Back in 2002 as a doctor

Page 909

Huang Lao didn't sit down, but put his hands on the table, his eyes fixed on the film.

Zhou Congwen knew that the boss's clinical experience had reached a certain level, even if he was reborn, he couldn't match it.

But the film in front of him was weird enough to attract the attention of the boss.

Director Zhang didn't introduce any more. According to the 912 consultation process, we can just listen to what Huang Lao said.

Huang Lao was silent for a long time, his eyes were fixed on the film.

Time passed minute by minute.

"Boss, I met a patient before." Zhou Congwen said suddenly.

"Tell me." Mr. Huang said while squinting at the "octopus".

Director Zhang glanced at Zhou Congwen out of the corner of his eye.

The No.1 who has won the World Cardiothoracic Surgery Competition for two consecutive years is said to be strong.

But he is so young, even if he is surrounded by the halo of the world's number one for two times, it still makes people unable to feel a sense of trust.

But in a trance, Director Zhang felt that the young Zhou Congwen was intertwined with the octogenarian Huang Lao, and when they merged into one, they became two people again.

Chapter 1562 Pulseless Syndrome

"There is a young female college student who just graduated and found a job in a private company."

"On the first day of work, the patient passed out, hit her head on the corner of the table, and bled. The owner of the private company was shocked because she had just started work and hadn't had time to buy insurance."

"Insurance? Private companies buy insurance?" Director Zhang was taken aback.

"I was injured at work, which is a work-related injury." Zhou Congwen said this, and suddenly thought that now is the year of 2004, when the growth is savage, and there is a high probability that there will be no insurance or money.

Not to mention private companies, the same is true in hospitals. When it comes to working eight hours, it's like digging up the ancestral graves of the dean and department director's family and destroying their ancestors.

The key is!

The dean and department directors refused to give money, and they only talked about offering.

This way of doing things like a fool, paying attention to dedication, curing diseases and saving lives, and being willing to be poor has continued for many, many years.

Zhou Congwen paused, ignored the flaws in his speech, and continued, "When I was sent to the hospital, the boss even asked the director of the emergency department to help me watch the film. I guess he was very scared."

"Well, this person is fate sometimes. It is probably a small company, still in its infancy." Huang Lao asked.

"Yes, boss." Zhou Congwen said, "If something happens to someone, a compensation can bring the whole company down."

"Later, I checked the head CT. Fortunately, the patient is fine." Zhou Congwen continued, "But it's fine, it's fine. I fainted for no reason, so I have to investigate and deal with something wrong."

"At the end of the investigation, there was no conclusion. The patient's family was more reasonable and explained the truth. The patient had fainted frequently since he was a child. He had seen doctors in Jianghai City and the provincial capital, but there was no diagnosis."

Director Zhang suddenly became interested. She looked at Zhou Congwen's side face, and was moved by that youthful and heroic aura.

"Professor Zhou, what's the end?" Director Zhang asked.

"The patient has been discharged from the hospital." Zhou Congwen said frankly, "No problem was found. But when I read the literature later, I noticed a disease—Oriental beauty disease."

Huang Lao smiled slightly, very relieved.

Director Zhang frowned and said, "Is it Takayasu arteritis? Onset... No, it should be the carotid artery?"

"I guess it is." Zhou Congwen said, "This disease mostly occurs in young Asian women under the age of 30, and it is relatively rare in Europe and the United States.

Therefore, many doctors in the West call this disease "Oriental beauty disease".

If young people, especially women, often have dizziness, vertigo, headache, visual impairment and other symptoms, especially blurred vision or loss of vision when standing up and walking, you can suspect it is Oriental beauty disease. "

"The patient is 46 years old." Director Zhang retorted.

If Huang Lao said this, Director Zhang would definitely admit it directly, and then he would ask Huang Lao what treatment plan he should give.

But... Zhou Congwen, it's not enough.

Even with two halos of the world's number one, Director Zhang is still not convinced.

Every expert has his own pride, which is endowed by patients who have been cured for many years.

The emotions of pride and self-confidence are real, and Mr. Huang can question them, but young doctors like Zhou Congwen absolutely cannot.

Although Director Zhang didn't subjectively look down on Zhou Congwen's idea, she really thought so in her heart, and this idea really existed.

