I Can See Health

  Chapter 251 Proximity Experiment (Seeking Subscription Monthly Pass)

  Li Yao is a professor-level person. After hearing what Lu Chen said, she thought about it and knew what Lu Chen had in mind.

   "Lu Chen, are you talking about the propranolol experiment?"

  Lu Chen nodded quickly: "Yes, teacher, I feel like I can give it a try."

  Propranolol, a beta-blocker, also known as "propranolol".

The    propranolol test is mainly to identify non-specific ST-T changes caused by autonomic dysfunction and ST-T changes caused by cardiomyopathy.

  Zhu Zhonghua also looked expectantly at the two doctors in front of him.

  To be honest, he came from the county hospital below.

   He has gone to the best hospital in the county and the best tertiary hospital in the city, but no doctor can solve his ECG T wave inversion problem.

   Because the electrocardiogram failed, so the physical examination was stuck!

   But he clearly does not have any disease!

   The doctors in the Cardiology Department of the county and city hospital were all helpless, and even told him clearly that this T wave cause would accompany him for life.

   It will never be possible to stand upright!

  Zhu Zhonghua almost gave up.

   But this civil servant's post is in Jinghua City, and the benefits are really good!

  Zhu Zhonghua is really reluctant to give up!

  Jinghua Second Hospital is the best hospital in the province and the seventh hospital in China for cardiology.

   Therefore, this time Zhu Zhonghua came to Jinghua Second Hospital to try his luck.

   If there is still no way, then he really gave up!

   "Professor Li, what are you talking about? Whether it works or not, I'm willing to give it a try!" Zhu Zhonghua quickly asked.

   Now he can grab a life-saving straw, then he will hold on desperately!

   This is related to the direction of his entire life in the future.

  Li Yao hesitated for a moment.

   This propranolol laboratory, to put it bluntly, is to identify whether this patient is an autonomic disorder or really sick.

   But the specificity of this test is not strong.

  Propranolol-positive patients, she has seen only a few cases so far, and they are all female patients!

   But there seems to be no other way now!

  Li Yao glanced at Zhu Zhonghua. Slowly said: "The method we said is to do a propanadm experiment."

   After oral administration of propranolol, the 12-lead ECG was recorded at 30min, 1h, and 2h after taking the drug, and compared with the 12-lead ECG before taking the drug.

   If the T wave is inverted from the pre-drug lead to upright after the drug is administered, the propranolol test is positive.

   suggested that the ST-T changes before treatment were caused by autonomic hyperfunction.

   After listening to Li Yao's description, Zhu Zhonghua seemed a little impatient.

   "Isn't it just taking a medicine? I take... by the way... is this medicine expensive?"

   "It's not expensive, a box of 60 pieces is only 20 yuan, and you can eat two pieces." Li Yao said.

   "Okay, let me try this experiment!"

  Li Yao did not prescribe medicine to Zhu Zhonghua immediately, but recorded all the conditions in the course record, and then prescribed a box of propranolol to Zhu Zhonghua.

Li Yao explained: "I will open a box of medicine for you first, and then I will open an ECG application form for you. Remember to take the medicine for half an hour before taking the ECG. Compare the two ECGs before and after. If the T wave is upright, it will prove useful! "

"no problem."

  Zhu Zhonghua walked out of the outpatient clinic with the medicine collection form and the electrocardiogram application form.

   That excitement, Li Yao couldn't bear to hit him.

  …

   After dealing with this patient, the patient who registered later finally came in.

   "Hey, after waiting for a long time, it's finally my turn!"

   The patient this time was a middle-aged man with a fat head and big ears, with a briefcase under his arm.

As soon as I walked in the door, I started shouting: "I came here to have a physical examination. Before, my blood sugar was high, so I checked my blood sugar, and I also checked blood lipids, liver and kidney function, and electrolytes. By the way, my uric acid was also high before, so I will check again. Uric acid, I am afraid that I will develop gout in the future. Why don't you check a blood routine..."

   Before Li Yao could speak, the fat man in front of him had already "diagnosed" himself.

   "Let's drive so much first."

After   , the fat man added.

  Li Yao was expressionless and motioned to Lu Chen to ask him to open all the items that the patient asked to be examined.

   "Okay, then thank you." The fat man left the outpatient room with his briefcase in his hand.

   This man comes in a hurry and goes in a hurry.

  Li Yao smiled and said, "Nowadays, a lot of people can consult a patient, and even if they can't, they will Baidu. Look at this patient, I didn't say a word, he has already finished his diagnosis."

   "But the expert number is 300 yuan each." Lu Chen pouted.

   "Don't worry, they will come to see me when their test results come out."

  Li Yao is right, the previous patient with chest pain had already completed the echocardiography and returned to the clinic.

   Echocardiography results showed no obvious abnormality in cardiac structure and function.

   "Professor Li, you see my ultrasound results are normal, what is the chest pain?" The man's expression was very impatient.

   He has done a lot of checks.

  I have done a heart ultrasound four or five times, and every time there is no problem, but I can't find out what the problem is!

   This worry has ruined him!

   Chest pain, this taste is not good!

   However, Li Yao had seen this heart ultrasound, but a smile appeared at the corner of her mouth.

   "Your chest pain may still be related to coronary heart disease!"

   The man was about to interrupt Li Yao's words, but his blood vessels had been operated on, and there was no stenosis!

   But Li Yao reached out his hand to stop him: "Don't worry. You must first understand a concept, the blood vessels are not narrowed, and the chest pain may also be caused by coronary heart disease."

"Our heart blood vessels are like branches. In addition to large blood vessels, there are also small blood vessels, and even roots buried in the ground. The blood vessels examined by angiography are all large blood vessels and some small blood vessels. Those roots buried in the ground, we There's no way to check."

   "This root is what we often call microcirculation. If the microcirculation disorder reaches a certain level, the patient will experience chest pain!"

  The man looked quite flustered.

   "You mean, I am a microcirculation disorder now?"

   "It seems so." Li Yao nodded.

   "Microcirculation disorder... Then how to treat this disease?"

   "I'll prescribe you a medicine called Nicorandil. You can go back and take it for a while to see how it works. If it doesn't work, come back for a consultation."

  Li Yao immediately gave the man a prescription.

  Lu Chen typed it out on the computer very cooperatively.

   "Okay, then thank you Professor Li."

  The man went to many hospitals, but the problem of chest pain was not resolved.

   Now that he can get a cause for his chest pain, he is satisfied.

   With the prescription, he left the clinic.

  …

   For two hours, Li Yao saw more than ten patients in total.

  Lu Chen followed Li Yao and learned a lot of communication methods and diagnosis and treatment skills.

   But so far, they have not encountered any difficult patients.

   At least in Lu Chen's view, it is relatively easy to solve.

   This may be because Lu Chen has rich clinical experience and has seen many medical records, so he has this feeling.

   (end of this chapter)