Chapter 431 Anorexia Nervosa and Malignant Arrhythmia
A few days later.
Luo Hao came to the hospital early in the morning and saw Shen Zizai wearing white clothes waving to him.
"Director, it's so early." Luo Hao greeted.
"I was called to participate in the rescue last night. I just wanted to watch the excitement and show my attention." Shen Zizai said, "Ronald, thank you."
Thanks?
Luo Hao thought of Shen Zizai's son, Shen Yifei, and then smiled slightly.
It seems that Shen Yifei realized the gap, gave up his "dream" of becoming a professional player, and studied hard.
That’s right, he can’t even beat his training camp level. He really overestimates himself.
“How about Yifei?”
"It seems that he has really started to study. The teacher praised him to me yesterday." Shen Zizai chuckled, "What a bitch, if you don't teach him a lesson, you won't know how high the sky is."
Luo Hao smiled.
"Come, let's talk in the room."
Luo Hao originally wanted to see a circle of patients first, but he did not refuse Shen Zizai and entered the director's office.
After sitting down, Luo Hao asked, "Director, what patient?"
"A man with advanced cancer hanged himself last night."
Hang himself? !
This way of death is really tragic.
"The person was already cold when he was discovered. Director Feng called all the directors of the relevant departments to participate in consultation and rescue. You know~~~" Shen Zizai prolonged his tone.
“Oh, I understand.”
In similar situations, the hospital needs to take a good stance.
Should we rescue? We should rescue. We should rescue even if we shouldn’t. We’ll talk about the rest later.
"It's really hard to say what's going on now." Shen Zizai sighed, "Ronald, have you ever encountered something similar?"
"Have you ever encountered it? When I was studying for my Ph.D., I was in the hospital next door. Director Gu and the director of the cardiothoracic surgery department of that hospital went to the specialist clinic. As soon as we got on the escalator, a black shadow fell from the top."
"Is there any psychological shadow? Shen Zizai asked.
"It's okay, I didn't dare to look carefully. Later, I heard from the director of that hospital that the patient's cancer was found to be late in the examination and he only had about 3 months to live. It was similar to Chen Jiao at that time, so he jumped from the top floor of the clinic. ”
“The hospital paid too much "Less?"
"It seems that we lost tens of thousands of dollars out of humanitarianism. I heard someone talk about it later during the meal."
Shen Zizai smiled slightly, "Now, no. That’s the price.”
Luo Hao raised his eyebrows.
"This patient will have to pay at least several hundred thousand, that's what Director Feng said."
"Why?"
"I didn't know, I just reminded you that Chen Jiao is a student , If you are a student, you will not get into trouble. But if you meet someone who is a gangster, you may not be able to get away completely."
Shen Zizai's father warned Luo Hao.
"Yes, yes, yes." Luo Hao responded repeatedly.
Shen Zizai was very dissatisfied with Luo Hao's attitude.
"Ronaldo, your surgical skills are high. Let me test you with a question."
"Director, tell me."
"For example, let's go to CCU today. During the consultation, a patient was packing his things and shaking hands with the doctor to be discharged. When he was walking out of the CCU ward with half a leg, he suddenly collapsed and disappeared. Breathing, what do you think about it?"
Luo Hao thought about it and replied seriously, "I won't do it if you think about diseases such as heart rupture, especially in the acute stage, especially for patients in CCU. When this happens, it won’t be possible to sew even if you go on stage. Many caring seniors have confirmed this.”
Shen Zizai was a little surprised and took a deep look at Luo Hao.
"Director, don't worry, I never think that my level is high. No, it should be that my level is objectively high, but I am definitely not the kind of omnipotent god. I will not be cured or saved. These four words made it difficult to get off the stage."
What Shen Zizai wanted to say was said by Luo Hao, and he nodded slightly.
As the saying goes, when spring comes, Ronaldinho is at the age where he is arrogant and domineering. However, he does not belittle himself, nor does he think highly of himself. His evaluation of himself is quite satisfactory.
“I have seen many patients like this, especially at 912 Director Gu. Once I saw Director Gu explain to the patient’s family that he was not good enough and suggested that he go to Xiehe University to have a look, and the patient’s family readily agreed. .”
"?!" Shen Zizai was stunned.
