BXBX NOVEL Chapter 777: 【777】Believe in your own medical judgment
Xie Wanying chose to listen to the patient's heart at this time. Thinking about it carefully, there are many strange things in the case of Yangyang's mother that deserve careful scrutiny.
For example, the patient's jaundice is relatively mild, the hepatitis B index is positive but the transaminase is generally normal, and cirrhosis is generally the liver shrinkage, while the Yangyang mother is the opposite, which is hepatosplenomegaly.
The chest X-ray of the patient seems to be normal, only the left side of the two lungs are slightly thickened, the mediastinum is normal, and the heart shadow is roughly normal.
b-ultrasound, there is parenchymal diffuse damage in both kidneys, which is consistent with the performance of ascites in advanced liver cirrhosis. The liver showed widening of the portal vein. Due to ascites, the b-ultrasound doctor's field of vision is unclear, and it is impossible to see whether the inferior vena cava has obstruction symptoms, but the b-ultrasound doctor suspects it based on his own experience.
Such results, it is estimated that the lower and Budd-Chiari syndrome need to be excluded. Budd-Chiari syndrome is a post-hepatic hypertension caused mainly by blockage of the hepatic veins and inferior vena cava. Later, why the patient did not do the relevant examination of the inferior vena cava again, it is necessary to ask Dr. Gong why.
"Take a deep breath." Xie Wanying said to the patient.
Mother Yangyang took a deep breath and let out a long breath.
Xie Wanying listened to the patient's breath sounds from both lungs, and found that the patient's left lung breath sounds were thickened, which was indicative of some inflammation.
Listen carefully to the patient's heart. There is a systolic murmur in the apical mitral valve area, but it is relatively weak. If it is graded, it is estimated to be only grade two, which is far from the standard of organic heart disease.
In fact, the effect of pumping ascites in this patient is general. Therefore, the treatment plan was later adjusted to salt restriction and water restriction and diuresis, that is, the latter's overflow theory was used as the basis to deal with, and the effect was good. This is the only thing that can be done in the hospital, so the patient's condition is better and he is discharged from the hospital first.
Even so, after listening to the patient's heart, Xie Wanying took the stethoscope and continued to ponder, feeling that this case could be considered more carefully. Now she will pay more attention to her medical intuition, mainly because the case of Li Yaxi in the 21-bed next door has sounded the alarm for her.
Yangyang's mother raised her head as if to talk to her.
Xie Wanying put her ear close.
Yangyang's mother whispered to her: "The girl next door can't sleep at night, she is very scared."
Don't look at Yangyang's mother who is seriously ill, but she does not forget to care about the patients in the same ward. Perhaps in the eyes of Yangyang's mother, the young and beautiful female college student who was admitted to the hospital was a pity.
The medical staff knew Li Yaxi's fear, and the nurses specially drew the Daoge curtain between the 20th and 21st beds to help the patients to block their sight. But it is useless, for fear that it will become ingrained for some patients in this environment. If the patient himself is not strong, like Li Yaxi, he feels that he is having nightmares every night and day.
"What disease does she have?" Yangyang's mother asked the doctor, probably wanting to help the patient.
Xie Wanying said to the patient: "No matter what kind of disease you have, the doctor will do his best to treat it when you enter the hospital."
Xie Wanying has confidence in Li Yaxi's illness, because Brother Tao arranged for Dr. Song to take care of her, so there will be a breakthrough.
Mother Yangyang felt a little more at ease listening to her.
"I'll discuss it with Dr. Gong when I go back, and see if I can give you another checkup." Xie Wanying said to Yangyang's mother, "Check more clearly. The medicines prescribed in the future will be targeted and the curative effect will be better."
(end of this chapter)