If a tube is left in, a simple pneumothorax with only gas in the pleural cavity can be drained out with a thin tube. Other substances such as blood exudate enter the pleural cavity, resulting in the coexistence of fluid and gas in the pleural cavity. This type of pneumothorax is not a simple pneumothorax but is called hydropneumothorax. Clinically, it can be further divided into hydropneumothorax, hemopneumothorax, pyopneumothorax, etc. A small tube may not be able to handle it.
For this patient, the most clearly visible thing on the film is the pneumothorax line. The lung collapse has not reached an extreme percentage. Are there any obvious signs of exudate in the pleural cavity?
"Teacher, it is very difficult to identify hydropneumothorax simply from the perspective of X-rays," Xie Wanying pointed out.
The most easily seen thing on an X-ray is that the lungs are compressed, but how can we determine that the compressed lungs contain more than just air? X-rays are not camera lenses that can penetrate the human body to carefully identify. Sometimes, CT scans can be used to rule it out, but we must know that the instrument is not omnipotent.
If the patient is like the one in the respiratory department, the doctor will have a relatively large amount of effusion, which is clear and intuitive. If the effusion is a small amount of localized hydropneumothorax but the location is far away and it affects the patient's condition, it will be more difficult for the doctor.
Of course, Duan has already mentioned the first point, but her classmates and other students misunderstood Duan's meaning.
"He probably meant that the pleura is thickening." Xie Wanying said, "My classmate was right about the blunting of the diaphragm angle. It also means a symptom of pleural thickening when it comes to possible infection. If there is fluid accumulation, the fluid level is usually visible at the bottom on the X-ray film, which will flatten the arched shadow on the diaphragm. This patient's arch is not a typical flattened one. If the diaphragm angle is blunted first and then flattened, it is easy to confuse the judgment."
Hearing Xie's words, Zhang Desheng blushed: It was obvious that she was helping him to say something that was wrong. I can only say that Yingying is too kind.
The students of Guodu present were the most surprised. They grabbed their school's top students and asked, "Duan Sanbao, is this what you mean?"
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Asshole, you didn't even tell me that you were misleading the other party, causing a bunch of us to follow you astray.
Being attacked by his schoolmates, Duan Sanbao shrank his neck like an ostrich. He didn't know what to do when he heard it wrong. He was a guest, and he couldn't tell him in person that he had misunderstood him. Besides, he later mentioned the infection factor.
What is certain is that Duan Sanbao's eyes were shining as he looked at the pages of his notebook: this person could really be a "king bomb".
Doctor Cheng Yuchen turned back to read the film again, then turned back to Cao Zhao to confirm: "Teacher Cao, do you want her to try to perform closed chest drainage puncture on the patient?"
A group of Guodu students at the scene realized that the matter was serious.
As far as they know, students who do not have a practicing medical license basically have no chance to perform this kind of operation. The most an intern can do is change the patient's dressing alone in the clinic.
Facing this suggestion from his subordinates, is this a step forward? Cao Zhao's lips curled up, and the two dark eyes embedded in his jade face were smiling.
Looking at Teacher Cao's face from the side, the students could feel that the smile in Teacher Cao's eyes was very "evil".
"Okay." Cao Zhao nodded, approving the subordinate who "volunteered".
All I can say is that these kids in his class are all arrogant and unwilling to accept defeat. If a new classmate comes, he might be a bully, and they will definitely fight to the death.
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