Is this true? The clinical symptoms of patients are complex, so it is impossible to easily identify the cause. If it were possible, we would not suddenly discharge patients after three weeks of hospitalization.
Xie Wanying chose this time to listen to the patient's heart. Thinking about it carefully, there are many strange things in Yangyang's mother's case that deserve further scrutiny.
For example, the patient's jaundice is relatively mild, the hepatitis B index is positive but the transaminase is generally normal. Cirrhosis usually causes the liver to shrink, but Yangyang's mother has the opposite situation, with an enlarged liver and spleen.
The patient's chest X-ray appeared normal, with only slightly thickened texture on the left side of both lungs, a normal mediastinum, and a roughly normal cardiac shadow.
Ultrasound showed diffuse damage to both kidneys, consistent with late-stage ascites in cirrhosis. The liver showed widened portal vein. Due to ascites, the ultrasound doctor had a blurred vision and could not see clearly whether the inferior vena cava was obstructed, but he suspected it based on his experience.
Such a result probably needs to rule out Budd-Chiari syndrome. Budd-Chiari syndrome is a post-hepatic hypertension disease, mainly caused by blockage of the hepatic vein and the hepatic segment of the inferior vena cava. Later, why did the patient not undergo related examinations of the inferior vena cava? We need to ask Dr. Gong again.
"Take a deep breath." Xie Wanying said to the patient.
Yangyang’s mother took a deep breath and let out a long breath.
After listening to the breath sounds of the patient's two lungs, Xie Wanying found that the breath sounds in the patient's left lung were thicker, which was a sign of some inflammation.
...
...
Listening carefully to the patient's heart, there was a systolic murmur in the mitral valve area at the apex, but it was relatively weak. If graded, it would probably be only level two, which is far from meeting the criteria for organic heart disease.
In fact, the effect of draining ascites is not very good for patients like this. Therefore, the treatment plan was later adjusted to salt and water restriction and diuresis, that is, the latter was treated based on the overflow theory, and the effect was quite good. This was all that could be done in the hospital, so the patient's condition improved and he was discharged first.
Even so, after listening to the patient's heart, Xie Wanying continued to think about it with the stethoscope, and felt that this case could be considered more carefully. Now she will pay more attention to her medical intuition, mainly because the case of Li Yaxi in bed 21 next door sounded the alarm for her.
Yangyang’s mother raised her head as if she wanted to talk to her.
Xie Wanying put her ear close to it.
Yangyang's mother whispered to her, "The girl next door can't sleep at night. She's very scared."
Although Yangyang's mother herself is seriously ill, she still cares about the patients in the same ward. Maybe in Yangyang's mother's eyes, it is pitiful for a young and beautiful female college student to be admitted to the hospital.
The medical staff knew about Li Yaxi's fear, and the nurses specially put a curtain between beds 20 and 21 to block the patient's view. But it was useless, fearing that this environment would become ingrained in some patients. If the patient is not strong, like Li Yaxi, he would feel like he was having a nightmare every night and day.
"What disease does she have?" Yangyang's mother asked the doctor, probably wanting to help her fellow patient.
Xie Wanying told the patients: "No matter what disease you have, once you enter the hospital, the doctors will do their best to treat you."
Xie Wanying was confident about Li Yaxi's illness because Senior Brother Tao had arranged for Dr. Song to take care of it, and there would surely be a breakthrough.
Yangyang's mother felt a little relieved when she heard her say this.
"I'll talk to Dr. Gong when I get home to see if I can give you another checkup." Xie Wanying said to Yangyang's mother, "A clearer checkup will help the medicine I prescribe in the future to be more targeted and more effective."
Continue read on readnovelmtl.com
