Chapter 583 Diagnosis

"Say it if it hurts." Ling Ran palpated the patient's abdomen.

Compared with technical methods such as B-ultrasound, the slightly old-fashioned palpation can still obtain a lot of information. Therefore, in physical examination, it is still frequently used.

Of course, technologies such as imaging and palpation are not an either-or relationship, and are more often the choice of doctors.

Ling Ran is currently at the level of a master physical examination, and the accuracy rate of abdominal palpation is higher than that of B-ultrasound, so there is no need to occupy equipment.

The patient lay on the examination bed, looked at Ling Ran happily, and said, "It doesn't hurt, it can't hurt."

"Don't bear the pain, tingling pain, swelling pain, etc., you have to speak out." Yu Yuan stood on a small bench on the other side of the examination bed, reminding the patient for the nth time.

The patient gave her a disgusted look, let out an "en" in his nose, and then looked at Ling Ran.

"Will it hurt here?" Ling Ran now has his own views on the physical examination, and the order and mode used are slightly different from before.

The patient only took a breath when he reminded him, and said, "It doesn't hurt too much."

"Speak out even if you feel a little pain. Do you feel any pain after eating?"

"Occasionally."

"An hour or two after dinner?"

"Yes, you can guess that, Doctor Ling, you are amazing..."

"Stomach ulcer." Ling Ran didn't wait for the other party to finish, and interrupted him: "I'll order two more tests for you, you go for a diagnosis. The ulcer is not serious at present, but technical intervention should be used."

At this time, the man lying on the medical examination bed was stunned, and hurriedly said: "I exercise three or four times a week, how could I be sick?"

Ling Ran looked at him suspiciously, and asked, "Why don't you get sick after exercising?"

"Fitness...fitness is good for your body."

"When it's time to get sick, you'll still get sick." Ling Ran gave the order and added another sentence, saying, "Stress, fatigue, careless diet, climate change, or alcohol and tobacco may cause and aggravate gastric ulcers. You have to pay more attention and not take it lightly."

Yu Yuan said: "If it is not treated properly, once the gastric ulcer bleeds or perforates, it will be very troublesome. Maybe the stomach may be removed. In addition, there is a risk of transforming into a malignant tumor."

"Cancer?" The man being examined screamed.

"Not now, but there is a risk." Yu Yuan said, "I want you to go back and take a good look at the gastric ulcer. Just look at it, understand?"

The man asked nervously, "Is it really possible to get cancer?"

"There is a risk of gastric ulcer becoming cancerous, but the probability is relatively low, generally less than 3%." Ling Ran now has enough energy potions, and often reads books while taking drugs. He also reads a lot of internal medicine. can remember.

"Three percent won't work either..." The man didn't feel relieved at all, he jumped off the examination bed sullenly, and asked, "What should we do now?"

"I suggest you go to the hospital for a gastroenterology department." What Ling Ran gave was a referral opinion.

He can also prescribe medicine to patients with gastric ulcer, but he is not a professional after all. On the other hand, to diagnose gastric ulcer or related diseases, you may need to do a carbon breath test, and maybe a gastroscopy, which is not something that free clinics can do now.

Referrals are a common practice in emergency departments, but are a little more complicated these days.

Ling Ran handed the form to the other party and asked Yu Yuan to explain. The little nurse Wang Jia next to him invited another patient to come forward without waiting for orders.

While still inquiring, do a physical examination, and then make a basic judgment.

Ling Ran's diagnostic skills are not high, and his experience in outpatient clinics is close to none, but it is more than enough for this kind of community diagnosis.

Unlike the patients who come to Yunyi, they often have serious illnesses and need to be treated with caution. The free clinic in Bazhai Township itself has the nature of physical examination. Most of them are normal and healthy people. Some diseases are not serious, and they are mainly common diseases.

With the development of modern medicine, intractable diseases are still intractable diseases, and no matter how many inspection methods are used, they are only auxiliary.

Evidence-based medicine, which is highly respected, is the opposition party for intractable diseases.

Today's doctors actually prefer to deal with certain common diseases. When you hear the sound of horseshoes, the first thing you think of is a horse, not a zebra.

As far as Ling Ran is concerned, the current horse identification technology is gradually matured.

"Doctor Ling." Director Wang Haiyang from the hand surgery department called out and called Ling Ran over.

"This is..." What Ling Ran saw was a finger that had obviously been boned incorrectly.

"Do you want to have an operation?" Wang Haiyang pointed at Ling Ran, and said, "Dr. Ling is the best doctor in our Yun doctor's severed finger replantation. If you reconnect your finger, it won't hurt every day. It hurts."

The young man who was seeing a doctor suddenly took his hand back as if it was hot, and asked, "How much?"

"Do you have health insurance?"

"Just like 120 a year."

Wang Haiyang nodded slightly: "The entire operation will cost about 10,000 yuan."

"Then I'll think about it again." The patient dared not answer, stood up, and left hesitantly.

Wang Haiyang had no choice but to smile bitterly: "I thought I could have an operation. Let's see each of the outpatient clinics."

Wang Haiyang could only shrug his shoulders at Ling Ran, and continued to see the next patient.

They are all specialist doctors, but in this kind of free clinic, they are not so particular.

And the people who came to see the doctor didn't care.

Different from the higher-end thinking of foreign specialist doctors, Chinese people generally believe that an expert doctor should be comprehensive. At the very least, a good cardiologist should be able to treat a gastric ulcer with ease...

This is somewhat influenced by the ethos of Chinese medicine. For veteran doctors, it is both convenient and inconvenient. The same is true for Ling Ran.

After completing the physical examinations for most of the young people, fewer people lined up in front of Ling Ran.

Ling Ran didn't have to sit at the desk all the time, he was busy back and forth, and helped other doctors treat patients with mild symptoms—in two hours, he encountered as many as seven or eight people just because of corns and paronychia .

This kind of minor surgical illness is placed in Yunyi, that is, only residents and even interns are sent to practice. There was really nothing to do, it was originally the simplest surgical operation.

Today, Ling Ran didn't intend to let go. If there were patients with mild symptoms, what he could do on the spot was done.

The doctors who came to the free clinic all nodded.

Among the surgeons present, Ling Ran was the youngest. He took the initiative to do it, and the senses of the other doctors were much better.

"Looking at it this way, Ling Ran is quite sensible." Director Hong of the Respiratory Department saw that Ling Ran had gone to the cubicle to operate again, so he opened the third pack of cigarettes today, lit them, and talked with a smile.

"That's right. If you don't say a word, you still do a good job." A deputy senior from Puwai also nodded in agreement.

"It mainly depends on the patient's feelings. Ling Ran is still very serious about seeing a doctor." Wang Haiyang knew Ling Ran best, and said something to him with a smile.

"That's true."

"You're still young, if you're older, at least you can collect a few more pennants."

As soon as Director Hong finished speaking, he saw a pennant stretching in from the door.

The big characters on the pennant read "Save the dying and heal the wounded, the medical ethics are noble", and the small characters next to it read "For Dr. Ling Ran" and so on.

"Is Doctor Ling here? I'll send you a pennant." Hua Tao, the water tyrant who came in, was full of confidence. Standing on the land of Bazhai Township, he felt that he had inexhaustible strength, and he gave gifts with confidence.