrong with this, then he will not worried...

The following Western medicine diagnosis and treatment, for Xu Ze, naturally couldn't be easier. Xu Ze, who was in a relaxed mood, continued with a smile: "Western medicine diagnosis considers: acute cholecystitis and gallstones; acute cholecystitis and gallstones are not ruled out. Pancreatitis may be... It is recommended to perform liver and gallbladder color Doppler ultrasound, blood routine, blood amylase and other examinations. In terms of treatment, cephradine and ofloxacin anti-infection treatment are temporarily given, and cimetidine is given to suppress acid and 6542 to relieve spasm and relieve pain..."

"If gallstones are confirmed by relevant examinations, according to the patient's physical condition, it is recommended to perform surgical treatment under the condition of effective anti-infection and inhibition of gastric acid to protect the pancreas..."

Hearing what Xu Ze said, Old Dean Guo frowned slightly. Old Dean Guo obeyed Chinese medicine all his life. Although he gradually accepted Western medicine in recent years, he still resisted the operations that Western medicine is good at.

Because in his opinion, if the treatment can be conservative, using traditional Chinese medicine to help expel stones is naturally the last. After all, Western medicine surgery, although straightforward, is a matter of killing three thousand enemies and harming eight hundred. It is not in line with the way of Chinese medicine.

But at this time, although he was not very satisfied with the treatment method proposed by Xu Ze, this operation belongs to the category of Western medicine after all. Naturally, it is inconvenient for him to deny it easily, so he turned his head and looked at the two doctors from Capital Medical University beside him. Professor, wait for their judgment.

Old Dean Guo looked at Professor Tang Wuyou and Professor Jiang Lingyun, only to find that they were looking at Xu Ze with a hint of surprise in their eyes.

Dean Guo was taken aback for a moment, and couldn't help but wondered at the two professors: "Professors, please comment..."

Tang Wuyou and Jiang Lingyun glanced at each other, but Jiang Lingyun nodded and said with a smile: "Old Guo...this son's diagnosis and diagnosis are very close...the diagnosis of acute cholecystitis and gallstones is very clear, and the treatment The plan is clear…”

Hearing Professor Jiang's words, Old Dean Guo was taken aback. Could it be that the young man in front of him, Xu Ze, has already reached such a high level of attainment in Western medicine?

And Wang Laoguo next to him also smiled slightly at this time, Xu Ze finally did not let him down...

However, the rookies next to him, especially Guo Yujian, looked at Xu Ze with a hint of admiration in their eyes. They all studied Chinese medicine, but Western medicine can reach this level. That is naturally incomparable to them...

Especially Guo Yujian, at this time, also restrained the pride on his face,

While being surprised, Professor Jiang suddenly said, "It's just..."

"But what?" Dean Guo was stunned again, but he didn't think it was strange. Although Xu Ze seemed to be very skilled in Western medicine, he was still too young after all, and there might still be some shortcomings. It's going to be a bit hot.

At the moment, he was a little happy, assuming that Xu Ze would have no problems at all in this round of assessment. But if you can do so well in the Chinese medicine rookie assessment as a Western medicine student, then the face of everyone here is not good.

Moreover, his grandson Guo Yujian had already won the first place today, and he had a lot of face to face with him, but if Xu Ze can achieve such a good result in this round, then he will be able to cultivate ten grandchildren with his family carefully. The grandson of several years is keeping pace with each other... Naturally, he also feels uncomfortable...

Seeing that there were still some omissions in Xu Ze's answer, he breathed a sigh of relief and said with a smile: "Professor Jiang is in charge of judging today, so it's okay to say what you say... If Xu Ze's diagnosis is inappropriate, I will let you know." When Professor Jiang makes a point..."

Jiang Lingyun smiled and nodded, then asked Xu Ze with a curious smile: "Doctor Xu, right..."

"Professor Jiang...I'm Xu Ze!" Seeing Jiang Lingyun's appearance, Xu Ze was also taken aback, doubts arose in his heart, could he be wrong?

"Doctor Xu... just now your diagnosis of acute cholecystitis and gallstones is based on very clear evidence, and the diagnosis is also very good; but how can you be sure that he has the possibility of acute pancreatitis?" Professor Jiang looked at Xu Ze very much. Some unexpectedly asked curiously.

