blenderwars Chapter 433
Chapter 433
Chapter 433
At this time, the patient’s grandmother’s information: obesity, abdominal pain, shortness of breath…
Lin Feng’s first reaction:
“Check an ECG first…”
The electrocardiogram is faster, and you can ask for a doctor at the same time.
Elderly patients with abdominal pain must have an electrocardiogram to rule out cardiac emergencies such as myocardial infarction.
Moreover, grandma has shortness of breath, so she should be more alert to heart disease.
So Lin Feng arranged an electrocardiogram.
Lying on the bed,
Electrocardiogram.
Swipe~~~~
ECG drawings keep appearing.
Lin Feng asked for a doctor.
“Grandma, do you have any medical history before? Diabetes, high blood fat, high blood pressure…”
Grandma’s weight should be 160 kilograms, obese, and the probability of hyperlipidemia is very high. .
The husband of the grandmother next to him was thin, and replied: “There is high blood fat… but can’t lose weight… There is also diabetes. It has been 5 years, but luckily there is no high blood pressure.”
Lin Feng: “Grandma, just now you said that you ate something in the middle of the night and started to have abdominal pain and vomiting. What did you eat in the middle of the night?”
Granny: “Isn’t this just over the Mid-Autumn Festival, there are moon cakes, and then I ate a moon cake…”
Lin Feng nodded.
moon cake,
It may not be clean, so grandma may have gastrointestinal problems caused by bacteria or viruses…
“Grandma, did you take your temperature just now?”
“It’s measured, it’s a little low-grade fever, 38.7 degrees…”
fever?
fever?
·Check your blood pressure.
100/50mmHg.
The number of 50 is low.
However, Lin Feng looked at the number 100, so he didn’t think it should be a big problem.
“Grandma, I will give you a personality check… relax your muscles…”
·First is the heart and lung auscultation:
no problem.
·Then bowel sounds:
Significantly weakened, it may be inflamed.
Then,
Lin Feng does the physical examination with his hands.
Pressing his hand on his belly made it slightly hard.
“Grandma, don’t resist, relax…”
“good……”
“Grandma, where does it hurt?”
“Here… (upper left abdomen)…”
Clicked,
Grandma yelled.
Lin Feng: “Is there any other pain?”
Granny: “I feel a bit of pain in the back… it just feels like being pulled in the front, making the back hurt…”
Lin Feng nodded,
The pain in the upper left abdomen radiates to the back.
With pain in the upper left abdomen, Lin Feng subconsciously thought of pancreatitis.
Among the symptoms of abdominal pain, there are divisions.
· Pain in the upper right abdomen: it may be gastric ulcer, pancreatitis or gallstones, etc.;
· Upper abdominal pain: it may be gastric acid, indigestion, gallstones, gastric ulcer, hernia, pancreatitis;
· Upper left abdominal pain: it may be duodenal ulcer, gastric ulcer, bile duct obstruction, pancreatitis;
· Right abdominal pain: it may be inflammation of the urethra, lumbar hernia, constipation, kidney stones;
·Middle abdominal pain: may be early appendicitis, pancreatitis, large intestine inflammation, gastric ulcer, umbilical hernia, small intestine inflammation, Crohn’s disease;
·Left abdominal pain: it may be constipation, diverticulosis, inflammation of the large intestine, kidney stones;
·Abdominal pain on the lower right side: it may be a female gynecological disease (such as pelvic inflammatory disease, endometriosis), constipation, inguinal hernia, appendicitis;
·Lower abdominal pain: it may be appendicitis, urethral inflammation, pelvic inflammatory disease, diverticulosis, large intestine inflammation;
· Pain in the lower left abdomen: It may be inguinal hernia, pelvic inflammatory disease, or diverticulosis.
(Ps: If the book friend has abdominal pain, you can compare this partition.)
certainly,
This division may not be accurate, because some diseases will be weird. If it is not 100%, it must be accurate, and specific problems need to be analyzed in detail.
at this time,
The electrocardiogram also stretched a long chapter.
Lin Feng glanced at the electrocardiogram.
· ECG: No abnormalities.
so,
The patient’s grandmother had pain in the upper left abdomen, which ruled out heart disease:
High probability of diseases: duodenal ulcer, gastric ulcer, bile duct obstruction, pancreatitis.
Lin Feng: “Grandma, it’s okay, get up…”
Grandma got up and asked:
“Doctor Lin, what is my disease?”
Lin Feng: “It may be duodenal ulcer, gastric ulcer, bile duct obstruction, pancreatitis…”
Grandma patted her thigh: “It must be a stomach ulcer, I had a stomach ailment last time…”
Lin Feng sweats wildly: “Grandma, it was a stomach problem last time, but this time it may not be a stomach problem…it’s different…”
Grandma is wary: “Do you want to open more inspections for me? How to cheat my money?”
Lin Feng囧: “……………………”
The grandma’s husband next to her hurriedly pulled her grandma: “Shut up and talk nonsense…Dr. Lin, what kind of examination, please mention it. Everyone says that Dr. Lin is a good doctor and won’t cheat our old people…”
Lin Feng nodded: “Aber, don’t worry, I won’t do random inspections, but I still need to check carefully…”
finally,
“Grandma, wait for you to have a CT, and then have a blood routine…”
Grandma is unwilling: “Ct is very expensive? Last time I spent 400 for this. It’s so expensive…Doctor, can’t just check the stomach problem?”
Lin Feng hurriedly said: “We must rule out pancreatitis. If it is really pancreatitis, it is not as simple as an infusion. When it is severe, it will be fatal… And grandma, you have been sick for five hours, too long. , I’m afraid there is a problem 0 ……..”
…
Half an hour later,
CT came out the fastest.
Lin Feng took a look!
·Abdominal CT: Acute Pancreatitis! !
·CT teacher: Consider acute severe pancreatitis.
Soon, the results of the blood draw came out:
·Amylase increased by 10 times!
·Lipase: 10 times higher!
“Lipase”, mainly derived from the pancreas, is one of the digestive enzymes secreted by the pancreas.
“Amylase”: Increased lipase, most commonly seen in acute pancreatitis, is one of the important diagnostic indicators for acute pancreatitis. The activity begins to increase at 6-12 hours after the onset, reaches a peak at 24 hours, and begins to decrease at 48 hours, and after 3 to 5 days Back to normal.
Both indicators point to acute pancreatitis.
And the index value is too high, consider acute severe pancreatitis!
Lin Feng saw this result,
surprised,
His face suddenly became serious.
“Doctor Lin, what’s the matter?”
Granny’s husband asked nervously.
Lin Feng is serious: “Now it is considered severe pancreatitis, which is a bit serious at 2.3. It is an acute abdomen with a sinister condition!”
There is more serious Lin Feng did not say.
Severe acute pancreatitis is acute pancreatitis with systemic and local complications. It belongs to a special type of acute pancreatitis. It is an acute abdomen with many complications and a high fatality rate, accounting for 10% of the entire acute pancreatitis~ 20%.
The fatality rate is 27%!
Lin Feng: “Xiaoru, give grandma’s blood pressure again…”
A measure,
The blood pressure result surprised Lin Feng.
·80/45mmHg
(40 minutes ago: 100/50mmHg……)
Blood pressure is dropping!
This is already shock blood pressure.
(Blood pressure below 90/60 is called shock blood pressure, but generally it must be below 70/50 before fainting or coma occurs. Except for some special patients with hypotension)
. .