Chapter 408 I have no money
Once the toothpick is taken out, the operation is actually almost done.
After all, this was the source of all the patient's recent symptoms, including the patient's concurrent abscess.
Because the operation has already been performed, the abscess can be cleaned under the microscope. In this way, a period of anti-inflammatory drugs can be used after the operation to basically clear the abscess.
"Come on, I'll leave the rest to you."
Wu Xiaofu handed over the position of surgeon to Peng Xia. Now Peng Xia has grown rapidly because he often operates with Wu Xiaofu.
Peng Xia is basically proficient in many surgeries.
Cheng Shi took Peng Xia's place and started holding the mirror.
When Wu Xiaofu left the operating room, Cheng Shicai smiled and said to Jiang Bei.
"Congratulations, we can fight side by side again in the future."
When Jiang Bei heard this, she couldn't help but smile. "I just said that women from the Northeast are not too unlucky. Look, the boss is a soft-hearted god."
The other people in the operating room also laughed at this time. They could see more clearly than Jiang Bei. Jiang Bei was lucky enough to have a teacher like Wu Xiaofu who cherishes talent and has energy. It was important, but it was also true that there was a shortage of people in area F. Otherwise, If so, Jiang Bei would not have a chance.
Because of its initial construction, District F did not have many manpower. You must know that the ratio of doctors to patients in a department must be three to one, with five patients and one doctor.
Nowadays, patients in Area F are often over fifty, and even if they are discharged, they are almost seamless. Under such circumstances, even ten doctors are too few.
This doctor refers to the official doctors in the department, not including those who are advanced students, interns, graduate students, etc.
Because this kind of doctor is here to help, no matter when he leaves, his heart will not be here.
And excluding these, how many doctors are left in the department now?
Chen Zhendong, Zhang Xuewen, Zhao Xin, Feng Lingling, Yuna, Peng Xia, even if Wu Xiaofu is added, there are only seven.
Now Cheng Shi has come, that is, eight people, and these eight people are divided into four groups.
Wu Xiaofu is considered to be the general hepatobiliary specialist and receives the most diverse patients. Chen Zhendong is now mainly engaged in minimally invasive and new technologies, while Zhang Xuewen is taking on more of the trauma aspect.
Zhao Xin was responsible for stepping in just like Wu Xiaofu did when he first introduced him.
Relatively speaking, interventional surgery does not require so many people. It can be done by just two people, and the other one does not need to be too demanding.
So two training doctors who were willing to learn intervention were assigned to Zhao Xin's group. Of course, since Wu Xiaofu wanted to develop intervention, he couldn't just leave it like this.
So Wu Xiaofu asked Zhao Xin to take a look. If there are good seedlings, dig them out and focus on cultivating them. If there are any that look useful, you can just use them immediately.
There were eight doctors in total, which was really a bit few. Wu Xiaofu had always wanted to recruit people, but there were no suitable ones. Now that Jiang Bei was here, even if Jiang Bei wanted to go back, he had to persuade her.
Now that Jiang Bei wants to take the initiative to stay, she can't let him go.
After leaving the operating room, Wu Xiaofu changed his clothes and went straight to the physical examination building.
The First Affiliated Hospital is responsible for part of the physical examination business. To be honest, the most profitable business department in the hospital is the physical examination department.
Civil servants among real doctors have a normal schedule, have Saturdays and Sundays off, and do not work overtime. Even overtime work is tripled in overtime pay.
And because there is regular cooperation business, there is no need to worry about performance at all, so the bonuses are also quite large.
Many medical departments are envious of these medical examiners.
This time, the director of the physical examination department called Wu Xiaofu and asked him to look at a case. He said that a little girl was found and the case was a little special, so he asked him to come and take a look.
In fact, Wu Xiaofu was also very surprised when he received the call. After all, this was the first time he received an invitation for consultation from the physical examination department.
The Physical Examination Department is not a nosy department. It basically just ignores it after the physical examination. If there are any symptoms, the patient is sent to a professional department for diagnosis and treatment. How can he personally take action.
But Wu Xiaofu didn't ask any more questions. He was probably a relative of the director of the physical examination department.
After all, this is my first time calling, and he is the director of the physical examination department, so I still have to give him face. After all, he also comes for a physical examination every year. Or if someone he knows comes for a physical examination, he may also ask the director of the physical examination department to help. of.
In hospitals, we should help each other.
When he arrived at the physical examination department, Wu Xiaofu went straight to the director's office. The door was open, and Wu Xiaofu knocked on the door.
