NovelTags Chapter 711
Chapter 711
Lin Feng proposed that multiple myeloma has an important factor.
That is, this disease can cause amyloidosis, if this amyloidosis happens to occur in the liver, it can explain why the patient does not have obvious cirrhosis but has portal hypertension.
So much amyloid deposited in the liver will also cause obstruction of blood return, which may then cause gastrointestinal bleeding, spleen enlargement, ascites and so on.
After saying these things, Lin Feng said softly: "What I said may not be right, but the inspection can be done first!" "
Hear this.
The three nodded one after another.
Arrangements for the patient to begin the examination begin.
......
The next day,
The results of the examination came back quickly.
The proportion of plasma cells in the patient's bone marrow is as high as 40% (>30% is diagnostic),
There is M protein (lesion protein) in the serum, and the urine protein of the week > 1g/24H.
Examination of tissues sent for examination confirms myeloma.
Seeing this result, it was diagnosed at that time, and the patient was multiple myeloma.
This disease is not uncommon, the incidence is about one in 100,000, based on our huge population base, in fact, it is not less.
However, the cause of this disease is unknown, and it may be related to genetics, genes, immunity, environment, etc., and there will often be missed diagnoses.
The disease tends to occur in patients aged 50-60 years, and is more common in men.
Multiple myeloma, also a neoplastic disease, cannot be completely cured.
Lin Feng did not directly inform the patient of this news, but first told his wife.
As for whether to tell the patient, it is up to the patient's family to decide.
When she heard Lin Feng's news, the patient's wife froze directly.
This is much more serious than listening to the gastrointestinal bleeding, that is, vomiting a mouthful of blood at home, directly detecting a tumor, and instantly feeling that the sky is falling.
The patient's wife asked in a very low voice: "Doctor, how long will he live?" "
"It's hard to say! Generally, it is 4-5 years, but there are also people who live for more than 10 years. There are also people who survive with illness for a long time, this is completely personal, different patients are very different, and other people's situations have no reference value for you. Lin Feng said immediately.
Hearing these words, the patient's wife's eyes lit up again.
Looked at.
Lin Feng didn't say anything more.
Next, the patient's treatment is mainly chemotherapy, stem cell transplantation, and the rest is symptomatic supportive therapy.
After the patient's wife walked into the ICU, Lin Feng turned and left.
......
......
The next day.
The weather is sunny.
Another good mood for the day.
Lin Feng was already waiting in the consultation room at this time.
Xiaoru and intern Zhang Donglai cooperated and studied on the side.
8：50。
The first patient came in.
She is a middle-aged lady.
His face was a little flustered, and his complexion was not very good.
After entering the door, he immediately said when he saw Lin Feng: "Doctor Lin, I am here to admire, you must help me take a look!" A doctor in the last hospital said that I had a problem with my dirt, I just had some pneumonia, and even said that my heart was not good, you must help me take a closer look. "
"You sit down first, show me the chest x-ray you took!" Hearing this, Lin Feng said softly.
"Okay, okay." The patient immediately replied with a smile and hurriedly handed Lin Feng the chest radiograph he brought.
Take the film.
Lin Feng looked at it.
Above: lower right pneumonia, enlarged heart shadow.
Chest x-rays are generally error-free.
In general, cardioenlargement is caused by some problems in the heart, and when Jean may also be caused by systemic diseases.
But anyway, the patient does have a physical problem.
Then he said softly: "You come and lie down, I'll check it for you!" "
"Good!" The patient answered very sharply, got up and walked towards the side bed.
After the patient is lying down.
Lin Feng picked up the stethoscope and began to listen to the voice in the patient's chest.
Brows furrowed slightly.
After a few moments, put away the stethoscope.
The patient hurriedly asked, "Dr. Lin, how is it?" Is my heart okay? "
"Listen to the sound, there is really nothing out of the ordinary! However, chest x-rays are generally not problematic, so I recommend that you do a heart ultrasound first! Lin Feng said.
Chest x-ray is very casual to look at the heart, only a silhouette can be seen, as if looking at a beauty through a screen, shy to see clearly.
The heart color ultrasound is powerful, which is equivalent to directly admiring the beauty in the sun, it is fat or thin, round and square, and you can see clearly.
"Good!" The patient did not hesitate in the slightest.
Soon.
The results came in with mild aortic insufficiency and a small effusion.
Seeing this result, the patient himself knew that there was indeed a problem, and he was afraid in his heart, and quickly asked Lin Feng: "Doctor Lin, what is going on with me?" Do I really have a heart problem? "
"Don't be nervous! This mild closure insufficiency is not a big problem, mainly because this pericardial effusion is worth being vigilant about, and there should be no pericardial effusion at the good end. Lin Feng said in a deep voice.
"Doctors won't! I can eat and sleep, but I have some cough, is there really a problem with my heart? "The patient still couldn't believe it.
"I can't be sure what the situation is, but I can determine that you do have some problems with your heart, and I recommend that you stay in the hospital for a clear examination." Lin Feng said.
Hear this.
The patient was not happy.
Originally, because he didn't believe that the doctor said that he had a heart problem, he specifically came to Lin Feng and wanted to hear his examination opinion.
The result was the same as the previous doctor's conclusion, and I was not happy at that time.
Hospitalization?
Hospitalization is not possible.
Immediately left from Lin Feng.
I found another hospital doctor and prescribed a little oral antibiotic to treat pneumonia, as well as some cough medicine.
After eating, the cough eased a little.
The patient didn't care.
But later I found that although the cough was better, the cough became louder and louder at night, and I felt that my chest was about to be shaken out.
Finally, the patient came to Lin Feng again.
With an embarrassed face, he explained the current situation to Lin Feng again.
Lin Feng didn't say much.
Just listening to the patient's description, it is unlikely to tell anything.
The patient was asked to have a chest CT scan non-clear.
The patient naturally did not hesitate.
When he saw the results, the patient was stunned.
· CT showed multiple small nodules in both lungs, enlarged lymph nodes in the right septal angle, mediastinum, and bilateral supraclavicular fossa, local thickening of the pleura on the right side, a small effusion in the pericardium, and a small pleural effusion on the right. Contrast-enhanced CT of the chest is recommended.
After Lin Feng saw it, he said in a deep voice: "You are not ordinary pneumonia!" "
"According to the report, the problem of your lungs may not be small, maybe cancer, but the CT scan this time is not very clear, so you have to review a CT, do an enhanced scan, create a contrast agent into the blood vessels, if these are tumors in the lungs, the development will be much more obvious."
"Lung cancer?" Hearing this word, the patient almost couldn't stand still.
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