Since 1981 Health School

  Chapter 596 Diagnosis of epileptic abdominal pain

  Sodium valproate is a nitrogen-free broad-spectrum antiepileptic drug.

   It has different degrees of resistance to convulsions caused by various methods. It is effective for various types of human epilepsy, such as various types of petit mal seizures, myoclonic epilepsy, focal seizures, grand mal seizures, and mixed epilepsy.

In addition to antiepileptic use, sodium valproate can also be used to treat febrile convulsions, dyskinesias, chorea, porphyria, schizophrenia, pain caused by herpes zoster, adrenal dysfunction, and to prevent alcohol withdrawal syndrome sign and so on.

   It can be said that it is very versatile.

  There is another thing that ordinary people rarely mention, that is, it is also effective for mental diseases caused by epilepsy, which is also known as "neuropathy"...

  If Chen Qi is going to use sodium valproate, and if Yu Sisi is indeed suffering from epileptic abdominal pain, it will definitely be effective.

  But this medicine is not only unpleasant to say, but the key is that it has a lot of side effects.

  For example, the impact on liver and kidney function can easily lead to thrombocytopenia, purpura, bleeding and prolonged bleeding time, and hearing loss and reversible hearing damage in adolescents.

  But when a doctor sees a doctor, he can only choose the lesser harm between the two powers, or the greater benefit between the two powers, depending on whether the benefit is greater or the damage is greater.

  Everything is impossible to be perfect.

  A doctor from Xijing Hospital put forward a different opinion:

   "Dean Chen, the diagnosis is not clear yet, and the relevant examinations have not found any evidence. If you take sodium valproate directly, there will be certain side effects at that time. It is difficult for the parents to explain here."

  He kindly reminded her, after all, this is a 16-year-old young girl, and everyone wants to cure her illness at the least cost.

  Chen Qi patiently explained:

   "The little girl's clinical symptoms, medical history, and genetic history are more consistent with abdominal pain caused by epilepsy. We should try it. If it really doesn't work, the damage to the human body after one dose of medication is also controllable.

  If the abdominal pain can be relieved by using anti-epileptic drugs, then we can be sure that it is caused by epilepsy. This is called diagnostic treatment, and it is in line with the standard of diagnosis and treatment. Otherwise, what should we do? Failure to find out the cause is always a ticking time bomb. "

   The unknown is the scariest.

   There is a famous saying in Huaguo Chinese Medicine: go to the doctor before you get sick, if you want to get sick, go to the doctor and you are already sick.

  For diseases, early prevention, early detection, and early treatment can avoid the worst results. If you procrastinate and procrastinate, it is often late in the end, and there is no way to recover.

  Professor Tong made a final decision:

"We gastroenterologists' eyesight is too limited, we only focus on the gastrointestinal tract. Dean's."

   Many doctors in Xijing Hospital complained in their hearts. They originally wanted to see the awesomeness of endoscopic surgery, not to see other things.

  But these doctors forgot that this patient was a new diagnosis, and it was their inability to diagnose that led to the patient's trip to Haidong.

  Chen Qi doesn't care what other people think, he is a doctor, and a doctor treats patients, not an actor who specializes in performing endoscopic surgery for others.

  The doctor's order was issued soon, and the head nurse took the sodium valproate injection in person.

   Then everyone was waiting for the results of the drug test, waiting for Yu Sisi's abdominal pain to recur. After all, this abdominal pain has no time pattern and can only wait.

   This time it was a bit of a face, but just before noon, the girl's abdominal pain reappeared.

  The head nurse hung up a bag of sodium valproate needles as quickly as possible, and all the doctors, including Chen Qi and Professor Tong, ran to the hospital bed as quickly as possible.

  Everyone wants to see how it works?

  The doctors of Xijing Hospital want to see how capable this talking "double director" really is?

  The doctors of Yue TCM Hospital have no brains to trust the director. They feel that the director is 100% accurate.

  The most nervous and tangled are Yu Sisi's parents, because no matter whether the result is effective or invalid, it will be bad news for their family.

  If sodium valproate has no effect, it means that the cause of the disease has not been found out. Not only is it a waste of time to travel thousands of miles, but my daughter's condition is always a heart attack, and I don't know when it will explode.

  But if sodium valproate is effective, it will also confirm the existence of "epilepsy" in disguise, and the news is even worse.

  Goat epilepsy is crazy, it is too cruel for an unmarried young girl like a blooming season, it might ruin her life's happiness.

  Who is willing to marry a sheep epileptic in the future? What's more, the disease is also hereditary.