Hearing Professor Jiang's words, Xu Ze felt strange in his heart, and said to himself, "Don't these two professors know that the patient may have acute pancreatitis?" On the contrary, they have some conclusions. The two professors must have seen the patient in advance, but they did not conduct detailed inspections and inspections in all aspects, so they did not confirm this conclusion.

However, Xu Ze naturally didn't say that he made blood amylase for the patient to make sure...Of course, he was prepared and had already thought of a defense strategy.

Then he smiled and said: "Professor Jiang, the patient reported that before the abdominal pain, he had eaten a lot of greasy fried rice and beer, and then developed abdominal pain; this kind of abdominal pain after eating too much and drinking alcohol, although it can cause cholecystitis. However, there is also the disease of acute pancreatitis that must be considered, because the first article on this situation in internal medicine has mentioned that this kind of overeating and alcohol consumption can lead to this comparison. critical illness…"

"So, I think that although it can be concluded that there is a high possibility of cholecystitis and gallbladder stones through the positive Murphy's sign, this situation cannot be ruled out naturally, and the possibility is not small... So. I proposed this combination disease…"

Hearing Xu Ze's analysis, Professor Jiang and Professor Tang Wuyou looked at each other in amazement, but they didn't expect that Xu Ze could even remember such a small item in the book. It is so clear, and it can be taken out and analyzed so clearly...

Even if the two of them didn't rush or pay attention, they could analyze it in a short period of time. This young man is really extraordinary...

Thinking of this, Jiang Lingyun sighed and nodded towards Xu Ze with a smile, then turned to look at Old Dean Guo and sighed: "Old Guo...you young people are amazing...how can you rely on such a simple job? It is not easy to diagnose such a complicated situation... It is not easy..."

Hearing Professor Jiang's words, Old Dean Guo's expression froze. He naturally did not expect that Professor Jiang's just... actually made Xu Ze compete for a few points, and even two doctors from the field of western medicine The old experts are so praised...

At the moment, he could only stroke his beard and say with a dry smile: "Looking at the emergence of talented people in the younger generation, I am so gratified to be old... so gratified..."

After all, he could only laugh and comment: "Xu Ze performed very well today, and he was rated as excellent... All rookies passed the test smoothly... Director Lin, please announce the overall situation of this assessment..."

The deputy director Lin Zhikui of the National Medical Examination Center next to him nodded with a smile and was about to speak when suddenly an old man next to him interrupted with a smile: "Mr. In order to win, today we don't know if we can take a look... I don't know what you think?"

Hearing the old man's words, Xu Ze frowned secretly. It seems that he, who majored in western medicine, came to participate in this rookie assessment of Chinese medicine, but he got such a good result. He stole the limelight from these rookies.

However, the old men and national players next to him naturally nodded their heads in agreement after hearing this proposal. After all, Wang Yibo firstly praised Xu Ze's acupuncture and moxibustion skills. It would be a pity if he didn't take a look at it today. ;

Moreover, this kid is so good today, and his grades are better than most of the rookies in Chinese medicine. If this kid doesn't have that ability, it can be regarded as a little pressure on him, and it will make old guys like me not too much. dull face...

Seeing that everyone agrees, Wang Laoguo smiles helplessly. It is not good to object to everyone's admission of Xu Ze again...

At this time, the old director Guo also looked at Xu Ze and smiled, and said: "Xu Ze... Brother Wang admires your acupuncture skills, and I am also very curious, why don't you show it to this patient now?" how?"

Seeing the smiles on the faces of all the old men, but they could not be opposed, Xu Ze could only smile wryly, his certificate is still in your hands, can he not agree?

At the moment, he could only nod his head and said: "Since the senior teachers want to test me, I will naturally obey..."

The old men heard that although Xu Ze's words were a little bit resentful, they didn't dare to object, and everyone smiled at each other proudly, and then said: "That's naturally good...then let's start..."

Xu Ze took a deep breath, knowing that if he didn't show his hand today, he might not be able to explain it. The people in front of him are all senior national players, so it's better not to give them some face... Then he took out the bag he always carried with him. Silver needle, ready to start...(!)