I Can See Health

After dinner, everyone went back to their homes.

Lu Chen rested for a while in the apartment.

In the afternoon, he will also discuss difficult cases on behalf of Director Yan Wanfeng.

Nowadays, Yan Wanfeng basically doesn't care much about clinical matters.

Lu Chen is in charge of most of the clinical matters in the department.

afternoon.

Oncology ward.

Show classroom.

Directors or deputy directors of various major departments in Guanghai No. 1 Hospital came to attend this difficult case.

There is no other reason. One of the patients' condition is critical and complicated.

Second, the patient’s identity is special.

Upon arriving at the oncology department, a graduate student immediately took Lu Chen to the demonstration classroom.

"Hey, Director Lu, you're here."

"Director Lu, the patient with congenital heart disease successfully gave birth to a child last time. This is a good case! We can study it carefully!"

"Director Lu, we also have a troublesome case in our department. If you have time, please go to our place and have a look."

Lu Chen is now familiar with the directors of other departments.

Everyone gradually became familiar with Lu Chen's identity, but ignored his age.

The main reason is that Lu Chen's ability is too outstanding.

Whether it is clinical ability or surgical ability.

"It's easy to talk." Lu Chen smiled slightly and greeted everyone one by one.

The oncology department is a big and wealthy department!

The most important thing is that the oncology department has much less doctor-patient conflicts than other departments!

It is normal for the tumor to be diagnosed and cannot be cured, and the patient and the patient’s family accept it!

If the patient is cured, that means his medical skills are good.

Moreover, oncology drugs are very expensive.

Correspondingly, the benefits of the oncology department are also very good.

Before Lu Chen chose a department, he even thought about oncology for a while.

Ten minutes later, everyone arrived and the discussion of difficult cases began.

Director Tang of the Oncology Department was the first to stand up and speak.

"Hello, directors. The main reason for bringing everyone together this time is to solve a case. The patient has a special identity, so our department has no choice but to brainstorm and see if we can come up with a good diagnosis and treatment method!"

Director Tang's words made everyone more curious about the patient's identity.

However, the people in the oncology department remained silent.

Everyone can only give up.

Immediately afterwards, the patient's bedside doctor gave a brief introduction to the patient's condition.

Everyone had a medical record in their hands, and with the introduction from the doctor in charge, everyone quickly knew the patient's basic condition.

The patient was diagnosed with rectal causative carcinoma with liver and lung metastasis.

After current targeted drug treatment, he recently developed dyspnea and decreased activity tolerance.

"Everyone understands the patient's condition." Director Tang said, "What we are most confused about is the reason why the patient has such symptoms. In addition, in terms of treatment, can the anti-tumor treatment be continued?"

The words just fell.

A deputy chief physician of the respiratory department was the first to speak: "May I ask, Director Tang, if the patient has any history of lung diseases? For example, emphysema, etc."

"Yes." The doctor in charge nodded slightly, "The patient has a history of smoking for nearly 40 years. He only started quitting smoking in the past year. He has a long-term history of chronic obstructive pulmonary disease."

"Have you checked your lung function before cancer treatment?" the respiratory doctor asked.

"No." The bedside doctor shook his head. "The patient's symptoms were very mild at the time, so he didn't notice this problem."

"Yes. I looked at the patient's medical records and felt that in terms of dyspnea, first of all, heart failure cannot be ruled out. In addition, it is the state of lung function. Long-term emphysema, coupled with metastasis of lung cancer, or lung function must be not good."

The respiratory doctor talks a lot.

After all, it is the top hospital in the province.

Every director here has an excellent resume.

More than 90% of them have PhD degrees and have the opportunity to study abroad.

There are even some directors who are industry leaders.

Everyone expressed their opinions one after another.

After a while, the speech came to a brief stagnation.

"Well, the opinions of all the teachers are very valuable." Director Tang said, "Which department teacher will continue to express his opinions?"

In the audience, a doctor from the Department of Critical Care Medicine raised his hand.

Lu Chen knew him as Huang Xiaofeng, the captain of the rescue team some time ago.

"Director Tang, let me tell you my opinion." Huang Xiaofeng said.

"Okay, then let's listen to Director Huang's advice."

Everyone's eyes then turned to Huang Xiaofeng.

Huang Xiaofeng smiled softly, "I have consulted this patient before, and I noticed his electrocardiogram. I wonder if anyone has seen it?"

Subsequently, three electrocardiograms taken after the patient was admitted to the hospital immediately appeared on the projector screen on the stage.

"Have you noticed any abnormalities?" Huang Xiaofeng said, "Although I am not a cardiologist, it is obvious that the avr and st segments of leads v1-v3 in the first electrocardiogram are slightly elevated."

"The third electrocardiogram shows extensive st-segment elevation in the prethoracic leads and inferior leads."

"In addition, the patient's troponin is elevated. Do these all indicate that the patient has myocardial infarction?"

As soon as he finished speaking, whispers rang out in the classroom.

Lu Chen said nothing.

In fact, he had already noticed the patient's electrocardiogram.

However, if it is really myocardial infarction, which is so easy to diagnose, then this patient does not need to undergo a hospital-wide consultation, right?

Sure enough, after hearing Huang Xiaofeng's opinion, Director Tang said, "Director Huang's opinion is very good. We have considered it before, so we did a coronary CTA for the patient. You can take a look at the results of the CTA."

Coronary CTA is a non-invasive examination, which, like coronary angiography, can diagnose whether there is coronary heart disease.

Then, the attending physician projected the patient's coronary CTA image on the projector.

Lu Chen looked up and looked at it intently.

The patient's anterior descending artery is narrowed, but the degree of stenosis is not severe, only about 40% narrowed.

This degree of stenosis will not cause such serious symptoms at all!

Huang Xiaofeng obviously saw this result. He was a little unwilling to give up and continued to ask: "The normal results of the angiography examination do not necessarily mean that there is no coronary heart disease! I remember that in the field of cardiology, there is a disease called coronary microcirculation disorder, that is, the main trunk blood vessels may not be narrow, but microcirculation disorder may also lead to heart failure." Microcirculation disorder cannot be detected by coronary angiography or CTA. After saying this, Huang Xiaofeng also glanced at Lu Chen, "Director Lu is an expert in this field, you know better than me, there should be such a saying." Lu Chen smiled and nodded: "Director Huang, you are right, there is indeed such a saying." Everyone saw that Lu Chen said so, and they all raised questions. Could it be that the patient's heart failure caused by cardiac ischemia as Director Huang Xiaofeng said? Director Tang's attention was attracted by Lu Chen at this time. He suddenly said: "I have heard that our Guanghai First Hospital has a very good cardiologist. He is young and has won many honors and awards." This is naturally Lu Chen. Everyone also turned their eyes to Lu Chen who was not far away.

Director Tang paused for a moment and continued with a smile: "Director Lu came to participate in the case discussion today. I think everyone is very interested in Director Lu's opinions on this patient, right?"

Lu Chen finally understood the difficult situation of a tree that stands out in the forest and will be destroyed by the wind.

At this time, everyone present looked at him.

Perhaps Director Tang had no ill intentions.

But at this time, Lu Chen had to stand up and express his opinions and views.

If there was a slight mistake, he would most likely be labeled by everyone as "unworthy of the position", "academic clique", etc.

However, many doctors have already expressed their opinions. What new tricks can Lu Chen, who has been to the end, say? 　　16377/10590064