But Director Zhang's words seemed to be automatically filtered out by Mr. Huang and Zhou Congwen.

Huang Lao Youyou said, "I have met some patients, and I feel a little ashamed when I think about it now. At that time, in the countryside, someone suddenly passed out, and there was no pulse in the carotid and radial arteries, so I thought he was dead."

"There should be breathing." Zhou Congwen asked.

"It's very faint, probably ignored." Huang Lao said, "Once I heard that a young daughter-in-law in the next village came back from the dead. The family asked someone to exorcise ghosts or something, so I walked thirty miles to her."

"At that time...it was a mess, and you know it." Mr. Huang continued, "Fortunately, the villagers still respect me. I have observed it for a long time. It is pulseless syndrome in Chinese medicine, or Takayasu arteritis in Western medicine. .”

Director Zhang listened to the exchange between Mr. Huang and Zhou Congwen in a daze, and a rather strange feeling emerged in his heart.

It seems that no matter how incredible the communication between Huang Lao and Zhou Congwen was, there was no obstacle.

The two of them went from a heart like an octopus to a fainting young woman to pulselessness and Takayasu.

Director Zhang was a little confused.

"Generally speaking, if Takayasu arteritis occurs in the carotid and radial arteries, you really had nothing to do at that time." Zhou Congwen said.

"Yes, even immunotherapy can't help." Huang Lao sighed, "What's the use of a clear diagnosis, if it can't be cured, it can't be cured."

Zhou Congwen patted his boss on the shoulder.

The more you understand something, the more painful it is.

Because of the limitations of the technological conditions at that time, even if you understand what the disease is and give a correct diagnosis, there is no way to cure it.

This is the historical limitation that my boss said.

"Old Huang, is this patient Takayasu?" Director Zhang asked suspiciously.

"Director Zhang, what do you think about it?"

"I want to differentiate Behcet's disease and Kawasaki's disease."

"Let's prepare for the consultation. Let's sit down and talk." Huang Lao said with a smile, "The patient's situation is not urgent. Everyone expresses their opinions and talks about their own ideas."

"you……"

"I won't talk about it, Zhou Congwen is here for this consultation."

Director Zhang had heard that this closed disciple of Mr. Huang was doted on by Mr. Huang. Last year, Mr. Huang chased and beat Zhou Congwen in the 912 compound with a broom, which shocked countless people.

Huang Lao took Deng Ming to the front line, and refused to let Zhou Congwen go.

Everyone knows what this means.

Sure enough, Zhou Congwen won the first place in the world twice in a row, and he did a clean and beautiful job. He appeared on 912 this year and became the leading professor of cardiothoracic surgery.

Does Zhou Congwen have to come even for consultation now?

Director Zhang thought about countless things in an instant, and finally nodded.

"Zhou Congwen, have you seen him?" Elder Huang ignored Director Zhang and continued to ask.

"I haven't seen it, but I have seen it." Zhou Congwen said a very awkward sentence.

To see is to read a book; to see is to see a patient.

Although it is rather vague, it is enough for you and your boss to understand.

"Tell me briefly about your understanding." Huang Lao said.

"Takayasu arteritis is an autoimmune disease associated with the development of an immune response in the body.

Due to unknown reasons such as genetics or various primary infections, the body's immune response mistakenly attacks the wall of the aorta as a foreign body.

Antigen-antibody reaction occurs in this attack, and immune complexes are formed, which are deposited on the blood vessel wall, causing non-specific inflammation, causing immune damage, and then leading to aortic stenosis and occlusion. "

Chapter 1563

"Boss, the pulseless little daughter-in-law you met probably has a head-arm shape." Zhou Congwen continued.

"The shape of the head and arms?" Director Zhang was calling for a consultation, when he heard Zhou Congwen say this, he asked.

Pulseless syndrome is rare clinically, and Director Zhang does not know the specific type.

"Carotid artery or vertebral artery stenosis or occlusion will cause different degrees of cerebral ischemic symptoms, often accompanied by weakened or disappeared carotid pulse, physical examination may smell blood vessel murmur and upper limb ischemic symptoms accompanied by decreased or undetectable blood pressure , vascular ultrasonography showed decreased blood flow velocity in the brachiocephalic artery."

