A hundred days after signing in, the first surgery shocked the world!

Chapter 307

So, the priority,

Lin Feng wants to check the heart, liver, kidney...

Consult first:

Step 1,

Ask heart questions:

"Have you had a history of heart disease before? Or what kind of genetic disease does the relative have of the heart? "

Lin Feng asked the female patient seriously.

The female patient shook her head repeatedly: "No, absolutely not, no history of heart disease, no genetic history..."

Lin Feng nodded.

Although there is no medical history, heart problems cannot be ruled out because the patient has a fever and cough.

It is possible that the virus infected with pneumonia has infected the heart muscle, and then causes "viral myocarditis", which may cause heart failure, and heart failure will lead to edema.

Wait, you can do an "electrocardiogram", "cardiac ultrasound", or "myocardial enzyme spectrum", you can check this thing.

...

Step 2, liver:

Lin Feng continued to ask: "What about the liver and kidney?" Is there hepatitis B or something? "

Saying this, the female patient hesitated.

"It seems that there is, and it seems that there is not..."

Lin Feng frowned: "What do you mean?" "

Female patient: "It was very young, I don't remember clearly now, I don't know if it's hepatitis B, I have to ask my mother..."

Lin Feng: "Then you hurry up and call..."

The female patient quickly called her mother, who quickly connected the phone.

Telephone amplifier.

"Mom, did I get hepatitis B when I was a child?"

"Hepatitis B, yes... Xiaoyun, what's wrong with you? Why did you suddenly ask about this? Is it sick? The voice on the other side of the phone suddenly became anxious.

"No, no, Mom, I just suddenly remembered and wanted to ask..." the female patient quickly comforted.

Her mother was in her hometown, and she didn't want her to worry.

"That's good... You had severe hepatitis B at that time, and you had a fever and vomiting for a few days..."

"Oh, okay, okay..."

After a few words, the female patient hung up the phone with her mother.

Look at Lin Feng.

Lin Feng groaned.

If the mother of the female patient did not lie, the female patient had "hepatitis B" when she was a child.

If hepatitis B is not treated for a long time, it will further develop into "cirrhosis" or "liver cancer".

Whether it is "cirrhosis" or "liver cancer", it will make the liver unable to make enough protein, and then cause edema.

So

Wait for a "liver function" and "hepatitis B two to half" examination.

......

Step 3,

kidney

"Before, you had a congenital inheritance of kidneys? Or a related medical history? "

"Nope."

Lin Feng nodded.

If not, then you can only check "kidney function".

......

After the consultation,

Lin Feng began to open the bill.

"Wait a minute, do these tests..."

Heart: "ECG", "Cardiac ultrasound", "Myocardial enzyme spectroscopy"...

Liver: "liver function", "hepatitis B two to half"...

Kidney: "Kidney function"...

Lin Feng brush brush brush...

Billing...

Because the inspection was a bit much, Lin Feng explained.

"I think your cough may not be caused by pneumonia, and now there is edema of the lower limbs, it is best to find out the cause, maybe the cough is because of this reason is not necessarily ... So it's a bit too much to check..."

Patients trust doctors or Lin Feng.

"Thank you Dr. Lin, we will go for the examination now..."

"Hmm."

Lin Feng watched the couple and took the checklist to check...

......

Lin Feng returned to the emergency room and diagnosed 9 patients...

Then the couple, with numerous test results, returned.

Lin Feng looked up:

ECG: normal

Cardiac ultrasound: normal

Myocardial enzyme profile: normal

Other words

Heart, no problem!!

Lin Feng breathed a sigh of relief.

Next, there is the construction of the liver.

Hepatitis B two to half: negative (normal)

Liver function: more than a dozen indicators are normal, only "albumin" is only 22g/L (normal 35g/L or more).

“........................"

Lin Feng frowned.

One-third less albumin!

What causes it?

There can only be two reasons:

Reason 1: The liver produces less albumin.

Reason 2: Albumin is lost.

However, liver function is no problem, so rule out the cause one!

It can only be reason two!

So the question is: where is albumin lost from?

Lin Feng's gaze looked at the checklist of "kidney work".

Renal function results: other normal values fluctuate, only one index "blood creatinine" 281μmol/L (normal female 70.7~106.1μmol/L)

Nearly 2 times more than normal!

It suddenly aroused Lin Feng's idea!

The increase of blood creatinine, its clinical significance is: renal failure, uremia, heart failure, gigantism, acromegaly, salicylate treatment, etc...

So

Kidney, something went wrong!

This also explains why albumin is 'lost'!

Because of some kidney diseases, the permeable membrane of the kidney becomes larger, and then albumin will leak out and be excreted with urine.

Now re-derived:

The female patient's kidney problem caused high serum creatinine, resulting in albumin leakage, resulting in lower limb edema.

So, the answer points to:

The kidneys of the female patient, something is wrong!

However, there are many kidney diseases, and everything needs to be examined further.

