I heard that Chen Qi has a simpler detection method. Not to mention Qi Zhiyi, even senior experts such as Dean Gai, Director Lu, and Director Yao are full of curiosity.

While packing up the debridement bag, Qi Zhiyi asked: "What is the detection method?"

Chen Qi joked:

"Why are you the one asking me questions? Isn't this the opposite? Come on, Comrade Xiaoqi, Teacher Chen also wants to ask you a few questions."

Qi Zhiyi was stunned when he heard this.

His personality is a bit carefree, and he has always had a close relationship with Chen Qi. Even Chen Qi's wedding wine was one of the few classmates who could drink it.

Therefore, in his mind, Chen Qi has never been regarded as the dean or a superior doctor.

Now hearing that Chen Qi suddenly wanted to ask him a question, Qi Zhiyi felt nervous and unhappy.

If no one was around, he would definitely have a wild meal with Chen Qi, but now that the leaders of the unit are watching, he doesn't dare to be presumptuous and can only shake his fist at Chen Qi.

But he really couldn't answer Chen Qi's question, so he could only say with a grimace:

"Teacher Chen, please forgive me. Don't tell me that I don't know how to check chylofluid. I have never even heard of the disease chylothorax. I'm so ashamed."

Chen Qi nodded, pretending to be a leader and said:

"Although Comrade Xiaoqi is not good at studying medicine, his attitude is still very sincere. If we correct it, we will encourage you. Today, Teacher Chen will teach you!"

Qi Zhiyi suddenly ran to Chen Qi, pinched his neck and shouted:

"Speak quickly, if you don't tell me, I will beat you to death!"

"I say, I say, I can recruit anything~~~"

Hahaha, everyone in the clinic laughed. At this time, Chen Qi's naughty side was exposed, and everyone was shocked to realize that the international double director in front of them was just a 24-year-old young man.

Seeing that Chen Qi was preparing to give a live lecture, not to mention Qi Zhiyi who was listening carefully, even several senior directors pricked up their ears.

They know about chylothorax and the prognosis of chylothorax, but they don’t know exactly where the chylothorax comes from and how to treat it.

After all, the domestic textbooks from the 1950s and 1960s are there, and the types of diseases are just that, and they are not the latest textbooks from the 10th edition of the People's Medical Publishing House.

Medicine is very specialized, and there is no end to learning. Innovative research is done every year, and a batch of old knowledge is eliminated every year.

But as long as you have experienced it once and treated it in clinical practice, it will be difficult to forget it later, so it is also called "empirical medicine".

Chen Qi pointed to the remaining half bottle of chylolysis and said:

"This chyle-like effusion is actually the lymph fluid in the lymphatic vessels of the chest leaking out. Everyone knows that ordinary lymph fluid is transparent, why is this lymph fluid milky white?

This is because the fatty acids absorbed by the gastrointestinal tract are absorbed through lymphatic vessels and mixed with ordinary lymph fluid. The pleural effusion formed when chylofluid enters the pleural cavity is called chylothorax. If it enters the abdomen, it is also called chyloabdomen, so it makes sense.

One-stop service, right?"

To highlight the key points, a new disease emerges here: chyloabdominal disease.

This is also a very troublesome and rare disease.

Chen Qi briefly mentioned some knowledge points about chylothorax before continuing to talk about chylothorax.

"I just asked the laboratory to focus on checking the fat content such as triglycerides, because as long as the fat content exceeds 4 grams per liter, we can make a preliminary diagnosis of true chylothorax. This is also a very simple detection method."

Qi Zhiyi asked again: "How did the lymph fluid enter the chest or abdominal cavity? What is the cause?"

Chen Qi smacked his lips:

“There are so many reasons, it’s really hard to say. Generally, adult chylothorax is thought to be caused by trauma, such as cervical and chest injuries; there are also lymphatic obstruction, such as lymphoma, metastatic cancer, etc.; in addition, some people are caused by congenital

The thoracic duct is underdeveloped or fistulous."

Qi Zhiyi pointed to the baby who was tired of crying and fell asleep on the hospital bed and asked:

"Then what is the most likely cause of this little illness? After all, he can't have trauma or cancer, and he's only less than 2 months old."

Chen Qi thought for a moment and continued to explain:

"Chylothorax in newborns is mostly caused by congenital abnormalities of the thoracic duct or birth trauma, and is less common in older children. In some children, tumors, especially lymphangiomas, may also cause thoracic duct obstruction, and persistent severe coughing may also cause thoracic duct obstruction.

It causes chyle overflow. It’s really hard to say what the specific cause of this baby’s disease is, unless it is surgically incised and examined.”

Director Lu said helplessly:

"Parents are opposed to having a chest piercing. Now you want to use a knife on this little baby to open the chest. I'm afraid the parents will fight against you. It seems that the reason is not clear."

Chen Qi shook his head:

"That's not necessarily true. Conservative treatment of chylothorax is not very effective, especially since this little baby's condition is already in bad condition. I think surgery is very likely, and it is the only way to cure it."

