I Can See Health

   Chapter 821 Mu Xiuyu Lin

   After dinner, everyone went back to their homes.

  Lu Chen rested for a while in the apartment.

   In the afternoon, he will also replace Director Yan Wanfeng to discuss difficult cases.

   Today, Yan Wanfeng basically doesn't care much about clinical matters.

   Most of the clinical affairs in the department are handled by Lu Chen.

afternoon.

   Oncology ward.

   shows the classroom.

   The directors or deputy directors of each major department of Guanghai First Hospital came to participate in this difficult case.

   There is no other reason, one of the patients' condition is critical and complicated.

   Second, the patient's identity is special.

When    came to the oncology department, a graduate student immediately led Lu Chen to the classroom.

   "Hey, Director Lu, you're here."

   "Director Lu, the patient with congenital heart disease last time successfully gave birth to a child. This is a good case! We can study it well!"

   "Director Lu, we also have a troublesome case in our department. You can visit us when you have time."

  Lu Chen is now familiar with the directors of other departments.

   Everyone gradually became familiar with Lu Chen's identity, but ignored his age.

   is mainly Lu Chen's ability, which is too outstanding.

   Whether it is clinical ability or surgical ability.

   "It's easy to talk." Lu Chen smiled slightly and greeted everyone one by one.

  Oncology is a big, rich department!

   The most important thing is that the contradiction between doctors and patients in the oncology department is much less than that of other departments!

  It is normal that the tumor is diagnosed and cannot be cured. Both the patient and the patient's family accept it!

   cured, that means good medical skills.

   Moreover, the medicines in the oncology department are very expensive.

   Correspondingly, the benefits of oncology are also very good.

   Before Lu Chen chose a department, he even thought about oncology for a while.

   After ten minutes, all the personnel were present, and the discussion of difficult cases began.

   Director Tang of the Department of Oncology was the first to stand up and speak.

   "Hello, directors. This time, I am bringing everyone together to solve a case. The patient's identity is special, so our department has no choice but to brainstorm and see if we can come up with a good diagnosis and treatment method!"

   Director Tang's words made everyone more curious about the identity of this patient.

   However, the people in the oncology department kept silent.

   Everyone can only give up.

   Immediately afterwards, the patient's doctor in charge of the bed gave a brief introduction to the patient's condition.

  Everyone has a medical record information sheet in their hands, and with the introduction of the doctor in charge of the bed, everyone quickly knows the basic situation of the patient.

   The patient was diagnosed with rectal ca with liver and lung metastases.

   After the current targeted drug treatment, dyspnea and decreased activity tolerance have occurred recently.

   "Everyone understands the patient's condition." Director Tang said, "What we are most puzzled about is the reason for the patient's symptoms, and in terms of treatment, can we continue anti-tumor therapy?"

The voice of    just fell.

   A deputy chief physician of the Department of Respiratory Medicine took the lead and said, "May I ask Director Tang, does the patient have a history of lung diseases? For example, emphysema, etc."

   "Yes." The doctor in charge of the bed nodded slightly, "The patient has a history of smoking for nearly 40 years, and he only started quitting smoking in the last year. He has a long history of chronic obstructive pulmonary disease."

   "Have you checked your lung function before performing tumor treatment?" said the respiratory doctor.

   "No." The doctor in charge of the bed shook his head, "The patient's symptoms were very mild at the time, so he didn't notice this problem."

"Yeah. I looked at the patient's medical records and found that in terms of dyspnea, first of all, heart failure must not be ruled out. In addition, it is the state of lung function, long-term emphysema, plus the metastasis of lung cancer, or the lung function must be not good."

   Respiratory doctors talked eloquently.

   After all, it is the top hospital in the province.

   Every director here has an excellent resume.

   More than 90% of them have doctorate degrees and have the opportunity to study abroad.

   There are even some directors, who are industry leaders.

   Everyone expressed their opinions.

   After a while, the speech ushered in a brief pause.

   "Well, the opinions of all teachers are very valuable." Director Tang said, "Which department teacher will continue to express opinions?"

   Under the stage, a doctor from the intensive care department raised his hand.

   Lu Chen knew him, it was Huang Xiaofeng, the captain of the rescue team some time ago.

   "Director Tang, let me tell you my opinion." Huang Xiaofeng said.

   "Okay, then let's listen to Director Huang's high opinion."

  The eyes of everyone turned to Huang Xiaofeng.

  Huang Xiaofeng smiled lightly, "This patient, I have consulted before, I noticed his electrocardiogram, I wonder if you have seen it?"

   Then, on the screen of the projector on the stage, the three electrocardiograms made by the patient after admission immediately appeared.

   "Have you found something abnormal?" Huang Xiaofeng said, "Although I am not a cardiologist, it is clear that the first ECG showed slight elevation of the ST segment in leads V1-V3."

   "The third ECG showed extensive ST-segment elevation in the precordial and inferior leads."

   "In addition, the patient's troponin was elevated, do these all suggest that the patient has myocardial infarction?"

   As soon as he finished speaking, there were whispers in the classroom.

  Lu Chen didn't speak.

   In fact, he had already noticed the patient's electrocardiogram.

   However, if it is really a myocardial infarction and it is so easy to judge, then this patient does not need to have a general consultation of the whole hospital, right?

   Sure enough, after hearing Huang Xiaofeng's opinion, Director Tang said, "Director Huang's opinion is very good. We have also considered it before, so we performed coronary CTA for the patient. You can look at the results of the CTA."

   Coronary CTA is a non-invasive examination, and like coronary angiography, it can diagnose whether there is coronary heart disease.

   Then, the doctor in the tube bed projected the image of the patient's coronary CTA on the projector.

  Lu Chen raised his head and looked intently.

  The patient's anterior descending artery has stenosis, but the degree of stenosis is not severe, only about 40% stenosis.

   This level of stenosis will not cause such severe symptoms at all!

Huang Xiaofeng obviously saw this result, he was a little unwilling, and still asked: "The result of angiography is normal, it does not necessarily mean that there is no coronary heart disease! I remember that in the field of cardiology, coronary microcirculation disorder was diagnosed when there was a disease. That is, the major main vessels may not be narrowed, but the microcirculation disorder may also lead to heart failure."

  Microcirculation disorders cannot be detected by coronary angiography or CTA.

   After saying this, Huang Xiaofeng also glanced at Lu Chen, "Director Lu is an expert in this field, you know better than me, it should be something like this."

  Lu Chen smiled and nodded: "Director Huang, you're right, there is indeed such talk."

   Seeing that Lu Chen said so, everyone asked questions.

   Is the patient suffering from heart failure caused by cardiac ischemia, as Director Huang Xiaofeng said?

   Director Tang's attention was attracted by Lu Chen at this time.

   He suddenly said: "I have heard it for a long time, we have a very good cardiologist in Guanghai First Hospital. At a young age, he has won many honors and awards."

   This is naturally Lu Chen.

   Everyone also turned their attention to Lu Chen not far away.

   Director Tang paused for a while and continued to smile: "Director Lu came to participate in the case discussion in person today. I think everyone is very interested in Director Lu's opinion on this patient, right?"

  Lu Chen finally knew that Mu Xiu was in the woods and the wind would destroy him.

   At this time, everyone present looked at him.

  Perhaps Director Tang is not malicious.

   But at this time, Lu Chen had to stand up and express his opinions and opinions.

   Once there is a slight mistake, he is likely to be labeled by everyone, "not matching", "learning valve" and so on.

  However, many doctors have already published their own opinions about Lu Chen, so what new tricks can they say?

   (end of this chapter)