"It's okay, old man." Zheng Ren unplugged the old man's intravenous channel and lifted him up from the ground.
"Sit down and take a rest. Your illness has been diagnosed." Zheng Ren said with a smile.
"What disease is diagnosed?" The old man was a little cautious and a little confused.
From the looks of it, he was really afraid of diagnosing himself as having a mental illness. So much so that the way he looked at Zheng Ren was wrong and vaguely hostile.
"Swallowing or swallowing syncope is a rare type of nerve-mediated syncope, which is associated with life-threatening bradycardia and hypotension. It is usually difficult to diagnose in time." Zheng Rendao: "The tilt test has proved that it is a problem with the vagus nerve. .”
"..." The old man didn't understand a word.
"Don't tell me what the disease is, let's talk about how to treat it first," Zheng Ren said.
"Old Luan, are you injured?" Su Yun came to Luan Yingjie, helped him up, and said in a complaining tone: "I'm diagnosing your old man, what are you causing trouble there?"
"Uh..." Luan Yingjie clutched his injury in pain, unable to laugh or cry.
"You almost killed your father. It's not like you didn't see what happened just now. You just made trouble for nothing." Su Yun continued to stab him.
"Um... I'm sorry." Luan Yingjie didn't know why he was kicked, but he wanted to say sorry.
But my old man was sitting there, but his behavior just now seemed a bit strange.
It doesn't matter if you lower your head and admit that you are scared!
"This disease requires a pacemaker." Zheng Ren said: "Dual-chamber pacemaker, you can eat whatever you want after."
"There's nothing wrong with my heart." The old man wondered, "The electrocardiogram is over there. What kind of pacemaker should I insert?"
"There is nothing wrong with your heart, but when you eat, the esophagus expands and the vagus nerve is involved, which can cause cardiac arrest for a few seconds." Zheng Ren said with a smile.
The old man still didn't believe it, but because Zheng Ren didn't say it was mental illness, his attitude improved a lot.
Some elderly people of this age believe in everything, while others believe in nothing. It is obvious that Luan Yingjie's father belongs to the latter group.
After all, it is an operation. No matter how small the operation of inserting a pacemaker is, it is still an operation.
Zheng Ren smiled, obviously he had considered this.
"Old man, how about we do this." Zheng Ren said very gently: "If you don't agree with the pacemaker, that's fine. Let Boss Luan take you to the hospital tomorrow and take a 24-hour dynamic ECG."
"Um?"
"It will take one day to find out the problem." Zheng Ren said, "How about we find a few experts and then make a decision?"
These words made the old man feel extremely comfortable.
The diagnosis was given with certainty, but he did not force himself to make a decision. Instead, he asked for another examination and carefully asked other people to take a closer look. This little doctor is very good at being a good person.
"Yeah, I think this is better." The old man immediately agreed with Zheng Ren's opinion.
"Then if nothing happens, we'll leave." Zheng Ren said, "Boss Luan, if you decide to have surgery, come to me. It's different from ordinary surgeries. During the surgery, you need to test the impact of esophageal expansion on the heart."
"Okay, okay." Luan Yingjie quickly stood up when he saw Zheng Ren and Su Yun getting up.
His legs softened and he fell to the ground.
"Look at you, you can't be careful. How old are you? What if you fall and break a bone?" Su Yun didn't help him, but sprayed him.
Luan Yingjie smiled bitterly, wasn't he kicked by you
"You're welcome, let's go." Seeing the nanny helping Luan Yingjie up, Zheng Ren turned around and left.
"Boss Zheng, what happened just now?" Zhou Litao asked.
"Mr. Zhou, take your ambulance back to the hospital and help us along the way." Su Yun said with a smile.
"It's okay, it's okay, what happened just now?" Zhou Litao has been struggling with the disease of patients who become comatose after eating.
"The inhibitory response of the heart to esophageal dilatation is the underlying pathophysiological mechanism of syncope in patients. This case was reported in the BMC Cardiovasc Disord." Zheng Rendao: "The author also reviewed 101 cases of swallowing or swallowing syncope reported since 1793. The report has been sorted out and summarized.”
1793... 101 cases, Zhou Litao was speechless.
"This kind of syncope is more common in men and the elderly. The average age of case reports is 57.5 years old. 54.5% of patients will cause syncope regardless of what they eat, whether it is water or solid food." Zheng Rendao: "Generally, it is the esophagus Disease-induced.”
"So that's it." Zhou Litao silently wrote down the patient's condition. He felt the heat radiating from the piece of paper on his chest that recorded Boss Zheng's recent treatment, which made him a little excited.
"Pacemaker implantation is the most commonly used treatment method. 98.1% of patients have pacemakers implanted and report relief of syncope symptoms, and more than half of patients have permanent pacemakers implanted." Zheng Rendao: "So there is a high probability It proves that pacemakers are still useful."
"Get the pacemaker..." Zhou Litao pondered the function of the pacemaker.
"The second is treatment for gastrointestinal diseases. For example, 4 patients had hiatal hernia repaired. There were also patients who underwent successful vagus nerve ablation, long-term use of proton pump inhibitors and radical surgical resection of esophageal cancer."
"It scared me just now." Zhou Litao felt the same at this time, touching his chest, still feeling scared.
"Don't be afraid." Zheng Ren smiled and said, "Look, you have atropine in your first aid kit. With this medicine, there won't be any big problem."
"Um?"
"Atropine was commonly used before pacemakers were introduced, and limited data shows that the efficacy can reach 90%." Zheng Rendao, "If it weren't for the purpose of observing the patient for five minutes and seeing how low the patient's blood pressure can drop, we would directly push it." Atropine takes effect in 15 seconds."
"But the blood pressure is too low." Zhou Litao said.
"Well, my psychological bottom line is 35 millimeters of mercury. If it is lower than this value, atropine injection must be given." Zheng Rendao, "The patient's condition is quite cooperative, which is pretty good."
"Boss, you can really keep your composure. My psychological bottom line is 40 millimeters of mercury. Seeing that you didn't say anything, I endured it." Su Yundao said, "But I was anxious, so I kicked Lao Luan and I felt much better."
"Don't be so violent." Zheng Ren said leisurely, "Aren't you afraid of something happening?"
"I also saw atropine. With atropine here, how could anything happen? Besides, I am a doctor with a big heart. I can save him with defibrillation, compressions, and a hundred ways, so what are you afraid of!" Su Yundao said.
Zhou Litao felt a little ashamed.
I was really a little panicked at the time.
Although I know that if the tilt test is positive, it may be dangerous, but after all, I have never encountered it, and the diagnosis is much worse than Boss Zheng and Brother Yun.
The basic level is still not good enough. I should read more when I get home, Zhou Litao thought to himself.