"Dr. Fang, Dr. Sin ”

Fang Han and Xian Fen were joking, and Wang Haobo also walked over with a plate.

"Mr. Wang. Xian Fen said hello with a smile.

"Dr. Xian, don't make fun of me, what kind of Mr. Wang am I. Wang Haobo said with a smile, they have known Xian Fen for a long time, and they usually call Xian Fen Dr. Xian.

"Wang is always the chief resident physician of the emergency department, so naturally he is Mr. Wang. Fang Han also said with a smile.

"Doctor Fang, you're laughing at me too. ”

Wang Haobo sat on the side as he spoke, and after a while, Li Junxian also came with a dinner plate, and the four of them chatted while eating, with Wang Haobo and Li Junxian here, Fang Han and Xian Fen didn't joke anymore.

Halfway through the meal, Wang Haobo's phone rang, Fang Haobo picked up the phone and said a few words, and hurriedly stood up: "Doctor Fang, Dr. Xian, there is an emergency case, I'll go see it first, you eat slowly." ”

"Since you're in the emergency room, let's go together. Fang Han also hurriedly put down his chopsticks and stood up.

"No need, I'll go and see it alone, Doctor Fang, you can come back after eating." ”

"I'm done. Fang Han took two more bites, he was already eating fast, he was originally going to add some rice, but now he was not in the mood, when the patient came, Fang Han naturally didn't have the heart to sit and eat quietly.

"I'm done eating, let's take a look. Xian Fen also stood up and said,

Li Junxian looked at his dinner plate, he went to the bathroom and was delayed, he came the latest, and he hadn't eaten a few bites.

"Dr. Li eats first, let's go and see. Fang Han patted Li Junxian's shoulder, and then hurried to the department with Wang Haobo.

When Wang Haobo and Fang Han Xian Fen arrived at the emergency room, a resident doctor hurriedly greeted them: "Doctor Fang, Dr. Xian, Mr. Wang." ”

"What's the patient's condition?" Wang Haobo hurriedly asked.

"The patient, a 23-year-old female, is a junior at a nearby university and was transferred from the district hospital. ”

"What about the specific situation?" Wang Haobo first stepped forward to give the patient an examination, and then asked.

"The patient has no special past medical history, due to fever accompanied by abnormal mental behavior for two weeks, two weeks ago, the patient had a seizure without obvious triggers, and was treated in the school infirmary, considered an upper respiratory tract infection, and given oral cold medication, and the next night the patient suddenly had abnormal mental behavior, manifested as yelling, gibberish, self-complaining that he heard a little ghost calling his name in the stomach, and his limbs moved involuntarily for one hour. ”

"At the same time, it is accompanied by headache, swelling and pain in both eyes, and the symptoms are paroxysmal, five nausea and vomiting...... He was sent to the district hospital for treatment, and during the hospitalization, the gibberish did not improve significantly, and the frequency was still recurrent, and the frequency was higher than before, and there was still recurrent fever, and the diagnosis was considered to be encephalitis...... An hour ago, the patient developed loss of consciousness, repeated convulsions, accompanied by incontinence, and weak breathing, and was intubated and sent to the emergency department of our hospital. ”

The resident doctor explained the situation in great detail.

When the resident doctor told the patient's medical history, Fang Han examined the patient very seriously.

At this time, the patient is still in a state of tracheal intubation, the respiratory tract sound of both lungs is coarse, and a small amount of sputum sound can be heard, just now Wang Haobo reached out to touch the patient's abdomen, and did not touch the mass, and there was no edema in the limbs, the patient's consciousness was still blurred, and he did not respond to the outside world, his pupils were wide and round, the enchantment was sensitive to light, and his lips and jaw had involuntary movements.

Fang Han also inspected the patient's upper limbs, and the patient had the phenomenon of raising arms and grasping.

"Do another auxiliary examination, invite the internal medicine department and neurology department to come for consultation, and notify the director. Wang Haobo gave an order.

The patient was transferred from the district hospital to the emergency department, and it was in an intubated state, which was a first-class patient, and Wang Haobo's level was still somewhat insufficient.

If there are emergency patients in the emergency department, it is customary to notify the general inpatient first, and then the general inpatient will coordinate according to the situation, whether to notify other departments for consultation, whether to notify the senior doctor, etc.

After giving the order, Wang Haobo looked at Fang Han: "Doctor Fang, have you found anything?"

This patient reminded Wang Haobo of last night's patient, last night's patient also said that he was a ghost, and today's female patient also said that there was a little ghost in her stomach calling her name.

There are similarities in this regard.

"It's hard to say for the time being, let's wait for other departments to consult together. ”

The patient is in an intubated state, and he is still on a drip at this time, in this case, the pulse cut is not accurate, and Fang Han can only make some judgments through palpation and inspection and the description of the medical history just now, so he is not in a hurry to draw conclusions.

Not long after, Qian Xiaolin and a deputy director of the emergency department came, and then the internal medicine department and Shennai also came, and it turned out to be Han Jinwei, the director of the department.

"Director Han. Fang Han greeted politely, there was a deputy chief physician from the Department of Internal Medicine, and there was no deputy chief physician who held a position, Fang Han had never seen it before.

Several people examined the patient and then went into the consultation room together.

In the consultation room, Wang Haobo repeated the previous situation, and copied and printed the patient's previous test sheet and treatment in the district hospital, and put it in front of all the experts.