When Dean Gai saw them chatting freely, he quickly brought it back to the topic:

"Chen Qi, you haven't said yet which method can be used to quickly detect chylofluid?"

"Oh, this is simple, Zhiyi, go to the anesthesiology department and get me some ether."

Qi Zhiyi was startled: "Why do you want ether? Don't you want to do something bad?"

What can ether be used for?

Have you ever watched the social news? A stranger came over and covered your mouth and nose with a cloth. Then the person who was covered immediately fainted. There was ether in the cloth.

The anesthesiology department of the hospital always has drugs on hand for clinical needs, so doctors commit crimes. Hum, it is definitely a crime of high IQ, and the tools for committing crimes are all ready-made.

Chen Qi got angry and kicked him:

"Go away, I want ether. The fourth hospital doesn't have it, and I need your second hospital to provide it. Hurry up, don't you need to know the rapid detection method? My brother will teach you a trick."

After a while, Qi Zhiyi ran back, holding ether that can be used to kill people and set fires.

Chen Qi extracted a portion of the chylous fluid, put it into a test tube, added ether one by one, and shook it. After a while, the milky white liquid turned into a colorless liquid, with a layer of fat floating on top of the liquid.

Everyone quickly gathered around to check what was going on inside the test tube.

Chen Qi patiently taught everyone:

"In the future, you should remember in clinical practice that milky pleural effusion is not always chylothorax, but may also be pseudochylofluid formed by empyema or cholesterol pleurisy.

After the true chylofluid is shaken with ether, the fat precipitates and becomes clear, with high fat and triacylglycerol content, positive Sudan 3 staining, and chylomicron bands visible on lipoprotein electrophoresis.

If it is pseudochylophilus, it is impossible for the pleural effusion to become clear after shaking with ether. Do you understand the difference between the two now?"

Qi Zhiyi nodded fiercely, then took out a small notebook from his pocket and quickly wrote it down.

Chen Qi looked back at Dean Gai and said:

"Dean Gai, I am almost certain that it is chylofluid. Combined with the clinical symptoms, the diagnosis of chylothorax can now be initially established."

There was no relief as expected, but everyone in the clinic still frowned.

Dean Gai asked a little embarrassed:

"Chen Qi, it's hard to say that your medical skills are real. But even if the diagnosis is made now, how to treat it? We really have no experience with such a small baby."

Director Yao also quickly echoed:

"The mortality rate of chylothorax is too high. Currently, there is no record of a child being rescued in the entire Central Vietnam region. This little patient is quite special. We can't explain it to the child's father."

"Yes, yes, this matter has been fixed..."

"It's mainly due to bad luck. It's not good to get this disease. If you get this disease..."

Several directors in the clinic were talking about it, and they obviously had no confidence in the treatment, and they were not willing to take over this patient.

Chen Qi's eyes were rolling.

He didn't expect that celiac disease, which is relatively common in later generations, would be so rare in the 1980s, making doctors daunted. Is there anything that can be done about it?

Being able to cure diseases that others dare not treat, not only dare to treat them, but also cure them, then you can show your true qualities as a hero.

Chen Qi made up his mind when he thought of this. Since your Second Hospital doesn't want such a difficult and complicated disease, you can't blame him for Chen Qi's decision.

"Otherwise, I still have some experience in the treatment of chylothorax, so I can transfer this patient to our fourth hospital?"

Director Yao, Director Lu and others were delighted when they heard this. They were about to agree when they heard Dean Gai cough a few times:

"Ahem, this, this, the patient should be placed in the second hospital. We can't cause trouble to our brother units. What does Comrade Chen Qi think? Let's share the separation together. We are all hospitals in the same county and we can make progress together.

”

Chen Qi cursed in his heart: Old fox, do you want to have sex for nothing?

At the same time, I felt a little regretful. After all, I was too young and too impatient, and people immediately noticed something fishy. Otherwise, why would the Fourth Hospital take the initiative to take over a critically ill patient that everyone avoids?

At this moment, Chen Qi wanted to turn around and leave, letting your second hospital suffer to see if he would be transferred to another hospital.

But when he thought about it, he was taking the patient as a hostage. How was that any different from those old gangsters in the hand surgery department? It was too unethical.

"Okay, Dean Gai said so, then you can treat this patient yourself. There are a few principles in the treatment plan. One is to do a good job of chest tube drainage, pump out pleural effusion every day, and then directly inject tetracycline or erythromycin into the chest cavity.

Mycin.

Another important point is to provide nutritional support to the infant without injecting too much fluid. If you infuse too much fluid, more fluid will leak out, which will be troublesome. Finally, if necessary, provide plasma transfusion to supplement protein and coagulation.

factors to improve internal circulation."

In future generations, newborns with chylothorax will need to be put on a ventilator, which is the key to treatment. The problem is that the second hospital does not have this equipment now, and he is too lazy to say it.

Dean Gai rubbed his hands excitedly after hearing this: "Then how likely is it to be cured after this treatment?"
To be continued...