Chapter 187 All four causes were eliminated, the final breakthrough

The hospital's hierarchical system is strict, and I'm afraid no young doctor in the department dares to walk on equal footing with Lian Tao.

It is an attitude of the chief physician that the chief physicians are affable, but it does not mean that any young doctor can be arrogant and impolite in front of the chief physician.

If a young doctor is really that ignorant, he will most likely be marginalized, his career will get worse and worse, and he will gradually lose popularity.

The doctors and nurses in the Department of Respiratory Medicine noticed that Director Lian seemed to be very polite to this strange young man.

This also adds to everyone's speculation about the identity of this young man.

"Jingsheng, should you go to my office first to check the patient's information or go to the ward to check the patient's condition first?"

"Let's go to the office to read the information first! Drink some water to get rid of the alcohol. Otherwise, the patient and family members will think we went to see her because she was drunk!"

"Haha, Jingsheng is so funny when he talks! Do you know what you are called?"

"What's it called?"

"Mensao! Haha..."

Lian Tao smiled inconspicuously, and he was obviously in his forties.

There seems to be no age difference between the two, and they have established a very close friendship.

Entering the office, it is Lian Tao's exclusive office.

Being able to have his own separate office in the People's Hospital is not a treatment that ordinary chief physicians can have.

It is also enough to illustrate Lian Tao's status in the People's Hospital.

Lian Tao turned on his computer, logged in directly to his personal doctor account, and retrieved the patient's medical records, examination reports, etc.

"This is all the information about that patient. Last year, she was diagnosed with nasal polyps due to purulent discharge in both nasal cavities. She also had an operation to remove the nasal polyps in an external hospital."

Being sick is a great misfortune in itself.

What I fear most is meeting a quack doctor.

It would be better if you just prescribe some medicine and there would be no effect after treatment.

There are only two possibilities for directly performing surgery to remove nasal polyps. Either the doctor wants to complete the department's assigned tasks, or the doctor is really a quack.

Li Jingsheng checked the patient's detailed information and found that the physical examination temperature that day was 36.9 degrees, which was normal.

Blood pressure 114/65mmhg.

Pretty normal blood pressure.

Blood routine results, white blood cells 9.2 times 10 to the 9th power per liter. Hemoglobin 150g/L, platelets 320 times 10 to the 9th power per liter...

Urine routine and urine sediment were negative.

The 24-hour urine protein quantification ranges from 0.1 to 0.25g.

Liver and kidney function, ALT68U/L, AST44U/L, ALB47g/L……

The examinations done by big hospitals are really detailed.

The advantage is that it can prevent misdiagnosis and missed diagnosis to the greatest extent.

The bad thing is that patients need to queue up here and there, tossing around, and the high cost of examinations is also a drawback.

"Her sinus imaging examination is completely normal! This is not rhinitis at all!"

Li Jingsheng was speechless after watching the film.

Why did I have my nasal polyps removed?

I also had two surgeries.

"It is indeed not rhinitis. The result of consultation with the otolaryngologist in our hospital is bilateral nasal polyps. It will be fine without surgery. Of course, it will be better if it is removed. But nasal polyps are not the real cause of the patient's disease at all."

Lian Tao said next to him.

The "master style" of doctors from the hospital is worth learning.

Lian Tao didn't have any words to belittle the doctors from other hospitals, and he didn't even mean it.

"Tuberculosis can also be ruled out."

Li Jingsheng checked all the way down and found that the tuberculosis test was negative.

There are many other examinations that can rule out the possibility of tuberculosis.

“The patient’s blood, urine, and sputum fungal cultures were all negative. It’s really hard to pinpoint the cause!”

Before Li Jingsheng came, considering the need to use thoracic diagnostic skills, he also spent 100 health points to upgrade thoracic diagnosis to a proficient level.

Currently, there are not many places where thoracic diagnosis is used.

But it’s also good to look at the patient’s chest X-ray.

It is accessible both internally and externally, and the advantages in diagnosis are very obvious.

"Brother Lian Tao, what is your diagnosis?"

After Li Jingsheng read all the inspection information, he asked the other party.

"It is somewhat suspected to be an inflammatory granulomatous lesion."

Lian Tao gave a diagnostic opinion.

Judging from the examination results, granuloma should be supportive.

"Pulmonary Wegener's granulomatosis?"

Li Jingsheng also suspected that it was this disease, but the degree of agreement was not very high.

"Yes, I just suspect that the patient has this disease. But this patient only has fever, purulent discharge, and cavitary nodules, so there is no way to make a diagnosis!"

When Lian Tao encountered such a difficult case, even though he had rich medical knowledge, he still looked worried at the moment.

"How about we go to the ward and see the patients! Maybe we can find some breakthroughs."

Li Jingsheng suggested.

The two went to the ward one by one to check on the patient's condition.

Li Jingsheng carefully performed a physical examination on the patient and asked some questions.

"Is she being treated with prednisone now?"

Li Jingsheng asked when he happened to see the nurse coming to take medicine.

"Yes, she was initially given 40 mg of medication per day, but now it has been reduced to 35 mg per day."

Lian Tao answered for the nurse beside him.

Obviously, he personally prescribed the doctor's orders, and he also determined the dosage of the medicine.

This medicine is used for systemic lupus erythematosus, rheumatoid arthritis, rheumatic fever, nephrotic syndrome, chronic active hepatitis, ulcerative colitis, autoimmune hemolytic anemia, idiopathic thrombocytopenic purpura and other diseases.

It is usually administered orally.

After checking on the patient's condition, the two returned to the office to continue the discussion.

At this time, Li Jingsheng came up with a bold idea.

"Do you think we can start from the problem of space occupation in the right lung, which will make it easier to achieve a breakthrough?"

The hospital outside the hospital started with the patient's purulent discharge and found out that the patient had polyps on both sides of his nose. He was stuck in this endless loop and could not get out.

If we want to make a major breakthrough in this case, it is very necessary to change the entry point.

"I started with this problem, but made no progress."

How could Lian Tao not think of this problem?

"What I mean is to stop the prednisone first, and then make a diagnostic breakthrough in the direction of granuloma."

After listening to Li Jingsheng's suggestion, Lian Tao's eyes brightened slightly.

"This proposal is a bit bold, but the idea is very special and a bit eclectic. It means jumping out of the fog to find out the truth. You can try it."

"Okay, let's try it first."

Li Jingsheng could only wait until the medication was stopped and conduct further examinations on the patient before making a diagnosis.

…

The next day, Li Jingsheng opened the door for normal business.

There are quite a lot of patients.

After the door opened, they rushed to the clinic to see the doctor first.

Li Jingsheng asked everyone to line up in a civilized manner and then issued number plates to prevent queue jumping.

"Doctor Li, please take a look at my father's right hand. It seems that he broke his right hand. Can it be treated?"

The person who grabbed the first position was a young and strong young man in his mid-twenties.

He took his seat, and then a family member helped the patient in.
To be continued...