NovelTags Chapter 489
Chapter 489
"Move your tongue left and right..."
Lin Feng ordered.
Zhang Youfu tried to move left and right, it was a little difficult, but it was not impossible.
However, it was enough to make him panic.
"Doctor, can you determine that it was a stroke?"
Zhang Youfu was panicked in his heart.
Lin Feng smiled: "It doesn't have to be... Do you have a history of high blood pressure? "
Zhang Youfu: "Yes." "
Lin Feng: "Do you usually take medicine on time?" "
"Oh... This one...... Nothing..."
Zhang Youfu said a little ashamedly.
If you have high blood pressure and do not take medicine on time, then the possibility of stroke cerebral hemorrhage is greater.
Lin Feng: "High blood pressure is still a little dangerous, remember to take medicine on time in the future..."
Zhang Youfu nodded repeatedly: "Yes, yes, yes..."
With this incident, he didn't dare not take medicine.
"Lie down, I'll give you an individual examination."
Significance of physical examination:
General cerebral hemorrhage, cerebral infarction,
The brain will have dysfunction, including the paralysis of one limb on one side of the person, the paralysis of the tongue muscles, the expression muscles will also be affected, the corners of the mouth will be crooked, the nasolabial folds become shallow or disappear, and so on...
In severe cases, there will also be respiratory muscle disorders, and obvious dyspnea will occur.
Of course, there may also be impaired consciousness.
Lin Feng followed these and asked Zhang Youfu to do so one by one.
Soon Lin Feng was surprised.
Because Zhang Youfu is conscious except for his tongue and the corners of his mouth, his limbs are normal muscle strength, there is no hemiplegia, and his limbs are not even weak!
Instead, stroke (a typical feature) is not supported.
But
The problem of tongue and the corners of the mouth is most likely a problem in the brain.
Therefore, it is necessary to do a CT examination of the brain.
"I'm not sure if it's a stroke yet, let's go for a test first... I'll give you a brain CT..."
"Okay."
Although CT is a bit expensive, Zhang Youfu can't take care of it at this time.
Zhang Youfu took the checklist and quickly went for the examination with his wife.
......
After 20 minutes,
Zhang Youfu returned to the consultation room with the CT results.
No intracerebral hemorrhage!
Lacunar cerebral infarction, but not severe.
The possibility of cerebral hemorrhage is directly excluded.
The so-called "lacunar cerebral infarction": when arterioles are occluded, because of tissue necrosis, vascular occlusion, and finally form irregular tiny spaces.
But
Lin Feng looked at the CT, and the location of these tiny cavities did not belong to the functional area and would not affect the patient's tongue and the corners of the mouth.
So
With the current CT results, the truth cannot be found.
Lin Feng thought of another possibility:
Cerebral infarction!
Cerebral infarction is also a type of stroke.
(Stroke, also called stroke: involves cerebral hemorrhage + cerebral infarction.) ）
Cerebral infarction within 24 hours of the occurrence of CT cannot be detected because the brain tissue has not changed much.
24-48 hours after cerebral infarction, the brain tissue caused by ischemia and hypoxia due to vascular blockage has edema and necrosis, which can be detected by CT.
So
The CT in front of you does not prove cerebral infarction, but it does not mean that there must be no cerebral infarction.
Lin Feng repeated this speculation.
Zhang Youfu and his wife looked sad: "Is it still possible to have a stroke?" "
Lin Feng: "First hospitalized, tomorrow, that is, 24 hours later, and then re-check CT..."
Zhang Youfu nodded: "It can only be like this..."
Admission to the hospital,
Then Lin Feng prescribed conventional cerebral infarction treatment, such as anti-platelet aggregation, brain protection, nutritional nerves and so on.
......
One day
It passed quickly.
Lin Feng off work.
There are 83 patients seen today, which is also extremely fast.
The live broadcast room ended with 23 million viewers.
There are a lot of corresponding discussions on the Internet.
"Did you watch Dr. Lin live?"
"It's exciting to watch..."
"Dead man..."
"Got a glimpse of what ketone bodies are..."
"It's not good to lose weight..."
The network is very hot.
Douyin is very happy, because the installed capacity brush is rising.
There are also many doctors who have opened a live broadcast room, but unfortunately, the audience is less than a fraction of Lin Feng's live broadcast room.
......
The next day, 7:40 a.m.
Lin Feng entered the emergency department on time.
The live stream starts.
"It's coming~~~"
"Bored lying flat to watch and accompany Dr. Lin to work ~~~"
"I hope it's still wonderful today..."
"Dr. Lin went for ward rounds..."
In an instant, more than 2 million viewers poured in.
...
Lin Feng came to Zhang Youfu's ward.
Behind Xiaoru, the tool person live broadcast assistant followed.
Bed Doctor: "Doctor Lin..."
Lin Feng: "How is bed No. 8 (Zhang Youfu) now?" "
Tube bed doctor: "A little wrong, the symptoms not only have not improved, but even have a tendency to aggravate, saliva in the morning is flowing, I can't drink water, my stomach is hungry and uncomfortable, I want to open my mouth to eat something hard, my mouth can't open my mouth..."
Lin Feng: "........."
All at once alert.
This is not right!
Because Lin Feng prescribed drugs corresponding to cerebral infarction, it should be relieved according to reason.
"I'll see..."
Lin Feng walked in and took 3 minutes to check it.
It was found that the muscle strength of the right upper extremity appeared to be weakened, only grade 4 (normal grade 5).
Other conditions are similar to what the tube bed doctor said.
"Go for a CT!" (It's been 24 hours since the onset of the disease (drool running wet pillow in the morning.) ）
Lin Feng made a quick decision.
After 20 minutes,
CT results are in.
No cerebral infarction!
Excluded!
The live broadcast room suddenly began to talk about it.
Many of the viewers are medical students and doctors, all of whom come to watch the live broadcast and want to learn from the experience.
"It's not a cerebral infarction, it's not a cerebral hemorrhage, what is the reason?"
"Could it be rabies?"
"Rabies has hydrophobia, in fact, swallowing water and choking, so fear of water, isn't this the same as a patient?"
"Well, it really seems to be like that!"
"Is it really rabies?"
"If the patient is really rabies, then such obvious symptoms now must have already occurred, and it is estimated that he will die of respiratory failure in five or six days."
"Huh? Is rabies so serious? "
"I've heard of rabies, can't you cure it?"
"I tell you very seriously that rabies cannot be cured, and once it attacks, it will die in a few days."
The live broadcast room was suddenly fryering.
Everyone's focus went to 'rabies'.
Xiaoru has been staring at the live broadcast room, and she is burdened with the work of commentary.
When I saw the live broadcast room, they all said it was 'rabies'.
"Teacher, many people in the live broadcast room said that it was rabies..."
"Rabies?"
Lin Feng was surprised.
Rabies, indeed there will be drinking water cough, fear of water and other manifestations, since the patient is not a cerebrovascular accident, then only consider these rare reasons.
"It can't be ruled out for the time being, but it doesn't feel like ..."