"I was very surprised at the time, so I asked Director Gu. Director Gu said that the patient needed a valve replacement, but the preoperative assessment of the patient's basic conditions was not enough and the patient's hope was still high, so he refused. He declined implicitly. I asked twice, but the patient’s family didn’t understand.”
“Just push it to Xiehe?” Shen Zizai asked in shock.
“Who made Xiehe known as the last stop for domestic patients?” Luo Hao sighed, “I don’t blame the director. He said that the patient’s heart condition is like a piece of rag, and it will leak no matter how hard it is sewn. Even if he had the physical condition of a 20-year-old and the experience of Boss Zhou, he would not be able to perform this kind of surgery.
And if he told the patient, Anzhen and Fuwai, the patient might not be able to accept it. After all, my family is known as Xiehe. It is the last stop for domestic patients
False fame, false fame is tiring. "
You really know what you are doing, Shen Zizai thought.
"Director, don't worry, but have the doctor-patient disputes reached this level now? "Luo Hao was surprised.
"In the meeting yesterday afternoon, I will say something later, do you know what the medical insurance will check? ”
Luo Hao shook his head.
"For the glycosylated hemoglobin test, if a patient without diabetes takes this test, it will be considered a violation. If the inspection lasts for 5 years, whoever issued the bill will be compensated, and the money paid will go directly to the medical insurance."
"!!! ”
Shen Zizai’s words were more ghost stories than ghost stories, which made Luo Hao shudder.
“And they say – conventional blood glucose measurements usually reflect instantaneous blood glucose levels, while glycated hemoglobin reflects a patient’s average blood glucose level 2 to 3 months before the blood test was drawn.
Because the average life cycle of red blood cells is 120 days, glycated hemoglobin can be more stable and more accurately reflect the patient’s blood sugar control over a period of time. ”
"There is no point in repeating the test in a short period of time. Everything is done according to the most stringent conditions. Even if the doctor suspects a laboratory error, it will not be enough to do another glycosylated hemoglobin calibration."
"Medical insurance is already so lacking. Are you done?" Luo Hao asked in a seductive voice.
"Well, so you should be careful when doing things in the future." Shen Zizai warned, "This little money is nothing to you, but it can be said or heard badly, especially if it falls in the eyes of people with ulterior motives. ”
Shen Zizai almost didn’t say Wen Youren’s name.
"Understood, Director." Luo Hao smiled and nodded, indicating that he understood and accepted Shen Zizai's kindness.
"Go to the medical office to report on your work when you have time. Director Feng must be in a bad mood recently."
If an ordinary person encounters Feng Zixuan in a bad mood, he will definitely hide as far away as possible, and will never go there Go up to Minato.
But Luo Hao is different. He focuses on sharing weal and woe.
After taking over, Shen Zizai recounted the contents of yesterday's meeting.
There are very few patients involved in the scientific examination of glycated hemoglobin, and this aspect is not involved, but Shen Zizai still emphasized his tone and talked for a few minutes, taking one vaccination after another.
Then he went into surgery. After coming down, Luo Hao changed his clothes, took Meng Liangren and Zhuang Yan to take a look at the patient, and then went to the medical office to report to Feng Zixuan.
Knock on the door.
“Come in.” Feng Zixuan’s voice came out.
Luo Hao opened the door, and Feng Zixuan was flipping through his mobile phone while wearing flower glasses, with tea in his hand.
Huh? It's different from what I imagined.
"Director Feng."
"Xiao Luo, sit down, sit down. Do you have anything to do with me?"
"It's nothing. It's been a long time since I came to report to you. , I was panicking."
"Hahaha." Feng Zixuan took off his glasses and rolled his eyes, already knowing Luo Hao's purpose.
“It’s Shen Zi who told you something.”
Feng Zixuan made it clear directly.
"Yesterday, a terminally ill cancer patient hanged himself. That's what Director Shen was talking about."
"Well, indeed, Shen Zizai can't see clearly this kind of nonsense." Feng Zixuan said with disdain. , "He thought I would be overwhelmed, but actually there is no need to panic about this kind of thing."
"Oh?" Luo Hao became interested.
