I Can See Health

   Chapter 466 Unexpected Hypertension (First Update)

  Cough, hemoptysis and chest pain, and there is a shadow on the chest CT.

   The patient has a history of pulmonary tuberculosis.

   In addition, the results of the patient's morning blood test have all come out.

   The white blood cells were high in the blood routine, and other biochemical, liver and kidney functions were normal.

   And the results of tuberculin and T-SPOT will be out tomorrow.

   And these two tests, even if they are negative, can only indicate that the patient has been infected with tuberculosis in the past, and cannot be currently infected.

   This kind of patient, the impression diagnosis is nothing more than pneumonia, tuberculosis and lung tumors.

   "I still need to do a bronchoscopy as soon as possible!" Lu Chen thought.

  Clinically, many diseases cannot be diagnosed only by superficial evidence.

  However, with modern technology, the correct diagnosis can often be made.

  For example, in the age of no imaging technology, neurologists could not tell whether a patient was suffering from cerebral hemorrhage or cerebral infarction.

  The symptoms of these two diseases are very similar from the outside and cannot be distinguished at all.

   The most important thing is that the treatment of hemorrhage and cerebral infarction is completely opposite!

   One needs to be thrombolytic, and the other needs to be anti-thrombotic!

   What should we do at this time?

   can only rely on empirical diagnosis and treatment, rely on feeling.

   If the treatment is correct, then the patient's condition improves and he can survive.

   But there are also many patients, the more they are treated, the more severe they are, and eventually they disappear.

  …

   "Senior brother, I see that there is a patient in Teacher Fang's group. It seems that he will not have a bronchoscopy tomorrow." Wang Defa ran over and said to Lu Chen, "Just in time for Mei Yejun's father to insert it."

  Lu Chen smiled and glanced at Wang Defa, "Why are you so active in helping Junior Sister these days?"

   "Ah..." Wang De blushed, "No, no, it's all from the same school, I just wanted to see if I could help."

   "Okay, I'll ask Teacher Fang later."

   After Lu Chen was busy with the task at hand, he negotiated with Teacher Fang from the next group.

  Mr. Fang also heard about Lu Chen's name in the hospital and was very interested in him.

   Hearing that a patient in their group wanted to join in, he agreed.

  …

  Mei Yejun was also very happy to hear the news.

   Having a bronchoscopy one day earlier, she felt at ease.

   However, Lu Chen had a bad premonition in his heart.

   The health value on the patient's head slowly decreased. Although the decrease did not reach three minus signs, it was also a very terrifying thing.

   Early the next morning, when Lu Chen saw the patient, his health dropped by two points.

  Check the room in the morning.

   Fan Yujing took Lu Chen and Wang Defa to the endoscopy room of the Respiratory Department.

"Dad, don't be nervous, these doctors are all my teachers and senior brothers." Mei Yejun stood at the door of the endoscopy room and said to his father, "Their techniques are all the best, and they will be finished soon. "

   "Don't worry, Xiaojun, you still don't know your father and me!" The patient smiled, "Isn't it just an examination, I'm not nervous at all."

   Although he said so, Lu Chen still saw his hands trembling slightly.

   "Junior sister, just wait outside." Lu Chen whispered, "I'll come out and let you know if anything happens."

   "Yes." Mei Yejun nodded lightly, "Trouble teacher Fan, there are two more senior brothers."

  …

   Then, Wang Defa pushed the patient into the endoscopy room.

   "Come, lie down here." Fan Yujing beckoned and let the patient lie down on the operating table.

   The patient was lying on the operating table, looking like he was hesitant to speak.

   "Uncle, what's the matter? Is there any discomfort?" Lu Chen asked quickly.

   "That..." The patient said hesitantly, "If there is any problem, don't tell my daughter first!"

  Lu Chen was stunned.

   "Just tell me first, okay?" the patient repeated.

  Lu Chen said helplessly: "Uncle, your illness is your privacy, and we have no right to interfere. It is your choice whether to inform your family. However, your daughter is also a medical student. Do you think you can hide it from her?"

  Even if you can hide it now, as long as the follow-up diagnosis and treatment are available, Mei Yejun will definitely know.

   "Alas." The patient sighed.

  Lu Chen comforted: "Uncle, don't be so discouraged, we haven't started the examination yet."

   The patient nodded, barely showing a smile.

  …

   All the equipment and equipment of the bronchoscope are ready.

  Fan Yujing said to Lu Chen, "Get ready to start."

  Lu Chen nodded and discussed the risk communication with the patient again.

   "Uncle, do you know all the risks I mentioned?" Lu Chen said.

   "Well, I know, Xiaojun told me too."

   "Okay, I'll take your blood pressure, it's normal, let's start."

  Before surgery and invasive procedures, blood pressure should be measured routinely.

  Lu Chen took out the automatic blood pressure monitor and put it on the patient's arm.

   "Blood pressure 184/107mmHg."

   As the reading on the sphygmomanometer appeared, Lu Chen was stunned.

   "Why is the blood pressure so high?"

  The current Huaxia standard exceeds 140/80mmHg, even if it is high blood pressure.

   Systolic blood pressure is 140-160mmHg, which is the first level of hypertension.

  The systolic blood pressure is 160-180mmhg, which is the second grade of hypertension.

  The systolic blood pressure is more than 180mmHg, that is the third level of hypertension.

   In order to prevent the sphygmomanometer from malfunctioning, Lu Chen measured it again, and the results were almost the same.

   The patient has a history of hypertension, which Lu Chen knew.

   "Uncle, didn't you take blood pressure medicine this morning?"

   "Eat it!" The patient frowned, "Is the blood pressure very high?"

   "Yes." Lu Chen nodded, then looked at Wang Defa, "The blood pressure in the past two days doesn't seem to be that high, right?"

  Wang Defa scratched his head and said, "The patient was about 150/80mmHg on the day of admission, and the measurement yesterday morning was 154/85mmHg. When I measured my blood pressure, the patient had just taken antihypertensive drugs, so I didn't care."

   At this time, Fan Yujing came to the console, "What's wrong?"

  Lu Chen explained: "The patient's blood pressure is too high, just measured twice, and the blood pressure is above 180/100mmHg!"

  Fan Yujing frowned, "That can't be done for the time being."

  Lu Chen was also quite helpless.

   High blood pressure increases the risk of surgery several times before any operation and surgery.

   Patients are very likely to have bleeding, heart failure, and these unpredictable malignant events.

   "Uncle, you may not be able to do it this morning. Your blood pressure is too high. You can do it after your blood pressure drops steadily." Lu Chen said, "At least it must be lower than 160/80mmHg before we can do it with you."

   Although the patient was a little confused, he nodded and walked out of the endoscopy room without saying anything.

  Lu Chen had no choice but to pack up the endoscope equipment and put it back in its original place.

  Wait for when the patient's blood pressure is stable before performing bronchoscopy.

   However, when Lu Chen looked at the patient's back, he suddenly seemed to think of something, and he was shocked.

   "After staying in other departments for so long, I almost forgot which department I came from!"

   (end of this chapter)