"Boss Zheng, I was thinking about asking you to take a look a few days ago." Zhang Weiyu said, "But Director Wei said that we should finish the inspection first, so as not to waste your time."
"Yeah." Zheng Ren nodded, Director Wei was right.
"The patient is a boy from my main store in Piyang, which is quite far away from Fengxian County."
"Huh? The main store? This is not the main store?" Su Yun was surprised.
Generally, the normal business model is to set up head offices in super first-tier cities such as Imperial Capital and Magic City, and have branches spread all over the country.
But the main store of this Piyang store is actually in Feng County.
Since ancient times, Xuzhou has been one of the nine states in the world. Feng County is also an ancient city with quite a few historical legends.
"Old man, the century-old plaque in my house is more important than my life. I said it twice, and I almost said it," Zhang Weiyu said. Being kicked out of the house.”
This is also conceivable, Zheng Ren nodded. That's what tradition is.
"A distant relative at home suffered a cerebral hemorrhage last fall. He recovered well after the operation, but his child no longer wanted to go to school, so he went to work in a store." Zhang Weiyu said, "I took medicine to control my blood pressure after the operation. It was fine at first, but after a few After a few months, my blood pressure got higher and higher.”
The patient is an 18-year-old boy. He suddenly developed headaches and disturbance of consciousness half a year ago. He went to a local hospital for treatment. A head CT scan revealed intracerebral hemorrhage in the left basal ganglia-lateral ventricular body.
The blood pressure measured at admission was 220/110 mmHg. Considering intracranial hypertension, intracranial hematoma resection was performed immediately.
After surgery, enalapril maleate 10 mg was taken orally once a day.
At the beginning, I took oral antihypertensive drugs and performed antihypertensive treatment. My blood pressure was controlled at 110-120/70-80 mmHg, and the situation was pretty good. But as time goes by, the blood pressure gets higher and higher.
But after all, he is a young man, and he still doesn't pay enough attention to his body. Being able to take medicine on time every day is considered good. As for taking his blood pressure every day, he only insisted on it for about a month and then stopped taking it.
He felt uncomfortable again a few days ago, and his blood pressure was measured, which was 180/120 mmHg. As for the intermediate process, the patient himself cannot describe it clearly.
Now he was frightened. He hurriedly looked around and found Zhang Weiyu in the imperial capital.
That's how the whole thing started.
The medical history was not complicated. There was a family history of hypertension in the patient's family, but the others were taking antihypertensive drugs orally and their blood pressure was well controlled.
There is no such thing as his stubborn, uncontrollable blood pressure.
Because of his family history, Zheng Ren ruled out many hereditary diseases.
"Director Wei took me to see Director Zhang. At that time, Director Zhang suspected that it was an adrenal gland problem, so he did relevant examinations," Zhang Weiyu said.
Director Zhang Lin said: "The patient later changed the dressing and increased the dosage. He took amlodipine besylate orally, 5 mg twice a day, and terazosin hydrochloride, 4 mg orally every night. His blood pressure was controlled for a few days and then went back."
"I thought it might be something to do with the adrenal glands, but they did an MRI of the adrenal glands and a renal angiogram, and they were fine."
This examination was very detailed and almost ruled out the possibility of nephrogenic hypertension.
Hypertension is mainly divided into two types: primary and secondary, each of which has many branches. Director Zhang Lin's consideration was very thorough and her tendency was relatively clear. She considered it to be secondary hypertension.
The most common secondary hypertension is nephrogenic hypertension, endocrine hypertension and other rare triggering factors.
"How tall and heavy is the patient?" Zheng Ren asked.
"One meter eight, more than 230 kilograms." Zhang Weiyu said.
His body was a little on the fat side. Zheng Ren thought about it and asked, "Is snoring bad?"
"It's so awesome that I don't even dare to sleep with him. His snoring makes the bed shake." Zhang Weiyu said with a smile, "When I was in the hospital, I had a single room, and everyone in the ward was driven away by his snoring."
"Do you suspect obstructive sleep apnea hypopnea syndrome?" Su Yun asked.
"Stubborn hypertension can be considered a problem." Zheng Rendao.
"Well, I also suspect it is obstructive sleep apnea hypopnea syndrome." Director Zhang Lin said, "The patient has been given an enhanced MRI of the kidneys, but the hospital there is very unfamiliar with the OSAHS examination and cannot do it. "
This is normal, although obstructive sleep apnea-hypopnea syndrome is relatively common. In life, you will encounter many people snoring all night long, with yin and yang fluctuating, just like singing an opera.
However, induced hypertension can basically be controlled as long as you take appropriate medication. Those that are difficult to control are still relatively rare.
"Boss Zhang, tell me about his snoring." Zheng Ren is more interested in the patient's snoring.
"Forget about Boss Zheng." Zhang Weiyu sighed and said, "I went home during the Chinese New Year and only stayed for two days before running back because he snored."
"It's the Chinese New Year. The store is always open when business is good, and the neighbors come over to treat me when they are too lazy to cook. When I went back, I thought about drinking and chatting with my family. But I could hear him snoring through the wall. Voice."
Zheng Ren listened quietly.
"He was snoring, and I felt like the wall was shaking." Zhang Weiyu complained, "That's not all, he was snoring, and he felt like he was out of breath. Once I heard him snoring, and there was no sound at all. , it stopped for a full 50 seconds... it must have been about a minute."
Listening to Zhang Weiyu's words, Zheng Ren had basically clarified the patient's condition.
"I was afraid that if he had another brain hemorrhage and others were dead in bed, they wouldn't know, so I got up to go and have a look. When I walked to the door, the snoring started again, so I went back to sleep."
"You said, snoring is nothing, but who can bear to scare people like this in the middle of the night? I stayed at home for two days during the Chinese New Year and then ran back."
When people sleeping in the same room or bed find that the patient has apnea, they often worry that breathing cannot be restored and the patient will be awakened. The apnea usually ends with gasping, suffocation, or loud snoring.
This condition is called apnea and is a manifestation of sleep apnea-hypopnea syndrome.
Most people who snore can start breathing on their own due to lack of oxygen, but the person in front of me was holding his breath for a little too long.
Since there was no way to conduct a physical examination, Zheng Ren could only guess. It was hard to say whether it was correct or not.
"Boss Zhang, is the old store in Dianfeng County still busy?" Su Yun suddenly asked.
"It's a small county town. It closes early and there's very little nightlife." Zhang Weiyu didn't know why the topic changed here, but he still had something to say.
The young man next to Boss Zheng cannot be neglected. I even neglected Boss Zheng. He has a lot of adults and won't be angry. But this young man will be difficult to take care of, and he might cause some trouble by then.