Chapter 138

"Guillain Barre syndrome?" Hearing Xu Ze's words, director Qu was stunned. A glimmer of light flashed through his black framed glasses. He took a fixed look at Xu Ze. However, he said in an unexpected way: "do you also know this disease?"

Seeing director Qu's question like this, Xu Ze was very happy. He told him that he didn't need to spend a lot of time talking.

At the moment, he nodded gently, then handed over the medical record in hand, and said to director Qu, "look at this patient, director..."

Seeing that the medical record handed over by Xu Ze was the patient who had not been able to investigate Yin, director Qu was stunned. After taking a deep look at Xu Ze, he finally took over the medical record and looked at it.

Director Qu looked very carefully, turned page by page, and thought for a long time. He also went to see this patient today. However, there were too many patients at that time. He did some examinations. After listening to Qian Xuebin's report, he agreed to his diagnosis. However, he did not consider the disease at that time.

However, according to the data I saw last time, in retrospect, some symptoms are very similar, which seems to be more suitable for the diagnosis of neurogenic myasthenia gravis.

After thinking for a long time, director Qu looked up at Xu Ze and said in a slow voice, "did you also read the latest information?"

Xu Ze nodded, then looked at director Qu and said, "director, I have just had a detailed consultation and physical examination for the patient, which is slightly more detailed than the medical history recorded by doctor Qian. The patient has a history of infection two weeks before the onset of the disease, and has a history of limb and neck and back pain before the onset of the disease."

Listening to Xu Ze's explanation, director Qu's eyes gradually brightened, indicating Xu Ze to continue.

"Physical examination showed that in addition to the decrease and disappearance of muscle strength and the disappearance of tendon reflex, I also found that the patient had superficial sensory disturbance of lower limbs. Although it was only mild, it did exist..."

Xu Ze stopped for a moment. Seeing that director Qu looked at himself and listened carefully, he continued: "however, the effect of some drug treatments carried out by Dr. Qian is not sure. It only temporarily prevents the further aggravation of the disease, but does not achieve any practical effect. It shows that the diagnosis of neurogenic myasthenia is still questionable."

"So based on the current medical history and physical examination, the possibility of Guillain Barre syndrome is very high..." After that, Xu zeding looked at director Qu and waited for his reaction.

After listening to Xu Ze's analysis, director Qu nodded slowly, looked at Xu Ze with approval and said, "yes, you are at this age, but you can have such a wide range of knowledge, and it is very good to be so careful..."

"Yes, but we must be careful in the diagnosis of this disease. After all, it is a newly discovered disease, and there are few reports on this aspect in China..." Director Qu stood up, picked up the stethoscope and percussion hammer, looked at Xu zeshen and said, "go Let's go and check again! "

It can be seen that director Qu did not object to his own opinion, nor readily agreed with him. Instead, he insisted on checking and confirming again. Xu Ze could not help but nod in secret. This is the caution that a medical expert with high professional quality should have. At present, without hesitation, they went directly to the ward.

After seeing director Qu and his new disciples chatting for a while, they went out together. Zhang Qi looked up in surprise, and then continued to write his own course record.

They pushed open the door of the ward and went to the bed of the patient with fatigue. The family members and patients nearby met director Qu this morning. They knew that he was a professor of the first affiliated department and also the director here. When they came to the ward round today, Dr. Qian accompanied the examination respectfully.

At this time, director Qu came in. The family members were feeding the patient porridge. They immediately stood up and said, "Hello, director Qu!"

Director Qu nodded with a smile, and then said to the patient: "there are too many patients this morning, things are too busy, I didn't give you a detailed examination Now Dr. Xu and I will examine you carefully again! "

"Ah Good, good What a bother to you and Dr. Xu! " The patient looked at director Qu and Xu Ze on his side, and immediately he was excited and politely grateful.

Director Qu asked the medical history again with a smile. Listening to director Qu's inquiry, the patient was curious. How could director Qu like to ask some inexplicable irrelevant things like the first doctor Xu.

Hearing what Xu Ze said, director Qu nodded his head and then had a careful physical examination. The final result was exactly like what Xu Ze said. In addition to the disappearance of muscle strength and tendon reflex of the lower limbs, the patient also had slight superficial sensory disturbance.

After the examination, director Qu nodded to Xu Ze, and then they left the ward.

Looking at Qian Xuebin's medical record, director Qu frowned and shook his head. He secretly said that Qian Xuebin had not asked the patient more carefully. If he had asked carefully, he would not have missed out on the disease today.