  In this way, the three parties have their own thoughts, and they are all waiting for the patient's reaction after taking the medicine.

  The sodium valproate injection was slowly dripped into the patient's body through the infusion tube. Dr. Ma Xiaona was monitoring the patient during the whole process, doing physical examinations and asking questions from time to time.

   After about 15 minutes, Yu Sisi, who was still curled up in pain just now, slowly stretched out, and she was a little surprised:

   "Doctor Ma, my stomach doesn't seem to hurt so much anymore."

  Ma Xiaona pressed her belly quickly, then raised her head and said to Chen Qi: "The abdominal wall is no longer tense, and there is no obvious tenderness and rebound pain. Sodium valproate seems to be working."

  When the girl's mother heard this, she covered her face with her hands and cried bitterly.

  The girl's father also squatted on the ground all of a sudden, hitting the ground heavily, his face full of pain and despair.

  The doctors of the two hospitals looked at me and I looked at you. No one said anything, and they all quietly left the ward. The answer was already obvious.

   What Yu Sisi got was epileptic abdominal pain.

  Chen Qi touched the little patient's head lightly. He didn't know whether to say congratulations or comfort her to be strong, but he always wanted to give this little girl or her family a glimmer of hope.

"Now that the cause of your stomach pain has been found out, this is good news and bad news. But don't worry about it. As long as you take your medicine on time in the future, your stomach pain will never happen again, and there will be no pain." Other bad symptoms come out, understand?"

  A 16-year-old girl is not a fool. Seeing the reaction of her parents, she knows that "epilepsy" is definitely not a fun thing.

  But girls who are in the blooming rainy season are always easy to fool and optimistic:

   "Okay, I will listen to you, and I will take the medicine on time in the future!"

  People's sorrows and joys are not connected. When Yu Sisi's family felt that the sky was falling and fell into endless despair.

  When Chen Qi walked into the gastroenterology office, there was a burst of warm applause.

  Professor Tong kept nodding:

   "Not bad, Xiao Chen, you are indeed an all-round doctor. You can diagnose such a rare disease. Look at our Xijing Hospital. After half a month of investigation, you can't find it out. I'm ashamed."

  Chen Qi thought that the level of your Xijing Hospital is really not good. Since the gastrointestinal tract examination showed no positive results, other causes should be considered.

  In the final analysis, this is a drawback of specialization. Specialists only focus on their own specialized diseases, without the thinking and pattern of general practice.

   Of course, Chen Qi couldn't say that:

"Where, I was lucky. I saw the patient's mother at the train station for the first time, and found that the corners of her mouth were twitching from time to time. The frequency was not very high, but I could still see something strange. Later, I watched again. Been there a few times.

   So I was like, is this a small seizure? With this question in mind, I followed this line of thinking to find out, such as whether epilepsy will be passed on to her daughter, that is, Yu Sisi, and will epilepsy cause abdominal pain?

  I remember that when I asked the child’s mother if she had a history of epilepsy, many doctors, including Professor Tong, suddenly realized that we all wanted to go together. I didn't diagnose it before, I can only say that you were unlucky and didn't see the corners of the child's mother's mouth twitching. "

  Chen Qi said this beautifully, and immediately eliminated the embarrassment of many doctors in Xijing Hospital.

  Many doctors are thinking: Well, if I realize that a girl has epilepsy, I can also guess that it is epileptic abdominal pain.

  Although this disease is rare, doctors in primary hospitals may not have seen or learned about it, but doctors in Xijing Hospital must have studied it.

  Professor Tong waved his hand:

   "When we see a doctor, it's like a sports game. If you win, you win, and if you lose, you lose. If you can't lose, blame the weather, the referee, and luck, right?"

  Director Liang Sting is a bit regretful:

   "It's a pity, I thought Yu Sisi had some kind of gastrointestinal disease, and I want to see Dean Chen's endoscopic surgery."

  Chen Qi also smiled: "It's not easy to see endoscopic surgery, we have a lot of patients in this area now..."

  Before he finished speaking, he saw Yi Zewen, the chief of the emergency department, rushing in, and was shocked when he saw so many people:

   "Ah, Dean, you are in a meeting, sorry to interrupt you."

  Chen Qi knew that his confidant would not bother him if he was fine, and knew that there must be other things, so he asked:

   "What's wrong? Is there something in the emergency department?"

"I have something to do. In the morning, we received a patient with abdominal pain. We also did an examination and used antispasmodic and painkillers, but it didn't work. The patient's abdominal pain is getting worse and worse. I don't want to ask your old man to help Take a look."

