Back in 2002 as a doctor

Page 465

"If it's Switzerland..." Zhou Congwen pondered.

Teng Fei couldn't laugh or cry.

Similar patients are more difficult to "serve", all kinds of picky.

It seems that Zhou Congwen is also in a difficult situation, and the patient does not know what will happen on the way to the imperial capital, so it may be difficult to get a referral.

He could only suffer for the time being, thinking of the patient's persistent third-degree atrioventricular block ECG, Teng Fei's head turned into two big ones.

If it doesn't work, we can only install a temporary or permanent pacemaker and let the patient go.

"Director Teng, if the patient lives in Switzerland, there is a disease, I don't know if you have heard of it."

"Are there still idiopathic diseases in Switzerland?" Teng Fei was confused.

She had never heard of anything Swiss had to do with third-degree AV block.

For Switzerland, Tengfei still stays in the banking industry and Alpine skiing.

"There is a disease called Lyme disease, which is a tick-mediated spirochete infection, a natural foci disease caused by Borrelia burgdorferi."

"..."

Teng Fei was taken aback.

Lyme disease!Teng Fei is more or less aware of this.

But all the cognitions are only obtained from books, and I have never seen a "live" patient.

"Lyme disease is characterized by chronic migratory erythema of the skin in the early stage, with neurological, cardiac or joint lesions appearing later."

"If the patient has refractory third-degree atrioventricular block, you can check to see if the patient has a rash, or ask about the medical history to see if there has been a similar situation in the past month."

Chapter 0798 Atrioventricular block treated with antibiotics

Teng Fei went to have a physical examination in person immediately, and Zhou Congwen pulled a chair and sat down by the way.

"Professor Zhou, I've never heard of Lyme disease." A small doctor in the Department of Circulatory Internal Medicine said approachingly.

"Oh, it's very rare in our country. The first confirmed case was only in Yichun Forest District in 1985." Zhou Congwen said, "But I just heard that the patient came from Switzerland, so I boldly speculate that it may not be the case."

"not necessarily?"

"Yeah, I didn't even see the patient, and I just heard Director Teng say a few words about returning from Switzerland. Since the incidence of Lyme disease in Switzerland is not low, I would like to remind you." Zhou Congwen said in a leisurely manner.

"..."

"Lyme disease itself is not common, and atrioventricular block is even rarer, about 8%. Such a small probability is really just a guess, and it needs to be checked in detail." Zhou Congwen said leisurely while sitting in a chair.

"Professor Zhou, did you memorize it?" the little doctor asked in surprise.

All kinds of data came out of Zhou Congwen's mouth like a treasure.

The little doctor has never seen anyone who can do this, so he is particularly envious and admired.

A rare disease can be remembered so clearly, it is no joke that he was favored by Mr. Huang at a young age.

"If you talk about this disease, it's still terrible."

"horrible?!"

Zhou Congwen thought that Justin Bieber and Avril Lavigne would both suffer from Lyme disease in the future, and Justin Bieber also publicly claimed on social media that it affected his skin, thoughts and overall mental state.

Second AIDS lives up to its name.

"This disease is also called the second AIDS." Zhou Congwen said lightly.

The little doctor's face turned pale instantly.

He is very clear about the name of AIDS, the second AIDS... the little doctor's thinking has been distracted by Zhou Congwen.

What to do if he is infected, this is all in his mind.

Ordinarily, physicians are not very worried about AIDS, it is something that only surgeons are afraid of.

Unexpectedly, my ward actually received a second AIDS patient.

"Hahaha, don't worry, it is not contagious under normal circumstances. Didn't you tell Director Teng just now that it is transmitted through ticks. Usually it is in late summer and autumn, when there are many small bugs."

"But it's winter now, so it should be on the Swiss side too."

"Is it a small probability event, and I haven't seen the patient, so I just guessed it casually." Zhou Congwen said with a smile, "Don't worry, nothing will happen."

"Oh, it's okay if it's just a parasitic disease."

"That's not what you said." Zhou Congwen shook his head, "This disease is relatively rare, but the consequences are very serious. The patients in your department sound like the first stage. It's okay to say that many people are diagnosed after the second or third stage .”

"Uh……"

"After the diagnosis, patients will be very anxious. Many people will continue to search for relevant pathological information. The more they look at it, the more afraid they become, and the more they look at it, the more anxious they feel.

The scariest thing is not to die immediately!It is that the patient does not know whether he will die in the next second, and has been living in suffering, unable to extricate himself. "

"..."

The little doctor was dumbfounded.

Zhou Congwen also sighed. Back then, Avril Lavigne retired because of the uncertainty of Lyme disease and its incurable nature after the first stage.

But before Justin Bieber and Avril Lavigne, Zhou Congwen really didn't know any well-known people who got Lyme disease and died of depression.

This year, Avril Lavigne officially debuted and was shortlisted for the Best Newcomer Award at the 45th Grammy Awards. She was nominated for the Best Rock and Roll Female Singer Award and the Best Pop Female Singer Award for her songs "Sk8er Boi" and "Complicated" respectively.

It would be many years before she contracted Lyme disease and was bloated and obese after treatment.

Come to think of it, Lyme disease is really a scary disease.

Its impact on people is not only physical, but also mental crit.

"Professor Zhou, do you have a special research on rare diseases?"

"I heard that a Swiss friend happened to have this disease, so I will remember it."

Just as he was talking, Teng Fei hurried in.

"Xiao Zhou, the patient really has maculopapular rash on the inner thigh, and it is said that it appeared half a month ago, and he had a low-grade fever at that time."

"Can our hospital do the screening for Lyme spirochete?" Zhou Congwen asked lightly without any surprise.

"It seems impossible."

