Chapter 777 【777】Believe in Your Own Medical Judgment

Is this the case? The symptoms of clinical patients are complicated, and it is impossible to say that it is simple and easy to distinguish the cause. If it was possible, it would not be said that the patient was suddenly discharged from the hospital after staying for three weeks.

Xie Wanying chose this time to listen to the patient's heart. If you think about it carefully, there are many strange things in Yangyang's mother's case that deserve further scrutiny.

For example, the patient's jaundice is relatively mild, the hepatitis B index is positive but the transaminase is generally normal, liver cirrhosis is generally a shrinkage of the liver, but the opposite is true for a positive mother, which is hepatosplenomegaly.

The patient's chest X-ray seemed to be normal, only the left side of both lungs was slightly thickened, the mediastinum was normal, and the heart shadow was generally normal.

In the case of b-ultrasound, the kidneys have substantial diffuse damage, which is consistent with the performance of ascites in the late stage of liver cirrhosis. The liver shows widening of the portal vein. Due to ascites, the B-ultrasound doctor's field of vision is unclear, and it is impossible to see whether the inferior vena cava is obstructed, but the B-ultrasound doctor suspects it based on his own experience.

Such a result, it is estimated that Budd-Chiari syndrome needs to be ruled out. Budd-Chiari syndrome is a type of posthepatic hypertension, the main cause of onset is hepatic vein and inferior vena cava hepatic blockage. Later, why the patient did not have the relevant examination of the inferior vena cava, we need to ask Dr. Gong again.

"Take a deep breath." Xie Wanying said to the patient.

Yang Yang's mother took a deep breath and let out a long breath.

After Xie Wanying listened to the breath sounds of both lungs for the patient, she found that the breath sounds of the patient's left lung became thicker, indicating some inflammation.

Listen carefully to the patient's heart. There is a systolic murmur in the mitral valve area at the apex, but it is relatively weak. It is estimated to be only grade two, far below the standard of organic heart disease.

In fact, the effect of pumping ascites in this kind of patients is average. Therefore, the treatment plan was later adjusted to limit salt and water and diuresis, that is, the overflow theory of the latter was used as the basis for treatment, and the effect was good. This is the only thing that can be done in the hospital, so the patient's condition is good and he is discharged from the hospital first.

Even so, after listening to the patient's heart, Xie Wanying held the stethoscope and continued to ponder, feeling that this case could be considered more carefully. Now she will pay more attention to her medical intuition, mainly because the case of Li Yaxi in the 21st bed next door has sounded the alarm for her.

Yangyang's mother raised her head, as if she wanted to talk to her.

Xie Wanying put her ear to it.

Yang Yang's mother whispered to her: "The girl next door can't sleep at night, she's very scared."

Although Yang Yang's mother is seriously ill, she never forgets to care for the patients in the same ward. Perhaps in the eyes of Yangyang's mother, it is pity for a young and beautiful female college student to be admitted to the hospital.

The medical staff were aware of Li Yaxi's fear, and the nurse specially drew the door curtain between the 20th and 21st beds to help the patients block their sight. But it's useless, I'm afraid it will become ingrained in some patients in this environment. If the patient is not strong, like Li Yaxi, he feels like he is having nightmares every night and day.

"What disease does she have?" Yang Yang's mother asked the doctor, probably because she wanted to help the patient.

Xie Wanying said to the patient: "No matter what disease you have, the doctor will do your best to treat it when you enter the hospital."

Regarding Li Yaxi's illness, Xie Wanying was confident, because Senior Brother Tao had arranged for Dr. Song to take care of her, so there must be a breakthrough.

Yang Yang's mother felt a little relieved when she heard her say this.

"I'll discuss it with Dr. Gong when I get back home, and see if I can give you another examination." Xie Wanying said to Yangyang's mother, "The examination should be clearer, and the medicine prescribed in the future will be more targeted, and the curative effect will be better."