"Sister Zhang, you are busy."
Director Zhang of the physical examination department is a general practitioner. He first worked in the day ward and later took over the physical examination department. Now he is over fifty.
Maybe it's because there are no night shifts. Director Zhang's body seems to be in good health. Some people believe him when he says he is in his forties.
Seeing Wu Xiaofu, Director Zhang's eyes also lit up, "Director Wu, you're here, you're not busy. This is the patient I told you about. I saw a 19-year-old girl named Huang Rui this morning."
As he said this, he pointed to a little girl next to him who looked like a flower. Literally, she was just like a flower, with the same age as the flower and the same face as the jade.
She is the kind of girl that makes people fall in love with her at first sight, especially the sick look on her face, which makes people feel distressed and protective.
This love has nothing to do with men and women, it is really: everyone has the love for beauty.
Huang Rui, who was sitting next to Director Zhang, stood up and looked at Wu Xiaofu nervously.
"Director Wu."
Wu Xiaofu nodded, walked into the office and sat down, "Is your liver uncomfortable?"
Director Zhang was not surprised to hear that Wu Xiaofu pointed out the essence of his illness without any inquiry or basis. This was the power of Wu Xiaofu. If not, she would not have invited Wu Xiaofu over.
Director Zhang began to explain the specific process in a leisurely manner.
It turned out that Huang Rui came to the hospital for a physical examination in the morning and did an abdominal color ultrasound. The doctor in the ultrasound department asked about the medical history as usual: Why did he come to check the liver, gallbladder and spleen?
You should know that the Physical Examination Department of the First Affiliated Hospital, in addition to cooperating with some units on physical examination matters, is also open to the public. Anyone who wants to come for a physical examination can also make an appointment.
Regardless of whether it is a complete set of examinations or a single examination, Huang Rui is here to perform a single abdominal color ultrasound. According to experience, these patients all have underlying conditions.
Asking in advance will help you check, so you can focus on it when you check.
But when she first asked, Huang Rui only said she was here for a physical examination. When the ultrasound doctor was scanning the liver, she suddenly said, "Doctor, how is my liver fibrosis?"
Liver fibrosis!
Normal physical examinations will not mention this word because it is too professional, and normal people will not have liver fibrosis. Only older liver disease patients will pay attention to this aspect.
Just like some patients with hepatitis or cirrhosis, and Huang Rui is only nineteen years old, it shouldn't be the case.
So the ultrasound doctor paid more attention and carefully scanned her liver. At first glance, the echo was uniform and nothing special. However, upon closer inspection, there were hypoechoic nodules of various sizes scattered throughout the liver.
This made the ultrasound doctor a little frightened. What was going on?
Unlike ordinary hepatitis patients, liver fibrosis appears in young patients. The physical examination department has also seen some cases, and most of them are suffering from hepatitis.
There are fewer people now. In the past, many people were infected with hepatitis due to various reasons.
However, the physical examination and ultrasound department is still different from the outpatient department. Most of the patients they examine are normal people, so experience and other aspects are actually lacking compared to the outpatient department.
You can only report what you see.
The specific diagnosis is less clear.
However, the ultrasound doctor was also a little curious and more distressed. She was only nineteen years old and still so beautiful. How come her liver condition was like this.
So I asked more questions, "Have you ever had an ultrasound examination before? Have you ever seen a doctor tell you that you have multiple nodules in your liver?"
Huang Rui was not surprised when he heard this, and just continued, "Doctor, I have hepatolenticular degeneration."
Hepatolenticular degeneration!
To be honest, when the ultrasound doctor heard this word, he reacted a little, saying it was familiar, but he couldn't remember the details. After all, it was not a diagnostic department, and the memory aspect was different.
You can't ask the patient what the disease is. You can only keep this word in your heart and prepare to go back and take a look.
Of course, in order to report more carefully, the ultrasound doctor still asked some other questions, "Has your disease been diagnosed?"
Huang Rui also had these sad eyes at that time, saying that it was hereditary, and her sister also had it. It was her sister who was diagnosed first at that time, and later died of cirrhosis of the liver. It had been several years since she was diagnosed, and she had been getting regular check-ups since then.
Hepatolenticular degeneration!
Wu Xiaofu was also shocked when he heard this, it was indeed rare.
Hepatolenticular degeneration, also known as Wilson's disease, was first reported by Wilson in 1912, hence the name. It is an autosomal recessive copper metabolism disorder mainly affecting adolescents.
Yes, it is a hereditary disease, a genetic disease.