"What are we? Ownership by the whole people! Ronaldinho, test you Ma Yuan, please explain to me ownership by the whole people." Feng Zixuan looked at Luo Hao with a smile.
“Refers to a form of public ownership in which all working people in a socialist society jointly own the means of production.”
“Yes, the means of production in our public hospitals are jointly owned by all working people. , is also part of all the working people, what do you think I am worried about?"
"!" Although Luo Hao understood what Feng Zixuan meant, he was still a little surprised.
"This kind of thing can be handled as the above says. The medical office is only responsible for appeasing the emotions of the patient's family members. And similar things are not uncommon, but the compensation has been increasing in recent years."
"What can I do? I'll pay for it. Isn't it popular now to distribute according to the situation?"
"I'm just watching to see when the boomerang hits the spectator's back."
Luo Hao was silent, Feng Zixuan said one thing, but what he expressed in his tone was another. set.
Feng Zixuan’s cell phone flashed, and he picked it up, his expression suddenly becoming serious.
Luo Hao sat upright and looked at Feng Zixuan seriously.
"It's okay, Ronaldinho, go ahead and go ahead. There's no need to comfort me." Feng Zixuan grinned.
Luo Hao had a thought in his mind and wanted to give Feng Zixuan a "say something". But it was not good to do so. Luo Hao just thought about it.
"Then I'll go first, Director Feng. Are you free to pet the cat on the weekend?" Luo Hao initiated the invitation.
Feng Zixuan was a little excited, but then shook his head, "I'm busy on the weekend, I don't have time, I'll give it another day."
"Okay, Director Feng, call me whenever you have time."
Luo Hao greeted Feng Zixuan politely and then left.
There were classes in the afternoon, and when Luo Hao came back from his lectures, it was almost time to get off work. After asking Meng Liangren and Zhuang Yan to go around the ward, Luo Hao found no fault with Meng Liangren's ability to manage patients.
Using a long and difficult sentence from the Northeast to express it is - Meng Liangren manages all patients in an upright and orderly manner.
It can save him a lot of worry, and Luo Hao is quite satisfied with Meng Liangren.
It’s just that Luo Hao has been thinking about Feng Zixuan. He recently saw some strange scenes of Feng Zixuan. Although he couldn’t explore them, Luo Hao still remained curious.
"Luo Hao, promotional video..."
Before Chen Yong finished asking, Luo Hao's cell phone rang.
"Luo Hao, emergency department!" Feng Zixuan's voice came directly after Luo Hao answered the phone.
"Okay!"
Luo Hao stood up and strode out of the office.
As expected, little tail Zhuang Yan followed behind with a curious look on her face, and Chen Yong also followed. "When will the promotional video be finished?" Chen Yong asked.
“Why are you so anxious?”
“I want to see what kind of bamboo they have cut it into.” Chen Yong is eager to try, “If I do it well, I guess I can have a terminator. Effect. I feel happy when I think of bamboo becoming a big boss in The Terminator."
"Don't make trouble, how can you make a terminator." Luo Hao quickly walked towards the fire escape and replied, "The people's view of history is not the heroic view of history. Your three views are wrong."
As he spoke, he strode down. His voice echoed in the fire escape, like an echo in an empty valley.
Zhuang Yan took small steps and tried to follow Luo Hao's footsteps, but Chen Yong did not follow and ran over to watch the excitement.
He just looked at Luo Hao and Zhuang Yan quietly as they ran down. When he saw Zhuang Yan staggering, Chen Yong's fingers moved involuntarily.
"Huh?" Chen Yong was a little strange. He seemed to be dissatisfied with the results of his calculations and calculated again.
......
Luo Hao ran downstairs and strode down the corridor.
He was tall and had long legs, so Zhuang Yan had to trot to catch up with him.
"Senior brother, senior brother!"
Luo Hao ignored Zhuang Yan, but quickly came to the emergency department and went straight to the rescue room.
Feng Zixuan rarely called himself to go to the emergency room. This should be one of the few times.
When we arrived at the emergency room, a skinny girl was lying on the emergency bed. The emergency doctor was applying coupling agent and preparing for defibrillation.
When Feng Zixuan saw Luo Hao come in, he didn't say anything. He grabbed the electrocardiogram from the professor in the Department of Circulation and Internal Medicine who was reading the electrocardiogram next to him and handed it to Luo Hao.
