Author: Zong Jianping, Ningbo First Hospital
Lies are remarks that distort the facts for the purpose of deceiving others under the premise of being known.
But there is a "lie" in clinical medicine, which is true. If the clinician overly believes in the "facts", it may pay a great price for this.
The case to be shared with you in this issue is a medical accident caused by the "lies" of "infertility". As Zhejiang Satellite TV reported the matter, he also blamed the doctors’ negligence, which caused great attention from the public.
Patients are a married young woman. In the past year, more than a year’s weight gain is very clear, and my menstruation is abnormal. I have repeatedly checked in various experts in many hospitals.One day, the patient came to the emergency department of the Department of Internal Medicine of our hospital and asked to be hospitalized. The director who took the consultation checked the diagnosis of the disease in the past and believed that it was not the disease of the emergency department. It is recommended to go to the obstetric clinic again.EssenceThe patient listened to the doctor’s suggestion and returned to the obstetric examination. After the reproductive endocrine hormone and uterine attachment B -ultrasound, it was clearly told that the patient was not pregnant now, and it was impossible to get pregnant.
Unexpectedly, the patient came to the emergency department again and begged the physician to be hospitalized for her diagnosis and treatment.The doctor told the patient that the situation was relatively complicated. Even if the hospital was hospitalized, it was not necessary to check it clearly. Moreover, this situation is not the scope of emergency diagnosis and treatment. It is recommended to go to Shanghai, but she is unwilling to insist that we will help her hospitalize for hospitalizationCheck, considering that the patient was so urgent, other subjects were unwilling to accept such cases, so she arranged for her to live in the emergency ward.
Because the bed bed was very tight, she was not an emergency, so she had an empty bed in ten days later. She notified her to be hospitalized, and she was also very happy.
After admission, according to the actual situation of the patient, a full body examination was conducted, and the focus was on endocrine. I asked the Department of Endocrinology to consult and prescribed her thyroid, adrenal glands, and pituitary glandular examinations.The weight gain is obvious, and there is no possibility of insulin tumors, and no problems are found.
Considering that the patient had infertility, and the uterine attachment B -ultrasound was opened, but no one expected that this time the B -ultrasound actually found that the patient was pregnant early.After, the whole abdomen CT was just done in the first two days. The patient’s early pregnancy was generally prohibited. The CT’s rays had a great impact on the fetus of the early pregnancy.The patient’s attitude also changed a major change in 180 degrees. Complaints everywhere, coupled with reports from Zhejiang Satellite TV, have detonated the widespread attention from public opinion and media.
Because of the second marriage, the patient wanted to have a child very much after getting married.
Indeed, is it easy for others?Isn’t it worth reflecting as a doctor?Intersection
Doctors also felt wronged. Many hospitals checked that patients could not be pregnant. More than half a month ago, the results of obstetric endocrine and B -ultrasound examination results. Patients were not pregnant and could not get pregnant.Patients’ problems were not in our emergency department, because the patient repeatedly asked for demands. We were the hospital that we agreed to live in the spirit of humanitarianism.
Is it useful to call injustice?The clinician in charge of such medical accidents must be responsible.Who told you not to think deeply, who told you to trust the diagnosis of others too much.
The reason is that first of all, the test results of the obstetrics clinic of many hospitals have interfered with the thinking; secondly, more than ten days before the hospitalization, they still have the same conclusion. Without pregnancy, it is impossible to get pregnant. Further "covered our eyes."" ".
In fact, regarding women in fertility, do B -ultrasound or CT first, we have specifically stipulated: For women during the birth period, no matter what the abdomen CT is, we must do the uterus and annexes of B -ultrasound and pregnancy test.If there is no problem, do CT.Especially when you encounter acute abdomen, do this.
The chief director of this patient has done this in the past, but this time, because of considering the patient infertility, he did CT first. This is also his only time to choose a CT for women.B -ultrasound case.This is the first time that I have made a mistake that should not be made.It is natural to lose money, but being condemned by the media is helpless.
I provide this case for everyone, mainly to remind our physician: Can you believe in the diagnosis of other physicians?The diagnosis of other doctors, like "matchmaker", cannot believe it.Ten days ago, the patient was not pregnant, and wouldn’t he be pregnant after ten days?Wait, it is worth thinking.
In addition, there is a problem of understanding of the results of laboratory inspections.Laboratory inspections reveal that it is impossible to get pregnant, and will they not be pregnant?To understand, the laboratory inspection is a enhanced version of the "matchmaker", let alone fully believe it. The reason is sufficient: the experimental test is normal, which is a statistical concept, that is, most people are in this so -called normal value in this so -called normal valueThe scope, the normal value is artificial, the normal value is not "normal", and it cannot ensure that everyone is like this; a little bit of explanation, the laboratory inspection results are normal or abnormal, which only represents one possibility.It must be normal; in addition, laboratory inspections sometimes have technical factors, and deviations or errors occur.
Perhaps you will say that being a doctor is sometimes too busy, he doesn’t think so carefully, or someone says that we should not accept such patients. It is useless to complain about the wrongdoing. If we make mistakes, we have to take responsibility!
Now it is promoted to recognize the test results between hospitals. This is good. First, it can save medical funds; second, for the laxative of patients, there is no need to do repeated examinations.But have you ever wondered, can the examination of different hospitals be homogeneous, do you have similar "lies" or questions? Besides, can you fully agree with the results of previous inspections?
In my opinion, the results and information of different hospitals and information are conditional. They must not believe it or believe it.Only specific analysis of specific situations and avoiding similar medical accidents that should not happen is the goal we are pursuing.
This article was first published in Zonghua11, and the doctor was published by the right!