Chapter 1879 【1879】Counseling and Hard Disease

The current X-ray of the patient shows that the condition of the lungs is generally normal, except for some pulmonary fibrosis. The county hospital has some basis for suspecting that the pneumonia has not healed, but it needs to be carefully identified. Without a CT machine, it can only be judged to this point. Now when conditions permit, clinicians can make further judgments in combination with CT films. The texture of lung tissue was thickened and blurred, the bronchial wall was thickened, and fibrosis appeared in some parts. There is bronchial inflammation, which is consistent with Chang Jiawei's previous judgment.

Seeing this, Xie Wanying couldn't help but admire Teacher Chang's ability to see very accurately for a non-cardiopulmonary doctor.

Beside her, I only heard classmate Geng asking the monitor: Why did someone say that his younger brother was suspected of having tuberculosis.

Now the characteristics of tuberculosis are not seen on the lung film for the time being.

Before Fu Xinheng and Chang Jiawei did not arrive, the only ones who suspected that the patient had tuberculosis were Teacher Ren or Dr. Guo. If it is specifically specified, their teachers are not clinicians and will not express their opinions but come to understand the situation. It could only be that Dr. Guo was suspicious.

Hearing what the students discussed behind him, Fu Xinheng, who had just arrived in the future and had time to understand the whole picture of the patient's condition, asked Dr. Guo: "What is the reason for your suspicion of tuberculosis?"

Anyway, as a cardiothoracic surgeon, he dared to guarantee that these films could not confirm that the patient was tuberculosis.

Facing the question from the superior teacher, Dr. Guo carefully wiped his palms, and answered his medical reasoning path: "I can't see it in the film for the time being. But I have known the patient's medical history before. It is said that the patient's family has a grandfather who smokes and coughs all the year round. , it cannot be ruled out that this old man has a history of tuberculosis. Tuberculosis is just a type of tuberculosis, Mr. Fu."

Most tuberculosis bacteria invade the lungs, so it is commonly known as pulmonary tuberculosis. When it comes to tuberculosis, most people habitually equate it with pulmonary tuberculosis, which is wrong. Tuberculosis refers to the infection of the human body by Mycobacterium tuberculosis, which can be divided into pulmonary tuberculosis, digestive tract tuberculosis, lymphatic tuberculosis, etc. according to the different parts invaded by the bacteria, but the latter is a rare case that is rare in clinical practice, as is spinal tuberculosis.

A different thing about spinal tuberculosis is that most spinal tuberculosis seems to be secondary tuberculosis rather than primary disease. The so-called secondary, that is, like tumor metastasis, Mycobacterium tuberculosis does not directly invade the spine, but comes to the spine from other tuberculosis primary lesions such as pulmonary tuberculosis, digestive tract tuberculosis, etc. through blood circulation.

Dr. Guo's suspicion of tuberculosis is definitely not a non-featured lung film, but a film from the spine.

Spine x-rays include frontal and lateral views. Frontal radiographs showed that the lesion was in the middle of several vertebrae of the patient. It seemed that the soft tissue was violated and the bone showed signs of destruction. Just clinically, a huge difference between spinal tuberculosis and spinal cord tumors may be at this point.

Mycobacterium tuberculosis is not like a tumor. It is nicknamed a bullying bastard by medical leaders. It only dares to attack the soft tissues of the human body first, which is tantamount to bullying the weak. Tumor is the complete opposite. It is a guy who likes to confront the human body head-on. In clinical practice, it is more common for tumors to press in like an army and directly destroy bone tissue. A little disdain for the soft tissue of the human body is a combination of skills. The typical difference between the two makes ordinary doctors question whether it is tuberculosis when they see soft tissue damage on the film.

Of course, each patient has their own individual differences. Some patients have special physical conditions, and the symptoms that may appear are reversed. These are all factors that doctors must consider.