radicalducati Chapter 676
Chapter 676
「676」
"Coagulation factor XIII deficiency",
It is rare,
The incidence is about 1 in 2 million.
"XIII factor deficiency" is the only disease that can be normal with coagulation tests, and many hospitals' "coagulation factor set" does not include factor XIII, so the local hospital has not detected it.
Moreover, the four normal coagulation disorders, delayed blood issuance, and coagulation are its clinical features.
these
The little boy in front of you, all fit!
Lin Feng patiently explained to the young parents, Xiaoru, and Zhang Dong.
The four suddenly realized,
I see!
Therefore, Lin Feng's diagnosis is "factor XIII deficiency"!
But
You also need to draw blood for testing!
"I won't check the coagulation index later, but check the blood routine to see if the degree of anemia has progressed (continuous bleeding)... Also do a factor XIII check..."
Parents: "Okay, okay! "
blood draw,
Send for an inspection...
The next step is to wait for the test results, treatment...
......
Wait for the check, it may not be so fast.
But it is still possible to do some empirical treatment.
Although it is not determined to be "factor XIII deficiency", the bleeding in the little boy is certain, and the anemia is also certain, so blood transfusion is performed first to improve anemia and improve blood clotting capacity.
The nurse soon took the little boy to go for blood transfusion...
......
An hour later,
The blood routine results came out: 48g/L, which is already a very serious anemia.
And when it was time to leave work in the afternoon,
The results of the XIII factor check items are out.
Confirmed: "XIII deficiency"!
Exactly the same as Lin Feng's diagnosis!
Then the next treatment is even simpler.
Mainly to improve blood clotting function,
Regular infusion supplementation of factor XIII A subunits or purified products; If this product is not available, fresh frozen plasma or cryoprecipitate can be used, and factor XIII can also be supplemented.
The little boy, who will be hospitalized tonight, needs to be observed for a week until the little boy's brain is back in good condition and will not 'terrorize the big-headed baby'.
And the young parents were full of gratitude to Lin Feng at this time. Looking for thousands of times, I didn't expect to find the cause of my son here in Lin Feng.
If the cause is found, targeted treatment in the future, they will not have to panic so much.
......
Just when I was about to leave work,
The last patient walked in.
is a mother holding a small 5 month old baby.
Lin Feng wondered, why are there so many patients of today's little baby?
"Dr. Lin, help my baby see what's going on? Blood in the stool! Better! It's scary! "
When my mother came in, she looked panicked and sweaty.
The eyes were pleading.
Lin Feng was taken aback!
If a baby is only 5 months old, if it bleeds, it is terrible!
You can die at any time!
"Has anything happened before?"
Ask about the history.
Mom: "Last week, I was hospitalized because of a urinary tract infection..."
Lin Feng: "Hospitalized? How long to stay? "
Mom: "Two days and one night..."
Lin Feng: "What is the cause of urinary tract infection?" "
Mom: "At that time, the doctor's diagnosis was that the diaper was not changed in time, resulting in feces soaking into the urethral opening, and bacteria invading the urinary tract..."
Lin Feng: "Which hospital?" Are we harmonious? "
Mom: "Yes..."
Lin Feng called up the medical record system, quickly found it, and then read it.
Medical history is an important thing that must be asked during the consultation.
A minute later, Lin Feng finished reading it and couldn't see anything.
"Any other medical history? Have you ever had blood in the stool or urine before? "
"No..."
"When you were discharged from the hospital, did you check for any diseases?"
"Is there a cyst in the brain?"
"Subdural cyst?"
"Yes..."
"That's not a problem... Nothing else? "
"It's gone..."
Lin Feng nodded, and then began to ask about the symptoms:
"Blood in the stool, did you take a picture?"
"There is... There is..."
Mom took out her phone and opened a photo.
The photo is a diaper, open, a lot of slimy stool, generally the baby's stool is yellow, healthy.
But the color of this baby is red!
Very red!
It's as red as rust.
Lin Feng looked at it and didn't feel like blood red, but it was difficult to say, because the blood was mixed with the original color of feces (not necessarily standard yellow), and the color formed was not necessarily blood red.
"Does the baby have any other symptoms besides blood in the stool?" Such as restlessness, crying, not drinking milk, fever, rash ... Wait a minute...... Or rather a long sleep..."
"No... None of this. "
"Are you sure?"
"Sure, I've been doing well, eating well, sleeping well, and being in good spirits..."
When Lin Feng heard it, he probably understood.
This should not be bleeding.
If it is bleeding, especially stomach bleeding, then the baby should be very uncomfortable, stomach pain, and anemia, will be lethargic...
Therefore, eating well, sleeping well, and being in good spirits is basically impossible to have internal bleeding.
"Here, open the baby's clothes, I'll check the baby's steel door..."
soon
Clothes lined up...
Lin Feng did not see an obvious fissure.
As for what happens to the rectum and colon inside, it is not clear.
diagnostic process,
That's the end of it.
Next is Lin Feng's diagnostic opinion:
"At present, it seems that your baby should not be blood in the stool..."
"Huh? Not blood in the stool? "
"It's not blood in the stool... But my judgment may not be accurate, I want the baby to go for a check-up, to make sure... As long as the inspection is passed, it can be completely determined..."
"What check?"
"Fecal occult blood test"... The next time your baby poops, collect it and send it for a check-up... So, you can stay in the hospital tonight and wait for the baby to poop..."
This is just one of the methods.
Like so many red substances of this baby, if it is really bleeding, there must be a lot of bleeding, you can draw blood for the baby, do a blood routine, see how many red blood cells, whether there is anemia.
However, for a 5-month-old baby, it is more difficult to draw blood, and parents are also distressed, so Lin Feng simply does not mention it.
The "fecal occult blood test" is very good,
You can do it directly with the "Fecal Occult Blood Test Kit"...
Other than that
One more point,
Lin Feng felt that the red substance of the baby's poop should not be stool.
Because in the baby's last hospitalization record, when he was discharged, the doctor prescribed a drug called "cefdinib"!
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ps: Take care of the baby for a few months, prepare to open a new doctor's book, five changes a day and so on... So the update has been broken for a few days...