At the moment, he could not help but look at Xu Ze happily and said: "according to this situation, it is really like Guillain Barre syndrome, but there is no official information in China, so we still don't have a definite diagnosis..."Xu Ze chuckled and said: "director, Guillain Barre syndrome has a characteristic thing, that is the separation of cerebrospinal fluid protein cells We just need to do a lumbar puncture, extract some cerebrospinal fluid for testing, and it should be ok... "

"Protein cell separation?" Qu Ze looks at the information on his head, but he doesn't know what he said

"I remember that the treatment of Guillain Barre syndrome and this neurogenic myasthenia is almost completely different We must be careful about this! " Director Qu looked at Xu Ze and said earnestly.

Xu Ze smiles and nods, but he is absolutely sure what he just said is right, because the future medical technology has proved this.

"Well Let's do a waist now Don't delay. We must diagnose the disease as soon as possible! " Director Qu stood up resolutely.

Seeing that director Qu was so anxious, Xu Ze could not help but stupefied: "don't we have to wait for doctor Qian?"

"Not now He should be ready for lunch now. He will come to take over the shift at noon. Let's make a diagnosis as soon as possible Director Qu said decisively.

Seeing director Qu's affirmation, Xu Ze no longer hesitated, nodded, and then said, "then I'll go and prepare the utensils."

Although Xu Ze is not very familiar with the emergency department, but with the help of Hu Xia, a little nurse, she quickly prepared all the tools for waist wear.

Director Qu personally called the patient's family members to come over and told us about the new discovery and the need for this lumbar puncture examination.

Hearing director Qu's words, the family members remembered that it was the little Xu medical student who came to check and asked about the situation. Then director Qu came to ask again and considered the problem. However, they could not help but feel grateful to Xu Ze. If it was not for Dr. Xu who discovered the problem, he would have told director Qu responsibly, even if he could not find it Possible reasons.

At the moment, he signed the consent form of waist wear, and asked director Qu to pay more attention. Xu Ze, waiting for his waist to wear, came in. The family saw Xu Ze and was very enthusiastic. Xu Ze was not used to it.

Xu Ze is ready to see, director Qu with Xu Ze, two people carrying things, they went straight to the ward.

At this time, the patient also knew the situation from his family members, and wanted to do such an examination. At present, his eyes were very different from those of the first. His eyes were full of gratitude.

Director Qu pushed his glasses and watched Xu Ze skillfully position the patient in the posture of lying on his side and holding his knees. Then he was curious and said, "can Xu Ze even do lumbar puncture? It's not possible, is it? It's impossible to do this lumbar puncture in the clinic! "

However, out of his surprise to Xu Ze today, there is still a kind of inexplicable confidence. After Xu Ze is ready for himself, he looks at Xu Ze and says, "Xu Ze, will you do it?"

After listening to director Qu's question, Xu Ze was stunned a little, but he replied honestly, "yes..."

"Yes?" Director Qu's eyes flashed a ray of strange light, and also a glimmer of surprise Then you can do it! "

"Oh Good Listen to let yourself do it, Xu Ze is very excited to be able to actually operate a lumbar puncture surgery by hand. After all, he has only carried out simulation operation in the empty space before. Although these simulation operations are almost the same as the real operation, Xu Ze is extremely excited when he really does it.

Lumbar puncture is also a small operation with no low difficulty. Many doctors seldom succeed when they do it for the first time. However, Xu Ze is quite confident in himself.

At present, in order to make a successful puncture, Xu Ze adjusted the patient's position again, so that the patient's back is vertical to the bed surface, the head is flexing forward, the hands hold the knees close to the abdomen, so that the trunk is arched, so that the patient's spine protrudes as far as possible, so as to increase the width of intervertebral space and facilitate the needle insertion.

Then he began to select the puncture site. He stretched out his hands and determined the intersection of the posterior superior iliac spine line of the pelvis and the posterior median line of the spine as the puncture point. This is the position of the interspace between the third and fourth lumbar spine, which is also the best puncture position.

Then take out the complex iodine cotton swab, the puncture point for routine disinfection of the skin, and then wear sterile gloves, open aseptic waist wear bag, for the patient covered with disinfection hole towel

Director Qu watched Xu Ze's movements with satisfaction. Xu Ze was very skilled in these procedures, which fully conformed to the aseptic procedures. He did not make any mistakes at all, just like an old hand.

This makes director Qu can't help but marvel at himself. Today, Xu Ze has given him too much surprise. I really don't know where he learned these things? How can a junior student know these things?

At this time, seeing that Xu Ze had laid the disinfection hole towel and picked up the syringe, director Qu suppressed his surprise. He took a 2% lidocaine from the plate and opened it up to Xu Ze. He waited for Xu Ze to take medicine and did his duty as an assistant.

At this time, Zhang Qi, who had been in the office, followed him curiously. At this time, director Qu was actually working as an assistant for Xu Ze. At present, he was surprised. Director Qu served as an assistant to others, and he was still a new comer. Who could believe that?PS: the gap is narrowing step by step. Tiannan kneels down to ask for monthly ticket support...

... Ask for monthly ticket

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