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【2603】well-informed

"It seems that her cervical spondylosis is not serious, and it is not consistent with her self-reported symptoms." Cui Shaofeng placed his fingers on the copied medical record paper word by word, and studied word by word what the outpatient doctor wrote when the patient went to the hospital.

something to say.

Tan Kelin picked up the mr film and looked at it carefully. Although he was not an orthopedic surgeon, at his level as an academic leader, he could usually watch the mr film.

After careful study and judgment by the two bosses, they found that Xie and his colleagues were making their statements out of concern for others. In fact, the film and the report were not consistent with the symptoms reported by the patient.

First of all, we must know that the main cause of cervical spondylosis is degenerative changes in the cervical spine. Although there are many degenerative changes, the most common one is bone spurs. More than 90% of middle-aged men and women develop cervical bone spurs. Bone spurs

That is bone hyperplasia. The real symptoms of cervical spondylosis are not caused by bone spurs. Symptoms will only occur when the cervical intervertebral disc undergoes pathological changes, the inner diameter of the cervical spinal canal becomes narrowed, and the blood vessels and nerves running inside are compressed.

When you take a X-ray, you finally see that there is bone hyperplasia and ligament thickening, but the intervertebral disc is generally normal, the inner diameter of the spinal canal changes slightly, and there is no tendency for blood vessels and nerves to be affected, so it should be difficult to form typical and significant clinical symptoms.

Well, Tan Kelin and Cui Shaofeng's expressions were silent.

Liu Li's heart was racing.

This time she didn't think it was inappropriate for her non-obstetrics boss cousin and leader Cui to express their opinions.

After the previous thought-provoking education, she realized that she had been misled by the patient’s doctor friend.

The reason why big guys are called big guys is that in addition to being great at specialties, they have a common trait: they often have academic exchanges with big guys from other specialties, they have a wide range of information, they have listened to a lot of clinical cases, and they are well-informed.

The broad coverage of diseases within the scope of one's specialty can increase vigilance.

This is why when young doctors encounter difficult and complicated diseases in clinical practice, they do not suspect other diseases, and when clinical bosses come to make rounds, they can quickly determine that the disease is a specialist disease in other departments and order other specialist examinations.

Of course, clinical experts do not know everything. They can only be said to be better than rookies. At the same time, the experts often do not agree with each other. For example, the opinions of the patient's doctor friends are completely contrary to theirs.

Why the big guys have different opinions may be related to their different clinical ideas.

Maybe Axi's mother's doctor friend thinks that the patient pays attention to his own health, and all indicators have been maintained well since pregnancy, so the chance of accidents is very low. If there is a problem, it should have happened earlier rather than now. This is what a doctor friend said

An inference based on the patient’s familiarity and understanding.

In contrast, the doctors on site were not familiar with Aki's mother, and their diagnosis could only be based on clinical data.

In actual clinical cases, some doctor friends are right, and some on-site doctors are right. In the end, who is right and who is wrong is determined by the facts.

As Leader Cui said, doctors are using their own skills to compete for dominance over the patient's condition. If you don't compete, it's one thing if your number of patients decreases. On the other hand, it's possible that your failure to compete may lead to the death of this patient.

Some doctors are kind-hearted and will not say that you deserve to die if you don't come to see me. On the contrary, the latter result makes the doctor sad. If you don't believe it, the news around the world all writes about doctors' mentality in this way. The news is not exaggerated.

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