Chapter 462: Unexpected High Blood Pressure

Remember [new] in one second! Cough, hemoptysis and chest pain, and there is a shadow on the chest CT scan.

The patient also had a past history of tuberculosis.

In addition, the results of the patient's blood test this morning have come out.

The white blood cells in the blood routine were high, and other biochemical, liver and kidney functions were normal.

The results of tuberculin and t-spot will not be available until tomorrow.

Moreover, even if these two tests are negative, they can only indicate that the patient has been infected with tuberculosis in the past, but not that he is currently infected.

For this kind of patient, the impression diagnosis is nothing more than pneumonia, tuberculosis and lung tumors.

"We still need to do a bronchoscopy to confirm the diagnosis as soon as possible!" Lu Chen thought to himself.

Clinically, many diseases cannot be diagnosed based on superficial evidence alone.

However, relying on modern scientific and technological means, a correct diagnosis can often be made.

For example, in an era without imaging technology, neurologists had no way to tell whether a patient had cerebral hemorrhage or cerebral infarction.

The external symptoms of these two diseases are very similar and cannot be distinguished at all.

The most important thing is that the treatment of bleeding and cerebral infarction are completely opposite!

One needs thrombolysis and the other needs anti-thrombosis!

What should we do at this time?

Diagnosis and treatment can only rely on experience and feeling.

If treated correctly, the patient's condition will improve and he or she will survive.

But there are also many patients who get worse with treatment and eventually die.

…

"Brother, I see that there is a patient in Teacher Fang's group who won't be undergoing bronchoscopy tomorrow." Wang Defa ran over and said to Lu Chen, "It's just right for Mei Yejun's father to insert it."

Lu Chen smiled and glanced at Wang Defa, "Why are you so active in helping junior sister these days?"

"Ah..." Wang Defa blushed, "No, no, they are all from the same school. I just wanted to see if I could help."

"Okay, I'll ask Teacher Fang later."

After Lu Chen finished what he was doing, he negotiated with Teacher Fang in the next group.

Teacher Fang also heard about Lu Chen's name in the hospital and was very interested in him.

Hearing that a patient in their group wanted to step in, he agreed.

…

Mei Yejun was also very happy when he heard the news.

If she had a bronchoscopy one day earlier, she would feel more at ease.

However, Lu Chen had some bad premonitions in his heart.

The health value on the patient's head dropped slowly. Although the decline did not reach three minus signs, it was still an extremely terrifying thing.

Early the next morning, when Lu Chen saw the patient, his health had dropped by another two points.

Finished checking the room in the morning.

Fan Yujing took Lu Chen and Wang Defa to the endoscopy room of the respiratory department.

"Dad, don't be nervous. These doctors are all my teachers and senior brothers." Mei Yejun stood at the door of the endoscopy room and said to his father, "Their techniques are the best and they will be done quickly. "

"Don't worry, Xiaojun, you don't know your father and me yet!" The patient smiled, "It's just a check-up, I'm not nervous at all."

Although he said this, Lu Chen still saw his hands trembling slightly.

"Junior sister, just wait outside." Lu Chen said softly, "I will come out and let you know if anything happens."

"Yes." Mei Yejun nodded lightly, "Excuse me, Teacher Fan, there are two more senior brothers."

…

Later, Wang Defa pushed the patient into the endoscopy room.

"Come, lie down here." Fan Yujing waved and asked the patient to lie down on the operating table.

The patient was lying on the operating table, looking like he was hesitant to speak.

"Uncle, what's wrong? Are you feeling uncomfortable?" Lu Chen asked quickly.

"Well..." the patient hesitated, "If something goes wrong, don't tell my daughter first!"

Lu Chen was stunned.

"Just tell me first, okay?" the patient repeated.

Lu Chen said helplessly: "Uncle, your illness is your privacy. We have no right to interfere. It is your choice whether to inform your family or not. However, your daughter is also a medical student. Do you think you can hide it from her?"

Even if he can hide it now, Mei Yejun will definitely know it once the follow-up diagnosis and treatment are carried out.

"Oh." The patient sighed.

Lu Chen comforted him: "Uncle, don't be so frustrated. The examination hasn't started yet."

The patient nodded and barely smiled.

…

All equipment for bronchoscopy is ready.

Fan Yujing said to Lu Chen on the side: "Get ready to start."

Lu Chen nodded and discussed risk communication with the patient again.

"Uncle, do you know all the risks I mentioned?" Lu Chen said.

"Yes, I know, Xiaojun also told me."

"Okay, I'll take your blood pressure. It's normal. Let's get started."

Preoperative, invasive procedures require routine blood pressure measurement.

Lu Chen took out the automatic blood pressure monitor and put it on the patient's arm.

"Blood pressure 184/107mmhg."

As the reading on the blood pressure monitor appeared, Lu Chen was stunned.

"Why is your blood pressure so high?"

The current Chinese standard is that if it exceeds 140/80mmhg, it is considered high blood pressure.

The systolic blood pressure is 140-160mmhg, which is the first grade of hypertension.

A systolic blood pressure of 1hg is grade two hypertension.

If the systolic blood pressure exceeds 180mmhg, it is grade three hypertension.

In order to prevent the sphygmomanometer from malfunctioning, Lu Chen measured it again, and the results were almost the same.

Lu Chen knew that the patient had a history of hypertension.

"Uncle, didn't you take antihypertensive medicine this morning?"

"Yes!" The patient frowned, "The blood pressure is very high, right?"

"Yes." Lu Chen nodded, and then looked at Wang Defa, "The blood pressure didn't seem to be so high two days ago, right?"

Wang Defa scratched his head and said, "The patient's blood pressure was about 150/80mmhg on the day of admission, and it was 154/85mmhg yesterday morning. When I measured the blood pressure, the patient had just taken antihypertensive medicine, so I didn't pay attention to it."

At this time, Fan Yujing came to the operating table, "What's wrong?"

Lu Chen explained, "The patient's blood pressure is too high. I just measured it twice, and the blood pressure was above 180/100mmhg!"

Fan Yujing frowned, "Then I can't do it for the time being."

Lu Chen was also quite helpless.

Before any operation or surgery, high blood pressure will increase the risk of surgery several times.

The patient is very likely to bleed, have heart failure, and other unpredictable malignant events.

"Uncle, you may not be able to do it this morning. Your blood pressure is too high. You can only do it after your blood pressure drops and stabilizes." Lu Chen said, "It must be at least below 1hg before we can do it with you."

Although the patient was a little confused, he nodded and walked out of the endoscopy room without saying much.

Lu Chen had no choice but to pack up the endoscopy equipment and put it back.

Waiting for the patient's blood pressure to stabilize before doing a bronchial endoscopy.

However, Lu Chen looked at the patient's back as he left, and suddenly seemed to think of something, and was suddenly shocked.

"I have been in other departments for a long time, and I almost forgot the department I came from!"