Just after 4 o'clock, Director Li and the rest of the trauma surgery department came up, and they came to see how Chen Wenqiang took the intern exam.Nurse Xiao Wu gloated to Director Li and told them about Chen Wenqiang's arrangement.At the end, he smiled and concluded with "dismounting".The interns who were lying opposite Xiao Wu and writing wildly frowned, did not dare to be angry or speak, and only dared to glance at her quietly when Xiao Wu was not paying attention, and then continued to bow their heads and answer the questions.Director Li and others followed Chen Wenqiang and Director Liang to look around the inside and outside of the room to see the answers of these interns.The phone rings.Nurse Xiao Wu grabbed the telephone: "Hey."
Well, he's in Corey. ”Then she turned her head and shouted loudly: "Dean Chen's phone, Director Luo of Endocrinology is looking for you." ”"Okay, come on."
Chen Wenqiang walked a few steps briskly to listen to the phone.Because Director Luo is fine, he won't look for himself."
Hey, Director Luo.I'm Lao Chen.What's the matter?
”......
"Okay, I'll go over and have a look." ”Chen Wenqiang put down the phone and said to Director Liang: "Old Liang, the endocrine side has accepted a patient with advanced diabetes, diabetic foot, Director Luo is considering amputation, can you go over and take a look?"
”Director Liang shook his head: "You are looking for Lao Xiang."
I looked at the amputation in general, not that I stretched my hand too long. ”"Of course he has to go.The endocrine side also called him.I mean, if you really want to amputate a limb, it's not very common for this diabetic foot to be amputated, so I'll have to show these students. ”When Director Liang heard this, he immediately stood up and said, "Then let's go." ”"Lao Li, can you help take a look here?""
Okay, you can go over."
Chen Wenqiang said to Xiao Wu: "Call Dr.
Li to me for consultation." ”Xiao Wu agreed to call Li Min.
*Director Luo of the Department of Endocrinology is an associate professor who was transferred from the Medical University.She was promoted to associate professor three years ago and obtained the qualification to lead graduate students.Even so, she is also one of the unlucky senior attending doctors who did not catch up with the deputy senior professional title of the medical university.When she went to the countryside, she responded to the call to join the "Iron Maiden Team" and jumped into the frozen ditch to build water conservancy like the male members in the cold winter, becoming a role model for young people in the countryside to learn.After fighting for a few years, she was recommended to the Medical University as a women's captain with a body of injuries and became a worker, peasant and soldier college student.After graduation, I was able to stay and work in the Hospital Affiliated to the Medical University.When there was a national craze for learning English, she once again answered the call and devoted all her energy to learning English.Heaven seems to be very pleased with a ruthless person like her, who is desperate to make every effort.When the enrollment of graduate students resumed, she was admitted to the first batch of graduate students after the resumption of the college entrance examination at the Medical University because of her good English.In the year when she successfully graduated from graduate school, the medical university began to use examinations to eliminate workers, peasants and soldiers who stayed in school.Because she has a master's degree, she can continue to stay in the Affiliated Hospital of the Medical University without taking the exam.Work is going well, but life is flat.The husband, who has been married for more than ten years, not only cheats, but also strongly demands a divorce."
Your mind is focused on studying and working, and I just want to have a stable family life."