Moreover, Lin Feng thought of a problem: kidney injury may not be the first occurrence, it may be pneumonia infection, resulting in kidney function damage, and then lead to edema, low albumin, high blood creatinine...

So

Thinking about it this way, it seems that what the patient wants to do now should be to find the problem of lung disease, and kidney disease is secondary.

Lin Feng: "...................................."

It feels like a trip to the wrong ~~~

Tragic!!

......

Lin Feng temporarily gave up the cause of kidney damage to find out.

Eyes were set on pneumonia again.

Again, physical examination:

Edema ...

Cough...

White phlegm...

Recurrent fever ...

And then to the checklist, read it over and over again...

Still didn't find the problem...

Lin Feng suddenly felt tricky!

It's so hard!

Lin Feng got up: "First of all, I'll go back and flip through the book to see if I can find the answer... Change the medicine today..."

drugs

First of all, drugs to fight kidney damage, and pneumonia ...

For the most severe pneumonia, Lin Feng decided to use "cilastatin (Tai Neng)".

This "Tai Neng" is an upgraded version of antibiotics, covering a wide range of bacteria, covering almost all bacteria.

Usually serious infections and fatal infections will use Tai Neng.

......

The day's work is over.

Lin Feng off work.

Female patients are placed under the care of other doctors.

This was the first time that Lin Feng's patient was stumped, so after Lin Feng came home from work, his mind was full of this patient.

Sitting on the sofa,

Search for hundreds of thousands of cases in memory.

"The patient does not have a rash..."

"Liver function is basically normal..."

"The infectious disease aspect may be small..."

"But the patient has repeated fever..."

Lin Feng thought of a lot of illness...

But then shook his head and ruled it out.

......

After thinking about it all night, I didn't find the cause...

The next day,

Keep going to work, handing over the doctor's shift...

outcome

It was found that the patient had been plugged in and put on the ventilator.

Lin Feng's face changed: "What happened?" "

The doctor on duty said tiredly: "Something happened last night and I was sent to the emergency room... The patient developed respiratory distress, CT examination revealed non-cardiogenic pulmonary edema... At that time, the fastest heart rate soared to 160, sinus tachycardia..."

When Lin Feng heard this, he immediately knew the seriousness of the matter.

Last night seemed very dangerous!

Moreover, the medicine "Tai Neng" that was given yesterday turned out to be ineffective!

What the hell is this disease?

Female patient: "Dr. Lin..."

Lin Feng approached: "How is the situation now?" "

The female patient was panting and her face was pale: "Save me..."

Compared to yesterday, she is noticeably more fragile, like a candle in the wind.

Lin Feng's heart ached, and he nodded solemnly: "Don't worry, death has never snatched a patient from my hands, and I will definitely try to find the cause... I will find you a doctor in various departments now and do a consultation..."

General consultation, Lin Feng has no rights.

But in a small consultation, Lin Feng still has this favor, and many doctors will give Lin Feng this face.

When the female patient heard this, she immediately bloomed with hope.

suddenly

Lin Feng was stunned!

He found a problem.

The tarsal conjunctiva of a female patient, with hyperemia ... The bulbar conjunctiva also seems to be a little edematous...

Crackling~~~~~

A flash of lightning flashed through Lin Feng's mind!

Crash~~~

Lin Feng violently pulled the sleeve of the's patient's hospital gown.

Show your arms!

I saw that there were bleeding spots on the skin and mucous membranes!

This was not done yesterday!

He thought of a special disease!

"Hantavirus Pulmonary Syndrome"

Its symptoms: cough, shortness of breath, bleeding spots, failure, arrhythmias...

It is too similar to the symptoms of the patient in front of you!!

The cause of "hantavirus pulmonary syndrome" is "hantavirus".

And "hantavirus" can cause "hemorrhagic fever with renal syndrome", which will just lead to kidney damage (decreased albumin, increased blood creatinine) in female patients!

That's right!

The symptoms are right!

Lin Feng was excited!

Lin Feng hurriedly asked, "Ask a question, are there any mice in your house?" "

When the female patient heard this, she was surprised: "Huh? Dr. Lin, how do you know that there are rats in my house? Not only there are, but there are also a lot, my family lives in the basement, there are often rats, how to kill is not clean ... Wait, Dr. Lin, did you find the cause? "

Her sick eyes suddenly lit up!

Lin Feng nodded: "If you have a lot of mice in your house, then it is very likely to be the "hantavirus"!" "

"Hantavirus", mice are the biggest source of infection!

"Xiao Ai..."

"Doctor Lin..."

"Immediately give Miss Qiu a 'hantavirus antibody test', talk to the laboratory department, and cut in line..."

"Yes!"

Lin Feng was relaxed.

His mouth opened and he laughed.

All the ailments of the female patient, cough, pneumonia, kidney damage, respiratory failure... It's all corresponding!

He dared to conclude that it was definitely the "Hantavirus" and did not run!

。