  Chen Qi laughed and cursed:

   "Get out, return to the old man. That Professor Tong, Director Liang, Director Zhou, and everyone, I'm sorry, I have an acute abdomen, so I have to excuse me for a while."

  Professor Tong listened with a serious face: "We are fine, you can go quickly."

  Doctors are naturally sensitive to emergency patients, and they will basically drop everything at hand and rush away. As a fellow doctor at Xijing Hospital, of course I understand.

   Seeing Chen Qi run away, the doctors in Xijing Hospital became idle.

  Director Liang looked at Professor Tong: "Teacher Tong, how many scenic spots shall we go to in Yuezhong next?"

  Many doctors in the back have bright eyes. Apart from studying, their bigger purpose is to travel at public expense.

  Professor Tong smiled:

   "What, you want to go play on the second day? Let's finish the main work first. This is not another emergency patient with abdominal pain. It just happens to be our professional counterpart, so let's go and see the excitement.

   Compare in your minds, what is the difference between the diagnosis and treatment ideas of Yuezhong Hospital and ours, and then think again, who has a higher level, and you have underestimated the heroes of the world, which has caused you to be so immodest now. "

  Professor Tong is an old master. After being criticized by him like this, everyone dared not say a word.

  The old man brought his group of apprentices and grandchildren here, and he was here to "strike and hit" them. Of course, he would not miss any opportunity.

  Chen Qi followed Yi Zewen and ran towards the emergency department:

   "Old Yi, what is the general condition of this patient?"

  Yi Zewen hurriedly reported: "The patient is Old Cui from the post office opposite our hospital, Tongzhi Cui. This matter has to start in the morning..."

  Cui Tongzhi, 45 years old this year, is a section chief of the post and telecommunications bureau. He is fat and round.

  Usually he is a kind person, and it is very straightforward to ask someone to do something, so he is very popular, and he knows many employees in the People's Hospital.

  In 1989, the Post Office and China Telecom had not yet separated, and the telegraph business was booming, so the work of the Post Office was leisurely, the wages were high, and it was convenient to make a phone call and send a telegram. It was a good job that everyone envied.

  Cui Tongzhi went to the emergency department to see a doctor by himself in the morning.

  When he came, he bent his waist, covered his stomach with his hands, his face was a little pale, and his fat and round face was covered with beads of sweat.

   Obviously the pain is not light.

   It happened that Yi Zewen hadn't finished his night shift last night, so Cui Tongzhi came directly to him.

   "Director Yi, hurry up, my stomach hurts badly, please help me relieve the pain quickly. Hey, hey~~~"

   "Hey, isn't this Chief Cui? My stomach hurts. I must have gone to another restaurant last night to eat and drink too much? Oh, come on, lie down here, let me check you, when did the pain start?"

  Yi Zewen started to check while joking, Cui Tongzhi also answered honestly:

   "I started to have a dull pain in the morning, and it became more and more painful 20 minutes ago. I couldn't take it anymore, so I came to the emergency department of your hospital."

   "Which one hurts the most?"

  As Yi Zewen asked, his brain quickly carried out a disease spectrum analysis.

   It is necessary to know that there are dozens or hundreds of causes of abdominal pain. Abdominal pain in different parts, the length of duration, the nature of pain, etc. may be the key to a successful diagnosis, and any clues cannot be missed.

   "Here, here is the most painful!"

   Cui Tongzhi pointed to his navel and said that the middle part of his stomach hurts the most. When he said that, he couldn't help but want to curl up his body, which seemed to relieve the pain.

   Such a strong middle-aged man is in pain like a little girl at this moment, it is probably really painful.

  Yi Zewen pressed a circle around his stomach, focusing on the area around the navel.

   But the strange thing is that the patient clearly said that the abdominal pain was severe, but he did not show any obvious pain response when pressed, and the abdominal muscles did not show a tonic contraction.

   The bowel sounds on auscultation were a little more active, but nothing else. This made Yi Zewen scratch his head a bit, but he didn't care.

   "The check is over, you can get out of bed first, do you remember what you ate last night?"

   "Last night, what I ate at home was ordinary home-cooked food. I really didn't go out to eat and drink."

   "What about this morning?"

   "I ate two bowls of small wontons and two drawers of steamed buns at Dayun Qiaotou in the morning. I used to eat these often, and there was no problem."

   It seems that there is no problem with the diet, so what is the trouble?

  (end of this chapter)