I Can See Health

   Chapter 714 The diagnosis was changed because of a look! (first update)

  The First Hospital of Magic City.

  ICU shows the classroom.

   All doctors who came to discuss difficult cases began to speak in turn.

   The focus of everyone's attention is nothing more than the cause of infection and fever, and the next steps for diagnosis and treatment.

   "I agree with Director Zhang. This patient is mainly in septic shock, and antibiotics must be upgraded!"

   "In addition to upgrading antibiotics, it is also necessary to prevent complications in other organs."

   "In addition, the patient is bedridden for a long time. Although the thrombocytopenia is low, there is a risk of deep vein thrombosis. Do you need anticoagulation therapy?"

  The discussion was very heated.

   However, the opinions are still relatively unified, and most doctors are considering septic shock.

  In terms of treatment, it is to upgrade antibiotics to prevent complications in other organs.

   In fact, in this case, the most relevant departments are the infectious diseases department and the rheumatology department.

   has little to do with cardiology, respiratory and other departments.

  ICU just follows normal procedures and invites other departments to see patients.

   After speaking in several key departments, the ICU director had a solemn expression and was somewhat dissatisfied.

  Su Zhengwen also shook his head slightly in his heart.

  The opinions of these doctors cannot be wrong, but they have no practical guiding significance.

   This patient has been to many hospitals, and the antibiotics used are all very advanced, and the remaining antibiotics are not used.

   They have been fighting infection for quite some time, but the patient's condition has not improved!

   If you continue anti-infective treatment, it is nothing more than the use of restricted antibiotics, such as imipenem and other drugs, and there is no other adjustment in diagnosis and treatment.

   is a commonplace.

   "Hey, it seems that this discussion of difficult cases is useless..." Su Wenzheng sighed slightly in his heart.

   Next, are the speeches of other departments.

   However, the ICU director has no hope for the opinions of other departments.

  The rheumatology department and the infectious disease department did not provide any constructive opinions, let alone other departments such as cardiology and nephrology.

   Sure enough, it was not as expected by the ICU director.

  The opinions of nephrologists and gastroenterologists briefly describe the conditions of the patients and their departments.

   As for the analysis of the underlying condition, very few!

   "Hey, forget it."

  The ICU director has no hope of discussing this difficult case.

  …

   "Finally, the cardiologist will consult the doctor, tell me your opinion." Su Wenzheng said sternly.

   Cardiovascular Medicine was the last department to speak.

   After he finished speaking, the discussion of difficult cases this time came to an end.

  Lu Chen finally got his chance to speak.

   He stood up, holding the patient's case data in his hand.

   ICU director and Su Wenwen didn't have any expectations when they saw such a young doctor.

  Lu Chen first cleared his throat, and then said slowly, "Teachers, in fact, I have a different opinion on this patient."

   As soon as he finished speaking, Lu Chen attracted everyone's attention.

   "This kid, how dare you speak!"

   Seeing Lu Chen's youthful appearance, everyone was in awe.

   Many people are still complaining about this, but the Cardiology Department actually sent such a young doctor to participate in the discussion of difficult cases? !

   ICU director and Su Wenzheng were also slightly taken aback, and then their expressions returned to normal.

   At this time, Lu Chen said, "Actually, when I first saw the patient's medical records, I also thought that the patient had a contagious fever and was in shock after a severe infection. But..."

   Having said this, Lu Chen was obviously stunned, and everyone's attention was mobilized.

   He continued: "But when I went to check on the patient, a look from the patient changed my judgment."

   "What? The patient's eyes?"

   Everyone present was stunned for a moment, and looked at Lu Chen with doubts on their faces.

   They have never heard of this argument, just because of the patient's eyes, make the diagnosis change!

   At this time, everyone's interest was hooked.

   Looking at the young resident of the Cardiology Department in front of him, everyone was chatting and asking about Lu Chen's origins.

   "Dr. Lu, please analyze it for everyone, don't give a shit." Su Zhengwen said quickly.

Lu Chen smiled and continued: "Although the patient is lying in the ICU and inhaling high-flow oxygen through a mask, his eyes are still alive and shiny. So I judge that the patient is not an infectious fever, but an immune fever! "

   "Huh? Is this all it takes?"

   Everyone frowned, wouldn't this be a bit sloppy?

   These senior physicians and deputy chief physicians here seem to not understand what Lu Chen meant.

  When do you see a doctor with your eyes? Didn't you read the lab report?

  Su Wenzheng frowned deeply and asked suspiciously, "Doctor Lu, what do you think about the eyes of patients with infectious fever?"

   Hearing this question, everyone looked at Lu Chen, wanting to hear Lu Chen's next answer.

Lu Chen smiled slightly and explained, "A patient with prolonged infectious fever, especially a patient with septic shock, is sleepy and indifferent in his eyes due to the action of bacterial toxins. While immune fever There are not many "toxins" in the body, even if the fever is several months, the eyes are still very smart, as long as the fever subsides, the appetite will be good."

   After Lu Chen finished speaking, the audience was silent.

   So people are trying to figure out the connotation of Lu Chen's words.

  At first, everyone thought that Lu Chen was just exaggerating, but now he gave his reasons.

  People began to re-examine this issue.

   At this time, a deputy chief physician of the rheumatology department suddenly said, "I think this statement makes some sense!"

   "What do you say?" The ICU director looked at the rheumatologist.

  The rheumatologist thought about it and said: "This phenomenon may be better explained by the differential diagnosis of sepsis" (infection) and "subsepsis" (adult Still). "

   Then, the rheumatologist introduced the general situation of the two diseases to everyone.

   "So, is it really possible that it is an immune fever?"

  Su Wenzheng was slightly startled. The way he looked at Lu Chen had already changed.

After the rheumatologist finished speaking, Lu Chen couldn't help but nodded, "The rheumatology teacher is right! I think this is a clinical phenomenon that cannot be described in books and papers, and we can use therapeutic diagnosis to verify it. !"

   "You're arrogant, using hormones?" The rheumatologist looked at Lu Chen tentatively.

  Lu Chen smiled and nodded: "Yes, this patient is mainly immune fever, first increase the dose of the hormone dexamethasone. After three days, if the fever subsides, it can be preliminarily judged that the patient is immune fever!"

   At this moment, Lu Chen not only put forward his own diagnosis opinions, but also gave the next diagnosis and treatment methods.

   This makes Su Wenzheng eager to try, and he can't wait to give the patient a shot of hormones now!

   (end of this chapter)