"That's why it's called pulseless syndrome. The treatment in Chinese medicine is acupuncture at Taiyuan point." Zhou Congwen glanced at his boss and asked, "Boss, did you treat it like this back then?"

"Yeah." Huang Lao nodded, "Acupuncture at Taiyuan acupoint has some effect, but the effect is not obvious. Three months of treatment can't be cured. Although I also know that it is necessary to treat the immune system, it is best to have a carotid artery stent... ..."

As he spoke, Huang Lao's voice became lower and lower, and finally converged into a faint sigh.

Acupuncture and treatment, Director Zhang is completely unaware of this.

She looked at Zhou Congwen in confusion, and Huang Lao sat there silently, becoming Zhou Congwen's background. Director Zhang had no idea why this young man knew more than herself.

The consulting doctors arrived one after another, Mr. Huang sat in the main seat, and Zhou Congwen sat next to his boss.Facing the arrival of all the directors, Zhou Congwen was not nervous, and greeted each of them gently.

"Director Zhang's illness looks very strange, what does Mr. Huang say?" one person asked.

"Mr. Huang suggested that the whole hospital consult, and then..." Director Zhang paused.

"Then what?"

"Mr. Huang will not participate, let Professor Zhou Congwen Zhou consult." Director Zhang said.

"Uh..." The director was stunned for a moment, "Mr. Huang really thinks that young people like Zhou Congwen are good?"

"I guess so."

"The old man is really confident. I thought that Huang Lao's body couldn't keep up, and his eyes were shaking, so I found a young man to do surgery. By the way, Director Li from the Trauma Hospital went to a private hospital in the Pearl River Delta to do surgery. Finger replantation, you know?"

"I don't know, what's the matter?" Director Zhang frowned slightly, this topic was a bit far-fetched.

"He has more than a dozen young doctors in their 20s who are not even allowed to take the exam for the doctor's qualification certificate. They perform operations, operations, and operations every day."

"Is that okay?" Director Zhang was puzzled.

"A double-headed microscope? Director Li can just look at it, and he guides the students to suture." The director smiled, "Actually, he knows how to do it, and he has relevant experience to deal with special situations. This is clinical experience. Cooperate. The young man's eyes and hands are simply perfect."

Director Zhang glanced at Zhou Congwen who was chatting with Mr. Huang, and felt that their combination seemed to be like this.

But it doesn't seem like it.

Although Mr. Huang is old, he was able to perform any operation before Zhou Congwen came.It is said that this year's World Cup of Cardiothoracic Surgery is also a green leaf, and Zhou Congwen won the first place in the world.

Thinking of this, Director Zhang was a little envious.

Such a dedicated teacher is hard to find even with a lantern.

"This is called a surgical beast. It is said that Lao Li can replant thousands of severed fingers a year in the Pearl River Delta."

"The operation was done well, that is one aspect, but the diagnosis is definitely not good." Director Zhang said, "Look at that big octopus. I have been in clinical practice for 30 years, and I have never encountered a similar patient."

"Hey, Mr. Huang is showing off his little apprentice." The director said with a smile, "Old man, it's all like this. What's the treasure, I'm afraid others won't know it."

"Zhou Congwen this time..."

"You are afraid that Zhou Congwen will lose face." The director smiled, "It's okay, isn't Mr. Huang sitting over there?"

Director Zhang suddenly realized Huang Lao's true intention. He wanted to formally introduce this closed disciple to the directors present.

As long as Zhou Congwen can say something, who would care about it like a young man.

She smiled, "I know, I will save face for Zhou Congwen."

"Right, don't look at the monk's face to see the Buddha's face, Director Zhang, don't think too much." The director simply persuaded him, and seeing Director Zhang wake up, he didn't say much.

Soon, the hospital-wide consultation began.

Director Zhang's hospital chief introduced the patient's medical history, and after all the directors had read the test sheets and CTA images, Director Zhang coughed twice and cleared his throat.

"The patient's situation is quite special, Mr. Huang..."

"You go first." Huang Lao waved his hand.

Director Zhang smiled slightly, "The patient's C-reactive protein increased, and the changes in the heart and coronary vessels, I think it is more likely to be Behcet's disease."

"first……"