I Can See Health

   Chapter 445 You can't watch movies at all!

   "Auntie, I saw that you had a chest CT scan in the central hospital. Did you bring the film?" Lu Chen asked.

   "Bring it."

   Auntie Wang squatted down and took a white bag from the drawer under the bedside table.

  Lu Chen smiled, took the bag, and took out a brand new chest CT scan.

   Compared the date, it happened to be a film taken a week ago.

  Lu Chen carefully read the chest CT and found that the patient's lungs did not have any abnormality except for a little infection.

   "This case is really not that simple." Lu Chen thought.

   Seemingly simple bronchial asthma, but why is it not effective?

  Because the other hospital has already given patients a full range of bronchial asthma treatment, the first thing Lu Chen thought about was whether the cough and asthma could be caused by other diseases?

   "Doctor, you, do you have anything else?"

   Aunt Wang said.

  Lu Chen shook his head, "Thank you auntie for your cooperation, I'm done asking."

   He returned the chest CT scan to Aunt Wang.

   "Then I'm sick..."

  Lu Chen paused, "I don't know yet, I need further examination. My superior doctor will come to see you later."

   For this case, Lu Chen really didn't have any ideas for a while.

   "Okay, then thank you doctor."

  Lu Chen nodded slightly, then left the ward.

  …

   When I first entered the Department of Respiratory Medicine, the first patient I encountered was a bit tricky.

  Lu Chen was also interested.

   For the first two months, he stayed in the operating room every day, which was too boring.

   Back to the doctor's office.

   Fan Yujing was already sitting in front of the computer, looking at her appearance, she should be waiting for Lu Chen.

   "What is the patient's condition?"

   As soon as Lu Chen sat down, Fan Yujing asked.

   "Consider an acute exacerbation of bronchial asthma..."

   Lu Chen's words were not finished when Fan Yujing interrupted: "I didn't ask you to talk about the diagnosis, but the condition!"

  Lu Chen frowned deeply and glanced at Fan Yujing, this teacher's temper is really weird.

   However, he continued: "The patient is a 43-year-old woman who was admitted to the hospital with cough, sputum, and wheezing for 5 days..."

  Lu Chen briefly introduced the medical history.

   "Where was bronchial asthma diagnosed and what treatment was used?" Fan Yujing said.

   "I stayed in the central hospital for a month, and I was given hormones, antispasmodics, and anti-infection treatments, but the results were not very good."

After Lu Chen finished speaking, Fan Yujing didn't speak. She took her stethoscope and left the doctor's office.

  Lu Chen saw this and followed behind her.

  …

   came to the ward again.

   The patient is already in bed.

   Walking into the ward, only half a meter away from the bed, I could vaguely hear the patient's wheezing.

  Fan Yujing came to the hospital bed and asked about his medical history again.

   This time, she also asked about some occupational disease history, dust exposure history, etc.

   All patients answered one by one, and she did not have any other occupational diseases and exposure history.

   "Have you seen the doctor's order form for the patient's treatment in the city hospital of traditional Chinese medicine?" Fan Yujing asked suddenly.

   "I have seen it." Lu Chen nodded.

   "What's your opinion?"

  Lu Chen frowned slightly, "Based on the current diagnosis of bronchial asthma, the treatment at the Central Hospital is basically in place."

   "Then why the previous treatment was not good?" Fan Yujing said again, "What is the reason for this?"

  Lu Chen shook his head and whispered: "I don't know for now, but at first glance, the first is that the dose of the drug and the course of treatment are not enough; the second is that the previous diagnosis of bronchial asthma was wrong!"

   The diagnosis is wrong, and it's just his current guess.

  Do not take lightly of each other, all Lu Chen's voice is very low, so as not to be heard by the patient's family.

   Fan Yujing raised her brows slightly when she heard Lu Chen's words, slightly surprised in her heart.

  I didn't expect this student to have two brushes.

   "Based on the patient's current examination results, besides bronchial asthma, what other diagnosis would you consider?" Fan Yujing said.

  Lu Chen shook his head slightly, "I don't know yet."

   Respiratory department is not the department he majored in, so naturally it is not as good as in cardiology department.

   Fan Yujing didn't say much, turned to the patient and said, "Take out all the examinations done in the central hospital."

   "Okay." The patient heard the words, took out the chest CT film again, and handed it to Fan Yujing.

  Fan Yujing took it lightly, held it in front of him, and looked at it carefully.

  CT images are divided into 16 rows and 64 rows, mainly due to the difference in resolution.

   It can be easily understood that a 16-slice CT is to transect the lungs with 16 cuts.

   The 64-row CT is cross-cut by 64 knives.

The larger the number of    rows and the more cross-sections, the more clearly the chest CT can be seen.

   After a long while, Fan Yujing slowly put down the chest CT film in her hand.

   "Have you seen the CT film?"

  Lu Chen nodded slightly: "I have seen it."

   "Can you read?" Lu Chen was taken aback by Fan Yujing's words.

   "I haven't studied it systematically, but I will read a little bit." Lu Chen said.

"Haha, I don't think you are at all!" Fan Yujing unceremoniously put the CT film on the table aside, and said coldly, "Looking at this CT film, you still don't know the cause of the patient? "

   Fan Yujing's attitude is really bad.

   But Lu Chen was stunned when he heard Fan Yujing's words.

   This patient's chest CT film, he just looked at it carefully.

   Except for signs of lung infection, he didn't find any other problems!

   Fan Yujing can actually see the cause of the patient from this chest CT film?

  Lu Chen immediately took the CT film.

   He carefully studied the comparison in every aspect.

   Lung window, mediastinal window, lung markings, bronchial shadows, all of which he spared.

   "It's a bit of self-knowledge, you should take a good look."

   Fan Yujing snorted coldly, and then left the ward.

  Lu Chen ignored her and continued to study with the chest CT film.

  …

   There is a lot of content about CT in the image, otherwise it would not be a separate subject.

   However, with the development of modern medicine, the division of labor among doctors has become more and more detailed.

   Doctors in many departments are not good at image reading, such as X-ray, CT and MRI.

  Most doctors rely on the results of the imaging department.

   However, in clinical practice, it is often the doctor in charge of the bed who knows the patient's condition best.

  Relying on the readings of the imaging department not only delays the best treatment results, but also may cause errors in interpretation.

  …

   "Call..."

   After a while, Lu Chen shook his head helplessly.

   Except for the images of lung infection, he still didn't see anything unusual.

   The ability to read films, Lu Chen knew, was very lacking.

   "Auntie, take the film back for me to take a look first." Lu Chen had no choice but to say to the patient, "I will return it to you when I see it."

   "Okay, no problem." The patient grinned, "Just don't get rid of it for me, I'll use it later."

   "Well, don't worry."

   Having said that, Lu Chen took the patient's chest CT film back to the doctor's office.

   in the doctor's office.

  Fan Yujing was giving the patient a doctor's order. At the same time, when she saw Lu Chen coming back, she said, "Write down the patient's course record."

"it is good."

  Lu Chen put the patient's chest CT film aside and began to write the patient's first disease course record.

   The course of the disease was recorded by Lu Chen, and he finished writing it quickly.

   However, he really didn't know how to fill in the line of diagnosis in the course record.

  Lu Chen ordered the doctor's order and frowned.

   Fan Yujing's doctor's orders are very routine, only a few simple doctor's orders for blood tests.

  Any anti-infection and bronchial asthma medicines are not available!

   Seeing the doctor's order, Lu Chen glanced back at Fan Yujing, and then fell into deep thought.

   (end of this chapter)