I Can See Health

There are three big characters at the signature place of the medical history record...

Sun Guoguo!

"The chief physician in the eighth district of the heart, Sun Guoguo?"

Cao Zhiying frowned.

"I remember she just started working independently not long ago."

Ren Feng nodded: "Well, she is Director Li Yao's student. After graduating a few years ago, she stayed in school."

"Well, this Sun Guoguo is very good. She can actually judge the patient's condition so quickly." Cao Zhiying nodded slightly, "The record of the disease process she wrote is organized and well-reasoned. It seems that she has a deep understanding of this familial disease. I understand hypercholesterolemia very well.”

"I had little impression of her before. It seems that in the ordinary ward in my heart, there are still many young people with potential who cannot be ignored."

"Director, could it be that Director Li Yao gave the guidance in the ward?" Ren Feng asked tentatively.

Ren Feng is very familiar with this Sun Guoguo.

She is indeed a young doctor who strives to make progress.

But, it doesn’t seem to be particularly outstanding, right?

He had only seen this rare case once.

And, because we haven’t encountered such a case for a long time.

I encountered it suddenly today and didn't react for a while.

"Probably not." Cao Zhiying shook her head, "Li Yao is having a meeting at the school today and won't be able to return to the ward for a while."

Cao Zhiying and Ren Feng analyzed it for most of the day.

But they overlooked one thing.

Graduate students, trainees, and interns do not have their own work IDs. They all use the work ID of their superior physician to write down the course of illness and issue medical orders.

…

At this time, the Eighth Department of Cardiology, Jinghua Second Hospital.

Sun Guoguo was sitting in front of the computer, checking the 10-year-old girl's medical records in the morning.

These disease course records are all written by graduate students or regular trainees.

Therefore, as the attending physician, she needs to check and proofread the disease history records again.

However, when she clicked on the latest medical history record of a 10-year-old patient and saw the contents clearly.

She was slightly stunned.

Critically ill patients like this not only need to write down the first course of illness record when they are admitted to hospital, but also need to complete the ward rounds of the superior physician as soon as possible.

Generally speaking, "condition analysis" is indispensable in the ward rounds conducted by superior doctors.

Mainly, the bedside doctor makes analysis and judgment on the patient's diagnosis and treatment plan based on the patient's condition.

"Condition analysis" is extremely difficult to write, and it is usually written by Sun Guoguo or Li Yao.

This "condition analysis" is an important indicator that reflects the level of a doctor!

"Friends, who wrote the medical history record of this 10-bed patient?"

"Senior sister, it's me." Jiang Qingyan said softly, "I admitted this patient this morning."

Sun Guoguo glanced at Jiang Qingyan in confusion.

"Why are you considering the diagnosis of familial hereditary hypercholesterolemia?"

Jiang Qingyan paused and said: "The patient's diagnosis of acute myocardial infarction is definitely correct. However, she is too young and has symptoms of hyperlipidemia such as tendon xanthomas and corneal rings, as well as intermittent claudication. , it is very likely to be vascular occlusion caused by blood lipid deposition!”

"Because the disease occurs at such a young age, it is very likely that it is homozygous familial hypercholesterolemia!"

Sun Guoguo nodded after hearing this.

"Junior sister, your analysis is good. Have you encountered this kind of patient before?"

"No, Lu Chen taught me to write this disease analysis." Jiang Qingyan shook her head gently.

"Ah? Was it taught by Junior Brother Lu?"

Why is it Lu Chen again?

A trace of surprise flashed in Sun Guoguo's eyes.

Looking around the doctor's office, Lu Chen was not there. He probably went to the ward to see patients.

Jiang Qingyan nodded, "When I first went to work in the afternoon, he told me that he had new ideas about this patient's condition."

"Then he has seen this kind of patient before?"

"No, but he found a similar document and printed it out."

Jiang Qingyan took out three pieces of A4 paper from the medical record folder, with dense English text on them.

"this……"

When Sun Guoguo saw this kind of foreign language literature, his head got big!

She suddenly admired Lu Chen and Jiang Qingyan.

When she was a graduate student, she spent every day in the department helping to give medical orders and write down disease histories, and spent the rest of her time chatting with other doctors.

When encountering a difficult case, she might think about it, but she never thought of searching for literature to get to the bottom of it.

However, Lu Chen's series of behaviors made her become a bit dirty.

This was the case with the last "fitness dry powder" incident.

This time the "10-year-old myocardial infarction" incident is the same!

Lu Chen seemed to always have a thirst for knowledge.

Like everyone else, he faces many clinical problems.

But he always thinks of various ways to further solve difficulties.

…

At this moment.

Lu Chen just returned to the doctor's office.

When he sat down, he noticed that the way Senior Sister Sun looked at him changed.

This look was very complicated, with surprise, appreciation, and a hint of loss.

"Senior sister?" Lu Chen called softly.

Sun Guoguo immediately came back to his senses and smiled quickly: "Junior Brother Lu is back."

"Yeah." Lu Chen smiled.

When he saw the English document in Sun Guoguo's hand, he understood a little bit.

"Sister, the 10-year-old girl's illness this morning..."

"The operation has been completed," Sun Guoguo said. "The coronary artery was diffusely stenotic and PTCA was performed."

"No stent?" Lu Chen asked doubtfully. UU reading www.uukanshu.net

"Not yet. Besides, I think your idea is very good." Sun Guoguo nodded, "I really didn't expect family hypercholesterolemia. But after reading your condition analysis, I feel that your idea makes sense. "

"But if you want to diagnose familial hypercholesterolemia, you need to do genetic testing. Our hospital does not have this test yet, so we can only ask patients to go to Kyoto or Shanghai to do relevant genetic testing to confirm the diagnosis."

"Yeah." Lu Chen nodded.

Many diseases are difficult to diagnose.

Once diagnosed, the rest of treatment is easy!

For example, familial hereditary hypercholesterolemia requires intensive lipid-lowering treatment in addition to conventional treatment.

Lu Chen looked through the little girl's interventional surgery records.

Coronary angiography showed: 75% stenosis in the proximal segment of the left main trunk and 80% stenosis in the left internal mammary artery (LIMA) at its opening. The left circumflex artery has a proximal 90% to 95% stenosis, posterior.

In addition, a renal arteriogram was performed on her, which showed that the left renal artery also showed 80% stenosis.

"If the blood vessels are so narrow, why don't we insert a stent?" Lu Chen was confused.

Generally speaking, if the blood vessel stenosis exceeds 75%, a stent needs to be implanted.

Of course, this also requires specific circumstances and specific analysis.

If it is an unimportant blood vessel, even if it is completely occluded, the stent does not need to be placed.

If it is an important blood vessel, even if it is only 60-70% stenotic, a stent will still be needed.

According to this patient's vascular condition, the stage for stent placement has been reached.

If the stent is not placed, restenosis is very likely to occur!

In other words, the patient may have another myocardial infarction!