Only later did she learn about her ex-husband's determination to have a son.After a face-tearing fuss, her four-year-old daughter was finally left with her.Because she wiped off her face, she went to the obstetrics and gynecology department of the Affiliated Hospital of the Medical University and gave her a diagnosis with a chance of reproduction of less than 1%.She was reluctant to send her daughter to long-term care, so she could only take her parents to live with her.Three generations of grandparents live in a single room in the tube building, embarrassed and ugly.The calm that she had endured for many years collapsed when she heard that the provincial hospital had announced at the endocrinology conference that it would use three rooms and one hall and hire a clinical professor with the title of associate high school or above in internal medicine as an academic leader.She was very careful to pay attention to the matter at the meeting, and quietly listened to the discussion of these matters among the qualified associate chief physicians and associate professors who attended the meeting.There is no other reason - the attending doctors of the Department of Endocrinology of the Affiliated Hospital of the Medical University are all graduate students, and there are too many people who have been hired as associate professors one after another, and the competition is too fierce.Being passive in the future work is the least thing.After the meeting, she carefully verified the news of the provincial hospital, and then called the medical office of the provincial hospital, and learned that the person in charge of the matter was the assistant to the dean and the dean in charge of surgical treatment, and she couldn't help but hesitate.Can an assistant dean with a surgical background pay attention to endocrinology?
Is there really a shortage of endocrinology leaders in the provincial hospital?
What should I do if I can't go?
She went to work in a trance the next day, and even the graduate student who had just graduated from the department inexplicably discovered that something was wrong with her."
Teacher, are you not feeling well?""
Nope."
But her haggard face and frowning eyebrows made her inexplicably unable to believe her words.But this smart girl knew that she was not familiar with her mentor, so she could only look at her mentor with concern and concern.But it was this silently concerned gaze that gave Luo Ying another burden.Although Prof.
Luo has been qualified to recruit graduate students early, she has previously worked with the head of the department to recruit graduate students.Inexplicably, she was the first graduate student she recruited independently, and she was a very hard-working and serious girl.- Inexplicably, it is also my own responsibility.What would she do if she went to the provincial doctor?
Luo Ying hesitated all night, listening to the sound of walking back and forth in the corridor, and finally did not resist the temptation of the three-bedroom apartment, and mustered up the courage to call Chen Wenqiang.She was afraid that she would miss this opportunity, and then she didn't know how many more years she would have to live in the box.Fortunately, the god of fate favored him again.…… Later, Chen Wenqiang took the detailed technical strength information of the endocrinology department she provided and transferred her to the provincial doctor.She was joined by associate professors in the Department of Nephrology and Hematology.That was because Luo Ying introduced the basic situation, Chen Wenqiang went directly to people, and of course, there was also an element of her lobbying - the main reason is: the upside of staying at the Medical University is limited; I also lived enough in the tube room, since I have a half-price house with a three-bedroom apartment, the position of the department director, and the positioning of the subject leader, why not go away.This solved the major matter that Chen Wenqiang had been worried about for several months.Of the remaining four three-bedroom houses, one was left by Chen Wenqiang to the director of pediatric surgery, and the other was seconded by the director of the neurology department from the medical school.* When Li Min followed Chen Wenqiang to endocrine, Director Xiang had already arrived first.Director Luo and her graduate students were preparing to introduce the patient's condition."
Dean Chen."
Director Luo is very respectful and polite to Chen Wenqiang, because this person has the ability and courage to break the dilemma that he has tried hard to break through in one fell swoop."
Director Luo, this is Director Liang of the general public.I thought that this patient was really going to have his leg amputated, and there were eight interns in the general department, all of whom were going to come and see this patient. ”Director Liang stretched out his hand to say hello to Director Luo, and then several people sat down.Standing behind Director Luo, he smiled inexplicably at Li Min, and Li Min recognized the inexplicable and smiled back at her."
There are so many students that I'm worried about getting more infected.Lao Chen, Director Cai Luo also wants to organize interns in the Department of Internal Medicine to take a look, and there are also 30 people. ”Director Xiang was not so approving of it."
That's not good for teaching hospitals."
Director Luo insisted: "But when we encounter such cases, we must also meet the interns, lest they encounter similar patients in the future and cannot grasp the principles and specific methods of treatment." ”Chen Wenqiang looked at the director and was about to speak, knowing that his competitive strength was coming, he hurriedly said, "How long has the patient been sick?"
Let's take a look in a moment. ”*Inexplicably, I stepped forward and started to report my medical history."