After Wang Haobo said the situation, Qian Xiaolin spoke: "Let's talk about it, the patient is transferred from the district hospital to the emergency department, the situation is not optimistic, we must come up with a treatment plan as soon as possible." ”

"Has the patient been examined in our hospital?"

Wang Haobo hurriedly said: "It has been done, combined with the previous examination, I sorted out some information, the patient's blood routine white blood cells are elevated, mainly neutral particles, liver function can be damaged, myocardial markers, autoantibodies are negative, and cerebrospinal fluid biochemistry suggests that white blood cells are elevated...... There were no abnormalities on brain MRI......"

"If the patient has a fever and has mental abnormalities, the district hospital should first suspect that the infection caused by pneumonitis, toxic encephalopathy and meningitis should be correct, and the symptoms can be considered as encephalitis caused by M. pneumonitis and then a mental disorder caused by M. pneumonitis can be considered based on the characteristics of the patient's condition and various examinations?"

One of the attending officers in the emergency department who participated in the consultation first expressed his opinion.

"The patients are all negative for autoantibodies, and this generation can be temporarily ruled out. The deputy chief physician of the Department of Internal Medicine interjected.

"What about schizophrenia, hallucinations?"

"Now is not the time to consider this problem, as far as the current clinical manifestations are concerned, the patient's physical illness is very serious, and the mental disorder caused by the physical illness should be considered first, and the patient has no series of factors, and secondary diseases can be considered. Han Jinwei interjected.

A few experts, you and I started the discussion one by one.

Xian Fen and Fang Han also participated in the consultation in the consultation room, but Xian Fen was completely a bystander and did not participate in the consultation.

Han Jinwei said: "The possibility of viral meningitis or quadrucleatic immune meningitis should be considered, and I recommend re-examining the cranial + abdominal MPI examination again, which should tell the patient's family the risks of MPI examination." ”

"I think what Director Han said makes sense, you can review it. The deputy director of the Department of Internal Medicine agreed.

"Then let's do these two tests first. ”

Qian Xiaolin said to Wang Haobo.

As he spoke, Qian Xiaolin saw Fang Han, who was very excited, and said, "Xiao Fang, you can also tell me your opinion." ”

Han Jinwei also said: "Yes, Xiaofang, you can also tell me your opinion, traditional Chinese medicine still has advantages for most external diseases." ”

Fang Han had actually been thinking about it at this time, since Qian Xiaolin and Han Jinwei had asked, Fang Han nodded and said, "Then I'll also tell you my opinion." ”

"The patient is intubated, and is still infusion, I did not cut the pulse, and there is no way to check the patient's tongue coating, can only be judged according to the symptoms shown by the patient, the patient is accompanied by abnormal mental behavior, which in traditional Chinese medicine is mostly heat evil invades the heart, the gods are evil, this sudden or even abnormal, can be considered to be Yang Ming's abdomen is really evil and hot to force, or the warm evil is reversed to transmit the pericardium, I consider the latter is more likely. ”

"What heart?"

After Fang Han's words were finished, before Qian Xiaolin could speak, the deputy director of the Department of Internal Medicine who came to the consultation spoke: "What a mess, since the patient is in a state of intubation and infusion, there is no way to cut the pulse, and there is no way to diagnose the tongue, it means that the diagnosis is insufficient, since the diagnosis is insufficient, don't rashly express your opinions." ”

The deputy director of the Department of Internal Medicine didn't know Fang Han, and he didn't know Fang Han, and Fang Han's current presence in Yanjing Hospital was limited to some people in the Department of Traditional Chinese Medicine and Outside the Liver and Shennei, and some people in the Department of Surgery also knew, after all, Fang Han had a liver resection, and the Department of Internal Medicine was not very clear at all.

The director of the Department of Internal Medicine has seen Fang Han individually, and the deputy chief physician is not clear at all.

Han Jinwei greeted Fang Han before, and Qian Xiaolin was heavy on Fang Han, which made the deputy chief physician a little unhappy.

One of his deputy chief physicians came for consultation, and there was no young man who was seriously affected.

This deputy chief physician actually has no grudge or grudge against Fang Han, that is, he is not used to it.

A young man, in his twenties, are Qian Xiaolin and Han Jinwei a little too much?

"You're right, the diagnosis is underdiagnosed, I'm not sure, I'm just talking about my own guess. Fang Han was not angry.

"Doctor Gao, Fang Han is just talking about his inference, there is nothing wrong with it, you have gone too far. Han Jinwei said.

"Director Han, I don't mean anything else, just talk about things. Dr. Gao replied lightly.

He is neither from the emergency department nor from the gods, and the dispute above the consultation, can Qian Xiaolin and Han Jinwei still announce their personal vendetta?

Doctor Gao was not stupid, he also guessed that maybe Fang Han had some origins, so he didn't say anything excessive, he just didn't look weird, he was unhappy, and he said a decent word to Fang Han.

Fang Han himself said that he did not cut his pulse, nor did he have a tongue diagnosis, so the accuracy of this inference was greatly reduced.

If the deputy chief physician of the Department of Traditional Chinese Medicine had been changed, Dr. Gao would naturally not have said this, and he didn't understand Chinese medicine, but he was a young man, what could he know, and he wouldn't be so uprooted in the background, right?

Xian Fen was silent on the side.

: It's the fifth watch again, ask for comfort, ask for support!