"That's more difficult." Zhou Congwen also knew that in 2003, many domestic inspection items were not opened.

Not to mention 2003, put it in 2030, the inspection of spirochete Lyme disease is a special inspection only in high-level tertiary hospitals.

"That……"

"How is the financial situation at home?" Zhou Congwen asked.

"I think it's not bad."

"I'll contact 912 to send samples." Zhou Congwen said with certainty, "As for the current treatment, use antibiotics."

Third-degree atrioventricular block, treated with antibiotics... After Teng Fei straightened out the logic, he felt a little unwell.

Only Zhou Congwen dared to say that antibiotics were used to treat heart disease. Anyway, Teng Fei herself would dare not say anything.

"Xiao Zhou, what antibiotic do you suggest?"

"Ceftriaxone is enough. Take two grams a day. It is estimated that when the test results come back, the third-degree atrioventricular block will be cured." Zhou Congwen said, "This is because it was discovered early. The patient's heart is not tolerant. It’s a very lucky thing.”

"..."

Are third-degree atrioventricular block still lucky?

"If it's later, there will be no cure for this disease after the second stage."

"Xiao Zhou, can third-degree atrioventricular block be reversed?" Teng Fei was a little confused.

Ordinarily, third-degree atrioventricular block is a problem with physiological electrical transmission caused by organic lesions, and it should be irreversible.

"Third-degree atrioventricular block emphasizes the irreversibility of lesions in the conduction system of the cardiac pacemaker, whether it is abnormal sinus node function, adult acquired atrioventricular block, or patients after heart transplantation." Zhou Congwen explained, " But with medication, AV block from Lyme disease can be reversed."

"!!!"

"Lyme disease often affects the AV node and causes AV nodal block, usually first degree, Wencke's phenomenon or complete heart block.

Some cases have more diffuse cardiac lesions, such as cardiomyopathy and cardiac insufficiency, or rarely, cardiac hypertrophy or pancarditis.

The course of the disease is only a few weeks, most cases can be cured, and some serious lesions can be fatal. "

"Fortunately, it was discovered early. If it was later, antibiotics would be useless." Zhou Congwen stood up, "Director Teng, I'll go and see the patient."

"Oh oh, have you confirmed it?"

"The main thing is to see if the patient is still in the first stage." Zhou Congwen said, "I hope it is still in the early stage, otherwise there is no way."

Chapter 0799 Use snail powder to cure diseases?

Zhou Congwen asked about the patient's medical history and performed another physical examination.

Fortunately, the patient was bitten by a tick not long ago, and the condition is still in the first stage, and it can be cured with antibiotic treatment.

The fate of man is so wonderful.

The patient's body reacted so badly to H. Lyme disease that fatal changes occurred in the heart in just over a week.

But it was this change that caused the patient to be hospitalized for examination and happened to meet Zhou Congwen, so this was the opportunity for Lyme disease to be diagnosed and treated in the first stage.

If the patient's reaction is milder, those who are older than the Chinese New Year, who ran back from Switzerland for a family reunion, will definitely ignore certain physical discomforts, thinking that it is caused by jet lag or running around.

After organic changes occur in the body, Lyme disease has progressed to stage 2 or 3, and antibiotics will no longer work.

It's too late by then.

Zhou Congwen was also very happy after confirming the stage of Lyme disease, and comforted the patient with a few words, "Director Teng, it's still the first stage, treat the symptoms with Rocephine, and wait for the test results sent to 912 to estimate the risk of third-degree atrioventricular block. become once."

Teng Fei seemed to be dreaming.

The patient's main complaint was syncope, and it was the limit of Tengfei's ability to find out the heart problem.

But after a syncope, it turned into antibiotics for treatment, which is really a miraculous thing.

Just do as Zhou Congwen said, Teng Fei nodded.

After hearing Zhou Congwen's words, the patient's face suddenly became very ugly, "Doctor, please be more professional! I am sick, how can you make fun of my health!"

"Professional?" Zhou Congwen looked at the patient sideways, surprised.

Isn't your performance professional enough?

Shouldn't be.

As far as his own performance is concerned, even in the world's top hospitals, there are very few doctors who can clearly explain the diagnosis and treatment of patients with a single mouth.

After all, Lyme disease is a relatively rare disease, and China is not an area with a high incidence of Lyme disease. In 2003, the whole world did not have a deep understanding of Lyme disease, let alone China.

In this environment, if you make a clear diagnosis immediately and take the right medicine, there is a high probability that the patient will recover and be discharged from the hospital.

If that's not professional, what is? !

"I told you, this is..." Seeing Zhou Congwen's expression was a little stiff, Teng Fei immediately reprimanded with a shudder in her heart.

But Zhou Congwen raised his hand, blocked Teng Fei's words, and smiled slightly, "Then what do you think I am unprofessional?"

"Snail powder is edible, it smells bad, but the more you eat it, the more addictive you become. You actually want to use this thing to treat me?!" The patient glared at Zhou Congwen and said contemptuously.

"..."

Zhou Congwen felt very blocked, blocked, and uncomfortable.

"How can Luo Shifen be eaten? It's served quietly." Tengfei didn't understand, and explained to the patient in amazement.

Zhou Congwen shook his head, "You heard it wrong. The ceftriaxone sodium produced by the Swiss Roche Pharmaceutical Group is used for you. The product name is Rochefen. It is not the snail powder you eat. There is a little difference."

"..."

The patient was also confused by the two awkward accents.

But when Zhou Congwen mentioned the Swiss Roche Pharmaceutical Group, she obviously relaxed.

"Misunderstanding of the homonym, let me put it another way." Zhou Congwen said, "Use ceftriaxone sodium, 2g of intravenous infusion a day, and your condition will improve in about a week."

"Doctor, what kind of Lyme disease do I have?"