NovelTags Chapter 724
Chapter 724
Right now.
Xiao Ru came back with the blood test report just now.
I took the report and glanced at it.
Lin Feng thought that his speculation was correct.
Blood calcium is only 1.7mmol/L, normal values should be 2.25mmol/L2.75mmol/L,
The patient's blood calcium is so low, it may cause muscle spasms at any time, and even hand and foot twitches, and severe arrhythmias.
Calcium ions in serum are very important to maintain cell activity, if calcium ions are low, it will cause a series of abnormalities, so the patient's lumbar muscle spasm should be related to this.
In fact, verifying this is also simple, you only need to inject 10ml of calcium gluconate into the patient, and wait half an hour to see it.
At this time, the patient is still moaning in pain.
Lin Feng explained to the nurse on the side to push 10ml of calcium gluconate to the patient.
Naturally, there were no objections from the patients and their families.
This time, however, the effect was remarkable.
In less than half an hour, that is, more than fifteen minutes, the patient's low back pain improved greatly, and a smile appeared on his face.
Looked at.
Lin Feng immediately looked at the patient's waist and found that the muscle spasms had basically disappeared.
This also confirms that calcium gluconate is effective.
Hypocalcemia is likely to be the main cause of low back pain, as long as calcium ions are supplemented, muscle spasms can be relieved, and pain will naturally be reduced.
But now there's another problem!
How can a patient have hypocalcemia!
At this time, Lin Feng suddenly remembered that when he checked the patient's medical records before, he saw that the patient had undergone thyroidectomy half a year ago, and it was possible that the parathyroid gland was accidentally injured during the operation.
The parathyroid glands, as the name suggests, are glands that settle next to the thyroid gland.
Rarely, the parathyroid gland may be damaged by surgery, and the consequence of the injury is that the patient may develop hypocalcaemia.
The hormones secreted by the parathyroid glands regulate the calcium-phosphorus balance.
Of course, now these are just Lin Feng's speculations and have not yet been confirmed.
The next day.
The patient again experienced low back pain, but the degree was not as strong as before.
The doctor on duty pushed the patient again for a while of calcium gluconate.
After 5 minutes, the pain was relieved.
After re-examination, the patient's blood calcium has risen to 2.1mmol/L.
After returning to normal, the patient no longer had lower back pain.
Afterwards.
Or according to Lin Feng's previous treatment plan, choose to use drugs for stone removal.
This patient's condition was indeed unexpected by Lin Feng.
Of course, even if there is no acupuncture to relieve pain.
Later blood test results can already see the patient's hypocalcemia.
.....
The next day.
Lin Feng was on duty at night.
When I first arrived at the hospital, I had not yet finished inspecting the situation of the patients in the ward.
A young patient appeared in front of him.
Dizzy lying on the hospital bed.
Lin Feng immediately stepped forward to check and found that there was a red, swollen and hot pain on the patient's neck, which was obviously inflammation, and immediately asked: "Was it bitten by a bug?
At that time.
The patient said to Lin Feng with strong spirits: "Half a year ago, I suddenly felt some pain in my neck, and when I looked in the mirror, I found that my neck was red and swollen. "
"Later, I rinsed it with disinfectant water, and although it didn't have any effect, it didn't hurt much, so I didn't care, and I thought about enduring. "
"After a while, I suddenly felt that the pain was a little worse, and my throat began to hurt a little, just like my throat hurt when I had a cold, and it hurt to swallow saliva. "
"I looked it up and knew it was a bacterial infection and inflammation. I went to the pharmacy and bought some amoxicillin, and after eating it for several days, the effect was not very good!"
"But the pain can be tolerated, so I thought of coming to the hospital during the day, but I didn't expect that after eating, the whole person began to feel cold, his forehead was hot, and he took his temperature to see that it was 40 ° C, and there was no fever-reducing medicine at home, so he quickly took a taxi to the hospital. "
While listening, Lin Feng examined the patient.
The neck is indeed red, swollen, hot and painful, it must be an inflammation, but I can't determine whether it is caused by a bacterial infection or bitten by some bug.
The patient's blood was drawn.
The patient's white blood cell count was significantly elevated, reaching 14x10E9/L.
Xiao Ru immediately said: "Teacher, with such a high white blood cell count, it must be a bacterial infection. Hurry up and give him antibiotics, shall we?"
Lin Feng shook his head.
An elevated white blood cell count is not necessarily a bacterial infection.
It may also be just ordinary inflammation.
Moreover, the patient's neck is swollen and painful, and it has to be considered that it is caused by an enlarged thyroid.
Because the red is not particularly obvious, or the swelling and pain are severe.
The thyroid gland is in the neck, and sometimes the virus infects the thyroid gland, causing inflammation inside the thyroid gland, and also causing obvious pain and swelling on this side of the neck, which hurts when touched.
It also radiates to the ear, and the pain is more severe when swallowing, and fever and tachycardia will occur.
Of course, Lin Feng could not be sure.
Immediately said to Xiaoru: "First give the patient levofloxacin injection to see how the effect goes!"
This is an antibiotic that kills most bacteria.
Small as ready to go.
Not surprisingly, the effect was not ideal.
After a few injections, the patient did not improve except for the drop in body temperature, sore throat, painful swallowing, redness, swelling and hot neck still existed.
"Teacher, how can it not work?" asked Xiaoru nervously.
Many patients with viral thyroiditis are mistaken for a cold sore throat or a bacterial infection on the side of the neck. Lin Feng said immediately.
Soon.
The patient is well examined.
Lin Feng also prescribed medicine to the patient and directly arranged prednisone tablets.
Originally, thyroid inflammation could be treated with ordinary antipyretic, analgesic and anti-inflammatory drugs, but Lin Feng considered that the patient's condition was somewhat serious, so he directly used prednisone tablets.
For Lin Feng's arrangement, the patient had no doubts.
Just ate for a day, and found that the effect was not very good.
Came to the hospital again.
Just as the thyroid function test results also came out, everything was normal.
Lin Feng immediately asked the patient to stop the prednisone tablets!
According to the results of the examination, the patient's subacute thyroiditis is not established.
If it wasn't thyroiditis, Lin Feng could only boldly speculate, doubting whether it would be an abscess.
After saying what he thinks.
The patient asked Lin Feng, "Doctor, what is an abscess?
I didn't see an abscess in the previous examination, but you can do a thyroid ultrasound again, in the place where your neck is most swollen and painful, use B-ultrasound to guide the puncture to see, there is a mass here, take out the tissue inside and test it to see what is going on!" Lin Feng said immediately.
Hearing that there was even a puncture, the patient immediately became calm, and hurriedly called his parents.
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