Even in today's era, genetic diseases are synonymous with "difficulty", because once this disease appears, treatment is not just as simple as starting with specific organs, but also with genes.
This disease is caused by genetic influences that cause excess copper ions to accumulate in the liver, brain, kidneys, and cornea, causing liver and kidney damage, extrapyramidal symptoms, psychiatric symptoms, and corneal pigment rings.
Well, this disease can affect the mind. Neuro-related diseases are even more difficult when it comes to this aspect. However, there is good news, that is, this disease is one of the few neurogenetic diseases that can be cured so far.
The most important thing is early diagnosis and early treatment. Once treatment is delayed to an advanced stage, it will be basically ineffective.
The clinical diagnosis of hepatolenticular degeneration is complex.
Director Zhang of the Physical Examination Department was a little surprised after hearing what the sonographer said. After seeing the patient, he felt even more pity.
Director Zhang is not good at this aspect, but he does know something about it. After knowing that the child is currently undergoing regular check-ups and no intervention is carried out, he feels that something is wrong.
But she didn't have any good suggestions, and she didn't want to see this flower-like child just go on like this, because if it continued like this, she would probably die like Huang Rui's sister at the age of a flower.
Director Zhang's little daughter was about the same age as Huang Rui, and her maternal instincts were gone, so she called Wu Xiaofu to see if she could help Huang Rui.
"Actually, the diagnosis of hepatolenticular degeneration is still difficult.
For diffuse nodular lesions in the liver, we most often think of nodular cirrhosis.
There are many factors that cause nodular cirrhosis, such as hepatitis, parasites, Wilson's disease, chronic liver congestion, etc.
The diagnosis of Wilson's disease is actually very important when we ask for medical history. A positive family history and disease history can help us rule out and diagnose the disease.
Huang Rui's sister was diagnosed with hepatolenticular degeneration, and after family screening, she was also diagnosed. Liver ultrasound for this disease often shows thickening of light spots or even nodular changes in the liver parenchyma.
Combining the images and family history, we can indeed diagnose Huang Rui as a case of multiple intrahepatic nodules caused by hepatolenticular degeneration.
At present, there is no effective method to cure this disease. The current treatment is basically symptomatic and causal treatment.
But what Huang Rui meant was that until now she had only been checking up regularly without intervention, which was not acceptable.
Fortunately, it's not too late now. She only has some liver symptoms and no neurological symptoms yet. ”
For patients with hepatolenticular degeneration, nineteen years old is really a more sensitive age, because starting from the age of nineteen, the probability of neurological symptoms increases.
This is related to the accumulation of pathogenic factors in the body, which is copper overload.
Therefore, the key to treating hepatolenticular degeneration is to inhibit copper overload.
The treatment of copper overload generally includes two stages: one is to remove or detoxify the copper that has been deposited in the tissue, and to prevent the re-accumulation of copper.
This is very important for Astragalus, because for such a long time, Astragalus has not been treated, and the accumulation of copper in the body has become serious, and the nodules in the liver are symptoms.
The basic principles of treatment are actually not that complicated.
In fact, it is to reduce the intake of a low-copper diet, and then use drugs to reduce the absorption of copper and increase the elimination of copper.
This kind of treatment is always better as early as possible. It should be started before the disease occurs, because once the damage occurs, it is difficult to correct it. Just like Huang Rui’s liver has been damaged now, it is not that easy to recover. .
Speaking of which, it was still delayed. Wu Xiaofu couldn't understand why he didn't intervene since he had been diagnosed long ago.
"Grandma Liu only said that she wanted to be reviewed regularly, but didn't say anything else."
Wu Xiaofu wanted to say something about quackery, but he couldn't say it out loud. He just couldn't figure it out. A doctor who could diagnose hepatolenticular degeneration should have some skills. How could he not know how to treat it?
Fortunately, Director Zhang called him here today, otherwise, the child would have already developed liver damage and might die from liver insufficiency in a few years.
Just like the patient’s sister.
"Grandma Liu?"
"Well, she is the doctor in our town. She has always been the one who sees me. She also asks me to come to the city for regular check-ups."
From the town?
Wu Xiaofu didn't think much about it this time. Maybe this Grandma Liu really only knew one thing but not the other. No wonder, even the ultrasound doctor didn't know, and Director Zhang didn't know much, not to mention that she had obviously already The old doctor in the town is getting older.
"You need to be hospitalized for a systematic examination and then start systematic treatment. If you have no objection, I will make arrangements for you."
"I have no money."
(End of chapter)