In the medical record, the patient only had five systemic diseases, which was already quite confusing.

But after Xu Qiu came for a physical examination in person, he discovered that his condition was much more serious than what was reported by the community hospital.

In addition to immune hepatitis, liver failure, anemia, thrombocytopenia, and leukopenia, the patient also had hyperbilirubinemia, hypoalbuminemia, hemorrhoidal bleeding, and mild splenomegaly. In addition, Xie Yunshi's tumor markers were also elevated.

.

"Check the blood routine again and do a heart color ultrasound..." Xu Qiu immediately gave further diagnosis.

This kind of patient has many types of diseases and only has one obvious symptom of repeated edema of the lower limbs. It is too difficult to pinpoint the cause.

What's more important is to find answers from various changes.

After returning to the office, Xu Qiu combed through the patient's medical records from beginning to end and discovered several noteworthy points.

First, the patient had undergone a cesarean section due to ectopic pregnancy ten years ago.

The second one, although she is only thirty-six years old, has a history of smoking for twenty-two years, is addicted to alcohol, and has multiple tattoos on her body.

During the physical examination, it was found that in addition to edema in Xie Yunshi's legs, a large number of dense petechiae could be seen on the skin of her calves and insteps.

Ectopic pregnancy, drinking and smoking, skin petechiae...

Every symptom seems completely unrelated.

…

In addition to symptoms, the patient's auxiliary examination also revealed more abnormalities.

Alkaline phosphatase 169, elevated;

Alanine aminotransferase 1, decreased;

Creatine kinase isoenzyme 45, elevated;

There are also abnormal increases in bilirubin, lipase, and brain natriuretic peptide precursor. Although the various body functions have not reached critical levels, the situation is very bad.

If it continues to be delayed, progress may continue at any time.

This is also the reason why Xu Qiu chose to do a cardiac color ultrasound - there are so many diseases in patients, and it is difficult not to affect the heart. In addition, there are anemia, edema of the lower limbs, etc. Even if the patient does not have difficulty breathing or other problems, he should have a systematic examination.

Cardiac screening.

While waiting for the results, Xu Qiu issued new medical orders.

"Glutathione, compound amino acids, torsemide injection..."

"There are also Gastrodia Injection and Potassium Chloride Injection..."

These are all symptomatic treatments.

Considering that the patient may have heart problems, Xu Qiu also specially adjusted the infusion volume to a level lower than that of normal people.

Immediately afterwards, Xu Qiu rushed to the clinic.

Nothing happened all morning.

At noon, Xu Qiu had just taken his second bite of lunch when another hurried call came from the emergency department.

Shi Lian glanced at the teacher's lunch box and said with a wry smile: "It's just the right time..."

A doctor chosen by heaven is destined not to have a complete meal.

Xu Qiu has long been used to it.

Patients do not specifically choose to get worse when the doctor is free. Emergency situations are the norm for doctors.

After taking two more mouthfuls of food, Xu Qiu grabbed the white coat hanging on the wall and rushed to the emergency room in a hurry.

On the way, he also learned the basic situation.

The nursing team had just arranged an infusion for Xie Yunshi. Within an hour, she suddenly lost consciousness, and her heart rate and blood oxygen saturation dropped sharply.

The rescue team immediately performed tracheal intubation and started rescue operations using adrenaline hydrochloride and other treatments.

"There is nothing wrong with the rescue process, let's continue with it." Xu Qiu nodded.

Arriving at the emergency room, Xu Qiu saw Xie Yunshi.

At this time, she was connected to a ventilator, and her blood oxygen saturation had increased to about 95%, returning to normal levels.

I just haven't regained consciousness yet.

"It should be out of danger." Xu Qiu felt a little more relieved.

Next, follow the normal rescue procedures and there should be no big problem.

But what’s puzzling is... why did he suddenly become comatose?

Xu Qiu frowned and asked, "Have the results of the cardiac color ultrasound come out?"

Shi Lian quickly called the cardiology department and soon brought the paper report.

Xu Qiu glanced at it.

Cardiac color Doppler ultrasound shows:

1. The forward blood flow velocity of the patient's aortic valve increases.

2. Mitral valve and tricuspid valve mild regurgitation.

"Just mild insufficiency?"

In this case, coma can't rely on the heart... Xu Qiu has a headache.

Then we can only infer from the existing diagnosis.

Half an hour later, the patient regained consciousness.

Xu Qiu immediately transferred Xie Yunshi to the ICU.

This kind of patient is in danger and may die at any time. Only in the ICU can we deal with various critical illnesses.

"Have you brought the blood test?" Xu Qiu asked.

At that time, he arranged two examinations for Xie Yunshi, one was a cardiac color ultrasound, and the second was another routine blood test.

Shi Lian nodded quickly: "I brought it, the situation seems to be more serious."

Then he handed the report to Xu Qiu.

Sure enough, as Shi Lian said, the patient had more abnormal indicators than before, and the abnormal values ​​were even larger.

In addition, what deserves most attention is C-reactive protein and related infection indicators.

Rapid hypersensitive crp increased, the percentage of monocytes increased, and the neutrophils decreased...

The patient's white blood cells are also reduced. Clinically, viruses, atypical pathogens and certain protozoal infections may cause leukopenia.

Bacterial infections such as salmonella, tuberculosis and brucellosis can also cause a decrease in white blood cells.

Moreover, judging from the patient's white blood cell count, the condition is continuing to worsen and may soon develop into a critical stage.

Other indicators suggesting inflammation were also abnormal.

"Is there inflammation in the body?"

Xu Qiu thought of the petechiae on Xie Yunshi's legs.

He suddenly realized something was wrong...

"Are there any photos of the petechiae?" Xu Qiu asked.

"Some, some..." Shi Lian took out his phone, and the lock screen showed a handsome photo of Xu Qiu wearing a surgical gown.

Shi Lian's hand shook, and he hurriedly unlocked his phone and clicked on the photo album as if nothing happened.

The first few pictures are of Xie Yunshi's calves, which are covered with spotty petechiae, which look densely packed and very penetrating.

"Hey, good news for people with trypophobia!" Shi Lian pretended to change the subject as if nothing had happened.

Xu Qiu stared at the picture for a long time, then zoomed in on a few details, and finally understood what the problem was.

Neat, too neat.

These petechiae look messy, but they have a sense of order.

"Teacher, are the infection indicators due to these petechiae? Allergies?" Shi Lian put forward his own opinion.

Allergy can explain many things, such as skin petechiae, and perhaps sudden coma is also due to infusion allergy...

For this type of clinical loss of consciousness, the first thing to rule out is the possibility of an allergic reaction to the infusion.

"No, take a closer look." Xu Qiu said.

Shi Lian quickly concentrated and took a closer look, and was suddenly stunned: "These petechiae...are all very consistent in shape?"

"right."

Saying that, Xu Qiu drew a few more circles.
Chapter completed!