Supraventricular tachycardia with differential conduction!
Luo Hao turned on the AI-assisted diagnosis, and the situation was similar to the ECG display. There was no difference.
Luo Hao knows this electrocardiogram by heart.
Luo Hao made a gesture to stop the emergency doctor from defibrillating.
He came to the patient and administered vagus nerve stimulation.
Carotid sinus massage and Valsalva maneuver Luo Hao did quite standard, "6mg adenosine." Luo Hao said.
The emergency department nurse immediately pumped adenosine into the patient's vein.
With vagus nerve stimulation, the patient's heart rate showed certain changes.
Ke Luohao did not relax. Vagus nerve stimulation was only a symptomatic treatment. He still did not know the cause of the patient's malignant arrhythmia.
About half an hour later, the patient's heart rate returned to an acceptable level, and Luo Hao turned around and left.
"Director Feng?" Luo Hao asked in a low voice.
"This is not the first time. It happens every 1-2 months." Feng Zixuan said seriously, "Do you see any problem."
Luo Haoyao Shake his head.
Feng Zixuan sighed, Luo Hao was a "secret weapon". Under normal circumstances, Luo Hao would find the corresponding cases of some rare diseases and difficult and complicated diseases in the Xiehe Medical Records.
But this time even Luo Hao shook his head.
"No underlying disease? No, let me look at the test results."
The patient's blood routine, biochemistry, myocardial enzyme and other tests, as well as cardiac ultrasound and other examinations, showed no obvious findings. abnormal.
It was strange, Luo Hao was a little confused.
Almost all examinations are normal, but where does the malignant arrhythmia come from?
"Where are the patient's family members?" Luo Hao asked.
"Here, my classmate." Feng Zixuan took Luo Hao out of the emergency room and brought him to a tall and thin man, "Liu Pei'en, Luo Hao."
Simple After the introduction, Feng Zixuan frowned and said nothing.
Luo Hao was not in the mood for teasing and asked about the relevant medical history.
Liu Pei'en is the father of a female patient. The patient began to suffer from arrhythmia intermittently at the age of 16, which became more and more serious.
At first, it could be maintained with medication, but later it was no longer effective and the patient needed to go to the hospital for defibrillation.
The patient's family also took the girl to the Imperial Capital and the Magic Capital, but they were not lucky. Her heart rate was normal when they went there. After many examinations, no problem was found.
We can't live in the imperial capital forever. In addition, almost all the expert accounts in Fuwai and Anzhen have been registered, and the family has no choice but to bring the girl back.
It was still like this after returning home. Arrhythmia occurred intermittently. In serious cases, I had to be sent to the hospital for defibrillation immediately, just like the situation I just saw.
Facing the normal laboratory reports and the AI-assisted diagnosis that did not provide a diagnosis of rare diseases, Luo Hao felt quite troubled.
"If that doesn't work, implant an ICD." Luo Hao could only say nonsense.
Feng Zixuan nodded, just like Luo Hao said, ICD can only be implanted.
ICD is an implantable arrhythmia treatment device that integrates the functions of pacing and electrical cardioversion. It has the characteristics of small size and safe and reliable cardioversion.
It’s not normal to have such arrhythmia all the time.
Luo Hao always felt that something was wrong, but that thought was flying in front of his eyes, but he couldn't catch it anyway.
What's the problem? Luo Hao frowned and stood outside the emergency room, thinking deeply.
"Senior brother, what are you thinking about? I just saw that your vagus nerve stimulation technique is really proficient!"
"No, there is nothing proficient about it. The more you practice, the more you will become proficient." Luo Hao said calmly, but his eyes were a little hollow.
Zhuang Yan raised her hand and waved it in front of Luo Hao's eyes, "Senior brother? Senior brother??"
"Don't make trouble, the patient's examination is normal, but he has malignant arrhythmia, why do you think it is? ?" Luo Hao wanted to see if Zhuang Yan could provide some ideas.
After all, Luo Hao never thinks that he is a god, nor does he think that AI-assisted diagnosis can solve all problems.
After all, the system gives AI a title of "auxiliary diagnosis", which has been marked as auxiliary.
