Review this patient,From initial diagnosis of pneumonia,Then suspect the tuberculosis,Lung cancer,Later, considering pulmonary abscess,Two fibrous glasses have been made,Also do lung puncture,Finally, diagnosed is the granuloma sex vasculitis.,Patient suffers from crimes,A temper,Dedicated service, no temper,People。

Good,She lives again。Bulseous vasculitis,If you can treat early,Most patients still make good prognosis,It is also difficult to cure,But to control the condition or can。But if you have not diagnosed,Delay diagnosis is not treated in time,Then the mortality will be high90。
This is not a trouble.
NS309chapter
This situation,We decided to be a lung puncture,That is to use a fine long needle,From the chest skin,Align this abscess,After the puncture is successful,Pumper the tissue inside,Let’s take the test,What bacteria,We are again targeted,The effect will be better。But this is a traumatic check after all.,So you need your consent。Superior doctors explain,Although the patient did not cure,But the superior doctor is still full of confidence,One stop next to the bed,That is the general,Need to be patient。
Patient said,This check is finished.,Do you have a good treatment for me?,Director,It is really uncomfortable.。It’s almost crying.。It’s unexpected,It is said that patients are stasic.,But at this time, it is an ordinary person in the moment.。
Generally, it can be clearly diagnosed.。The superior doctor said very art。
I understand,Do it when you do it,As long as you don’t die。Patient sighs。His husband hurriedly,What do you say?,Good,Have a look at the Director of Huang,This time I will definitely pass。
After explaining,Sign in the morning,I gave a puncture at noon.。
Lung puncture,In fact, it is minimally invasive small surgery.。But after all, it is puncture lungs.,Still there is a certain risk,Such as pneumothorax,Or wear a blood vessel caused a large bleeding, etc.,But this possibility is not big,Because the doctor isBUHR under super-positioning,Also made two fibrous glasses,I still have oneCT,Used so many antibiotics,Also always let the old lady burn grogly。
This is not logical.,Ordinary pneumonia treatment for three or five days,I have already jumped.。can only say,She is not pneumonia。This truth understands yourself,But no one changed.,See the relatively clear。
Successfully completed。
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Patients did not have adverse complications。Now I have to do it now.,Is waiting for pathological results。Since patients have repeated fever,The superior doctor makes the tube bed doctors smoke a blood,Check rheumatoid immunity indicators,To exclude this disease。
We must know,Repeatedly fever patient,Usually more three cases,One is infection,One is a tumor,There is also a disease in rheumatism immunity.。Rheumatism immune disease is a large type of disease,For example, everyone can hear the most systemic lupus erythematosus、Rheumatoid arthritis, etc.,This type of disease has tens of hundreds or more。
In front of this patient,Do you still tend to infect sexual disease?。As for why the treatment is not good?,May be antibiotic basis without coverage,Or special pathogen,The hospital has been worried about the tuberculosis。Tuberculosis,Diagnosis is very difficult,It is not that you have left a few times, you can exclude a tuberculosis.,Some people find9Supreme is negative,Until the first10The positive of the times is possible。
But rheumatism immunity, disease is also vigilant。Superior doctor。
I still remember the female patient of the systemic lupus ethnial year.,Superior doctor,At the beginning, we did not treat pneumonia.1How many weeks,Teaching is profound。
After listening to the tube bed,It is also a cold sweat behind it.。Part is frightened,Part is annoyed。Because from beginning to end,He didn’t take this way。If it is not a superior doctor reminder,He is now limited in infection、Tumor two types of diseases。After all, the patient is too like these diseases.。
So perfect check is,Today is blood,Check a rheumatoid immunity。Superior doctor patted his shoulders。
Pipe daughter point,It seems to be re-ignited。The pathological outcomes of pulmonary puncture now,There is also this rheumatoid immunization index.,People are ghosts,Very quickly。
Seeking only patients do not change before this,More time。
But reality is so funny。The more you worry about it.,The more you happen in your eyes.。
That night8point,Patients gradually occur。
Take a tube bed next to the bed,See the patient’s lips,The heart is faintly feeling bad.。Hurry and let the nurse attach the electrical monitoring。Patient breathed this,Ask the doctor what is going on,Is it a problem with the pulmonary puncture?。The patient’s husband is also the same as the ants on the hot pot.,Also give her a fan,It is also in the water。
The tube bed is calm down,The analysis will not be a lung puncture when it is pulmonary puncture.,Make up the pneumothorax?This is the most likely。If the lung ruptures,Then the gas will pour into the chest,It will oppress the lungs,The lungs want to expand more difficult,Patients will of course hypoxia,Be chest tightness,Be breathable。
The tube bed doctor quickly listened to the double lungs with a stethoscope,And repeated comparison,But the two lung breath sound is still symmetrical。This does not support the pneumothorax.。If it is really a pneumothorax,Then this side should breathe very low.,Because the lungs are not very expanded。
Hurry and make a bedside chest。Pipe practice makes nurse calling to let the radiology。At the same time, check if there is any other problem.。This check,I found a problem again,The patient didn’t have many urine today all day.。
This is really a housing leak in the night rain.。A patient,Once you have a less or no urine,It means that the kidneys are also damaged.。The human body is a whole,But when the disease,The last falling is often the kidney。If the processing is not good,The next possibility is the liver、Heart。I think of this,The doctor is not calm.。
After the electrocardiography,Seeing the blood oxygen saturation95,This is under the premise of oxygen。Still。Patient suddenly appeared,In addition to considering pneumothorax,Also be alert that there will be no pulmonary embolism、Heart failure, etc.。This is the basic clinical thinking of an internal medicine doctor.。
The superior doctor also rushed back after hearing the news.,The chest film is also finished at this time.,Didn’t see the pneumothorax。After evaluation,It is considered that the patient is still a disease.,As for where the problem,I am not good for a moment.,In case,Still firstICUStrengthen monitoring。
After all, this is a special person.,Can’t go out。