This kind of patient appears every day, but today the doctor happened to meet a stubborn and persistent child. Gong Xiangbin scratched his head and didn't know how to continue talking to the child. He took out his cell phone and said, "I'll call your grandparents."
"You don't have to call them. I'll donate it to my mother." Yangyang said as tears began to fall.
Gong Xiangbin quickly took out a tissue to wipe the child's tears: "Why are you crying?"
"I don't want my mother to die." Yangyang stood in the doctor's office, crying with his head tilted back.
The child cried so hard that his heart was broken. Who could resist? The doctors in the office cried so hard that they collapsed.
“Any candy?”
"Look for cookies."
The doctors and nurses were looking for candies one by one to see how to calm the child down as soon as possible.
When Zhao Zhaowei saw the child crying, he also wanted to cry, so he walked back to his ward to see if he could find some toys.
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Xie Wanying was wondering what was going on and why Yangyang's mother was suddenly asked to be discharged from the hospital.
During the morning rounds these days, Senior Brother Tao did not show such an attitude. However, due to being busy, the doctors' rounds in the morning have always been very hurried, and a bit cursory. Unless the patient needs surgery, there will be a key preoperative discussion in the group. So it can only be because this is the surgery department. For patients like Yangyang's mother who cannot wait for liver transplantation and cannot undergo surgery, they can either be transferred to the internal medicine department for treatment or be discharged. They can't continue to occupy beds like this. Maybe one day, the patient can be operated on and then come back to the hospital.
Let's go to the ward to see the patient's condition first. After careful consideration, Xie Wanying went to Yangyang's mother's ward.
Generally, she will not take the initiative to care for patients who are not under her care, mainly because she is afraid of conflicts with the attending physician.
In the ward, Yangyang's mother was half lying on the bed. She looked much better. The doctor must have discharged her because her condition had improved.
Xie Wanying approached the patient and asked, "Can I listen to your heart and lungs?"
Yangyang’s mother recognized her and nodded.
After the ascites was drained, the patient's belly was no longer swollen like a ball, but the root cause had not been eliminated and ascites would definitely reappear. Xie Wanying only needed to take a look at the patient's protruding belly button to know that the ascites had not disappeared at all.
Speaking of ascites, it should be called abdominal effusion to be more accurate. Because a normal person has about 200 ml of ascites, which lubricates the peristalsis of the intestines. If it exceeds 200, it is an abnormal case state, which is effusion. It is just that ordinary people and doctors commonly call it ascites.
There are many reasons why fluid accumulates in the abdomen. The most common is hepatic ascites, which is fluid that accumulates in the abdomen due to problems with the liver.
Other causes include cardiac, renal, peritonitis, and other systemic diseases.
There are two theories in the medical community about the cause of ascites caused by liver cirrhosis, such as Yangyang's mother's. One is called the classic theory, which says that portal hypertension, low albumin, and lymphatic reflux obstruction lead to ascites. The other is called the overflow theory, which says that ascites caused by water and sodium retention has nothing to do with the other reasons listed above. The reason why the latter theory is established is that a large number of patients in clinical practice do not have these characteristics of portal hypertension and low albumin.
The two theories seemed to contradict each other. Later, doctors believed that most patients were diagnosed with the classic theory in the early stage and the overflow theory in the later stage. The two theories were manifestations of different stages of the patient's disease development.
Logically speaking, Yangyang’s mother belongs to the overflow theory stage, and water and sodium retention is related to disorders of the renin-angiotensin system and the norepinephrine-adrenal system.
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