"Malignant arrhythmias refer to arrhythmias that cause hemodynamic disorders in a short period of time, leading to syncope or even sudden death in patients." Zhuang Yan began to endorse.
Luo Hao sighed. It was completely pointless to talk to Zhuang Yan at this time.
The patient has been to Anzhen, Fuwai, Peking University, 912, and Xiehe. It can be said that the experts from the imperial capital have hugged him and found no problem.
Weird.
Luo Hao used his system capabilities to go through the Xiehe Medical Records Database and found several similar medical records, but those patients all had rare diseases and the diagnoses were clear.
Where is this person in front of me?
I have no idea what caused it.
"Little Luo." Feng Zixuan came over and patted Luo Hao, "Thank you for your hard work. It would be fine if there was no diagnosis."
"No, Director Feng, I think it's not just that." Luo Hao said firmly, "Where are your classmates?"
"Liu Pei'en!"
"Hey." The patient's father was gloomy. He walked over with a stern face, exhaustion written all over his face.
The short road seems to be full of thorns, and every step is difficult.
"Hello, I am Luo Hao." Luo Hao stretched out his hand and shook the other person's hand.
"Hello..." The patient's family members greeted him dejectedly.
"Can you tell me the entire medical history? The more detailed the better."
The patient's family members glanced at Feng Zixuan helplessly.
"If you ask, just say it, Ronaldinho's diagnostic skills are second to none in the First Hospital of our Medical University. The previous Director Shen, whom you have met, is called Uncle Ronaldinho."
Hearing what Feng Zixuan said, the patient's family members cheered up.
He ran a hand through his hair.
Luo Hao was startled. This action of the patient's family seemed to be related to the patient himself.
That illusory thought suddenly became real and clear.
"Wait a minute!" Luo Hao suddenly interrupted the patient's family members loudly.
“???”
"???"
"Have you always been this thin?"
"???"
"!!!"
Feng Zixuan looked at Luo Hao in surprise, while the eyes of the patient's family members were a little confused, with a little anger in their confusion.
Zhuang Yan said nothing and stood behind Luo Hao.
"What I mean is, the patient looks very thin, does he have anorexia?"
"Anorexia will not cause malignant arrhythmia, Ronaldinho." Feng Zixuan reminded One sentence, and then I remembered something.
But ion disorder seems impossible.
This is not to say that ion disorders will not lead to malignant arrhythmia, but most of the patient's laboratory tests are normal. If anorexia causes ion disorders, they should have been there long ago.
"We both have anorexia nervosa, but it doesn't seem to be hereditary." The patient's family said with difficulty.
"Then how did you treat him?" Luo Hao asked directly before he could finish his words.
"Huh? There is no treatment." The patient's family members were stunned, and then raised their hands, "I have a similar problem. The medicines given by the hospital have all kinds of side effects. I feel that it is better not to take them. Eat. Besides, I had treatment when I was young, but it was of no use, so I didn’t let the child eat it.”
“No treatment? No treatment~~” Luo Hao held his chin in his hands, lost in thought.
Just as the patient's family members were about to speak, Feng Zixuan stepped on his feet and told him not to interrupt Luo Hao's thinking.
A few seconds later, Luo Hao frowned, "Since you are Director Feng's classmate, let me ask you a question directly."
"Professor Luo, please tell me." The attitude of the patient's family members is much better.
"Where is your lover?"
"I sent the child here at work. She... must be here soon."
Luo Hao's brows wrinkled more and more. It was tight, but Feng Zixuan felt that the window paper in front of him was about to be pierced.
This time, Professor Ronaldinho did not give a diagnosis at a glance, but was in trouble.
But just because of this, Feng Zixuan's confidence in Luo Hao increased.
Obviously Professor Ronaldinho has thought of something!
Seeing Luo Hao take out his mobile phone and looking for something, Feng Zixuan approached him curiously. Feng Zixuan has no clue what the relationship between malignant arrhythmia and anorexia nervosa is.
"The patient's diet... is wrong." Luo Hao took out his mobile phone, "Take a look and see if you have seen this thing at home."
Before Luo Hao could hand over his phone, the monitor in the rescue room sounded a sharp alarm.
The sound was shrill, like a wail.
(End of this chapter)