The patient, Huang Jiaqiang, male, 62 years old, was admitted to the hospital for two days due to lower limb pain and walking difficulties.…… The patient has a history of diabetes for about 20 years, and he has been taking medication regularly for more than 3 years.Physical examination: the patient's feet are black, partially ulcerated, and have a fishy odor.Pressure is non-tender.The left lower limb begins to change color and ooze from the middle of the calf.The right ankle began to change color.…… Laboratory tests: fasting blood glucose 23.2mmol/L this morning, urine glucose ++++. ”Director Luo added: "The patient reported that in the past three years, he has been regularly using drugs to control urine glucose, and oral hypoglycemic can control urine glucose at +++.Urine sugar we can only do as a reference.One is that the patient's medical history is watery, and the other is that urine glucose cannot be used to determine whether glycemic control is achieved in the advanced stage of diabetes.After being hospitalized yesterday, he was switched to short-acting insulin......
Inexplicably, do you go and see if the patient has been transferred to the ward first?
”"I'll go check it out."
Inexplicably, he smiled at everyone and explained: "Director Luo, in order to facilitate the interns, asked the head nurse to transfer the patient to the ward. ”Director Xiang was not very happy, but he knew that Director Luo's arrangement was correct.Those dozens of interns don't see diabetic foot in endocrinology, they have to go to orthopedics to see it.Chen Wenqiang will not allow himself to avoid the cause of infection and reduce the patient's contact with the outside world."
Director Luo, the patient has been transferred to ward 4."
Inexplicably came back quickly."
Then Dean Chen, let's go and have a look."
Inexplicably lead the way in front.Chen Wenqiang stood up and walked out, followed by Li Min after the three directors.*4 The ward is relatively large, and the room smells of disinfectant water mopping the floor.There is a space that can accommodate six to eight beds, and only 3 beds are placed, and only Huang Jiaqiang, a patient with the middle bed, lives.The patient leaning on the bed reading the newspaper had a fat head and big ears, a bulging belly, and a greasy smell of perennial smoky fire.The broad palms, the short, sturdy fingers, and the scars on the left finger all point to the countless years of this man's experience in the chef's profession.He heard the movement and looked up, and saw a string of people who inexplicably led in, looking at it not an ordinary doctor, and immediately sat up straight nervously."
Master Huang, this is Dean Chen, who is the director of surgery, and this is the director of the Department of Orthopedics, and the director of the Department of General Surgery, Director Liang, who is here to consult you."
Director Luo stepped forward to introduce the origins of these three.Some people talk without hesitation.In view of the mental pressure that Master Huang was under before and after admission to the hospital because of the amputation, Director Luo went straight to the point and first named the background of the consultation.lest Huang Jiaqiang embarrass him in his own department, and finally offend people, but he has to bear the consequences himself.Director Xiang heard that his heart was not big, and it was inevitable that he would be angry with himself.The patient struggled to squeeze out a smile, then looked at his own discolored and bare feet, and asked anxiously, "Dean Chen, can I keep this foot?"
”※※※※※※※※※※※※※※※※※※※※* Diabetic foot is a serious chronic complication of diabetes mellitus, which develops due to poor blood sugar control in the past, resulting in microvascular nerve lesions and blood supply disorders caused by microvascular macrovascular foot lesions.
**The chance of cure for diabetic foot amputation is mainly related to the patient's blood circulation, glycemic control, and general condition.If all three of these conditions are met or ideal, the chance of wound healing is 80%-90%.If blood vascularization is not well established, the probability of wound healing is relatively low, and the chance of cure is less than 30%.Sometimes it doesn't heal for a week, two, or even months.If the blood sugar is not well controlled and the blood circulation in the affected limb is still not smooth, the affected limb will have repeated symptoms such as bacterial infection, ulceration and suppuration, which often indicates that the patient is not healing well and needs to be amputated again.() The distance is a bit far