Li Qifeng poked his head out to look at the report. After reading it, he also called out: "I'm a sage."

In addition to the increase in aminotransferase, myoglobin is also abnormally increased, and creatine kinase is even more outrageous!

"There must be a problem." Li Qifeng said firmly.

Zhou Yewu also began to analyze: "There are these enzymes in the human skeletal muscle, liver, myocardial muscle, brain and other cells. The increase in these enzymes represents the damage to their respective cells. When the cell damage causes the enzyme to leak out and flow into the blood. At this time, we can see that these enzymes have increased significantly by taking blood tests."

But one thing that Zhou Yewu didn’t understand is that the sources of these enzymes are so widespread, which part of the problem is?

This is hard to judge!

Zhou Yewu did not continue speaking, and showed a puzzled look.

Li Qifeng took over the topic and said, "At present, it is most likely to be skeletal muscle. Aren't the patient suffering from limb weakness and chest pain? It can be an enzymatic increase caused by damage and rupture of muscle cells in the patient's limbs and chest wall."

It seems that this is true!

Zhou Yewu looked at the report again.

The delivery guy's troponin is normal and the electrocardiogram is also normal. This should be enough to rule out the enzymatic increase caused by cardiomyocyte destruction.

"What about the liver? If the liver is damaged, there will be so many enzymatic changes, right?" Zhou Yewu asked.

Li Qifeng immediately smiled strangely: "Yes, liver cells also have many enzymes, but there is only one enzyme that is very few, that is creatine kinase! Cretine kinase generally only exists in our skeletal muscles and myocardial muscles, and the liver has almost no, so creatine kinase increases, either by skeletal muscle cells or by injury to myocardial cells."

"Who do you guess?" He pointed to the report list and asked Zhou Yewu.

Since cardiomyocytes are normal, they are naturally skeletal muscles...

Zhou Yewu said without hesitation: "Skeletal muscle."

Then Li Qifeng also cooperated and clapped his hands: "I'm so smart. At present, there is a high possibility of skeletal muscle, and the patient's myoglobin is also very high. Myoglobin myoglobin naturally refers to the protein in the muscle, either skeletal muscle, myoglobin, or myoglobin, rather than the liver... The damage to the liver will not cause myoglobin to rise."

Zhou Yewu rolled his eyes immediately.

He didn't know if Li Qifeng was deliberately mocking himself for not understanding the meaning of these indicators.

Damn, these three words "so smart" are simply slapping themselves in the face.

Just like three answers, you have eliminated 2, and then ask you what the correct answer is!

However, just when Zhou Yewu sighed that his basic skills were not solid enough, he suddenly thought of a question: "Since the skeletal muscle is damaged, then the kidney function will not be affected, right?"

Li Qifeng nodded: "Not good, hurry up and teach the patient some urine, do some urine routine, and then add more fluids."

At this time, his expression suddenly became nervous.

...

Zhou Yewu prepared these items for catheterization, and waited for the delivery guy to arrive at the outpatient clinic again.

He immediately took the delivery guy to the treatment room beside him to prepare for catheterization.

Li Qifeng was still there, with a solemn expression.

Zhou Yewu opened the catheter and after regular disinfection, he was about to start inserting the catheter. It seemed that the model he was carrying was a bit large. The moment the catheter entered, the delivery guy screamed in pain.

This is really chest pain and pain below. This sourness is simply amazing...

However, after the urethra catheter entered, the patient never had a drop of urine flowing out.

This made Zhou Yewu a little confused.

How could I not have a little urine if I inserted it so stimulatingly?

It should be scared to be scared.

Zhou Yewu packed up his catheter and threw it into the medical trash can. At the same time, he was a little confused and took the culture and went to the culture. Why insert the urethra?

But Li Qifeng is the attending physician of the emergency department after all, and he is always extremely experienced, so Zhou Yewu dare not doubt this.

Since I get stuck, there is naturally his reason!

Zhou Yewu found Li Qifeng and said anxiously: "The patient has no urine."

"It may be a problem with the patient's kidney function." Li Qifeng sighed.

Li Qifeng said: "The blood creatinine is still normal, so why does there be problems with kidney function? Do you know why?"

Zhou Yewu thought about it: "Cretinine is a very small molecular substance, which is produced by the body's muscle metabolism. It is usually excreted from the kidneys. The blood creatinine value in normal people is stable. Once the blood creatinine value exceeds the limit, it means that the kidney cannot excrete creatinine well, which means that there is a problem with the kidney function, so those with uremia have very high blood creatinine."

"But when renal function is mildly abnormal, creatinine can still be excreted. Only when renal function is significantly abnormal can creatinine be difficult to excrete. At this time, creatinine in the blood will increase. In other words, normal blood creatinine does not mean that renal function is normal... Only when renal function damages to a certain extent will blood creatinine increase."

Zhou Yewu explained very well, and Li Qifeng nodded slowly with satisfaction.

"Take it to the observation room and go to the electrocardiogram monitoring first." Li Qifeng said.

Zhou Yewu nodded.

He looked around and finally stopped at Li Qifeng's body: "How many beds should I send them? Will I send them?"

Li Qifeng sneered: "Of course he walked over by himself. If the bed is in, let the nurse pull it into the system and arrange it."

"Then can I continue to eat my pancakes?" Zhou Yewu looked at the delivery guy and couldn't help but think of his takeaway again.

At this time, Li Qifeng's only son suddenly started to gulp.

"You are hungry, too." Zhou Yewu laughed.

Li Qifeng smiled awkwardly...

After taking ibuprofen capsules, the chest pain relieved a lot and the condition was still stable.

People are iron and rice, after all, they have to work night shifts tonight! How can you not eat?

Li Qifeng looked at Zhou Yewu and suddenly asked, "Is there a takeaway for me?"

Zhou Yewu smiled and said, "I don't know this. They ordered it, but I can share some of my servings."

...

Li Qifeng explained to the delivery guy a few words and asked him to go to the observation room to lie down and observe.

"This should be rhabdular muscle lysis." Zhou Yewu looked at the delivery guy walking away and suddenly spoke.

If the skeletal muscle cells in the patient's body are damaged so much, it is called skeletal muscular lysis, also called rhabdomyolysis. The texture of skeletal muscle is all transverse, so it is also correct to call rhabdomyolysis.

Li Qifeng said softly, "Yeah".

A large number of myoglobins run into the blood, and then pour into the kidneys and renal tubules in batches, which will block the renal tubules at any time, leading to renal failure. In the next step, the patient should have no urine.

Thinking of this, Li Qifeng was originally planning to have takeout with Zhou Yewu, but now he didn't dare to go...
Chapter completed!