The two live broadcast surgeries ended quickly.
Mu Tao regretted that his return was too short and he received far fewer patients than the Imperial Capital. I originally thought that 6 patients would be a lot, but I know my taste after eating the marrow. Now I really want to have 60 patients to practice my skills and mature as soon as possible.
It's a pity that we have to wait a long time.
Zheng Ren took off his lead clothes, changed his clothes, glanced at the time and said, "Old Mu, go down and check on the patient, and I'll be leaving. Just send the information on the surgery patient to my email."
"I'm in such a hurry. I originally planned to treat you to a very authentic Cantonese meal." Mu Tao said.
He knew that Boss Zheng didn't like eating very much, and that was the case in Pengxi Township. Su Yun was picky and told Director Jiang what he wanted to eat. But Zheng Ren seemed to have only eaten one meal, and Su Yun said he looked like a dog licking the plate.
Because of this, this boss Zheng feels difficult to deal with. Teaching tips for surgery was such a big deal, but I didn't even have the chance to express my gratitude.
Moreover, Mr. Zou from the Zou family in Xiangjiang was still waiting for him, but he didn't even show his face.
Mu Tao looked at Zheng Ren's somewhat honest face and was slightly stunned.
"It's okay, just buy a few hamburgers on the way." Zheng Ren said casually: "I'll go down and see the patient, and I'll leave. On your side, if you do another second-stage surgery, I guess I won't have to come again."
"No!" Mu Tao quickly stopped Zheng Ren's words, "Just now, I was still vague about some questions. After a while, I will make a few of them myself and save a dozen patients. Please come again."
"Think more about the key points of the second-stage surgery." Zheng Ren warned, "Don't be rough, you have to be skillful. The main skills have been mentioned, and the rest is surgical practice."
"Okay." Mu Tao responded.
After changing their clothes, Zheng Ren, Mu Tao and the professor returned to the ward and prepared to check on the patient.
As soon as I entered the ward gate, I saw a nurse pushing an emergency vehicle and running away.
Zheng Ren's heart suddenly tightened. Is this a rescue? !
The interventional department generally does not accept emergencies. If rescued, it would also be a patient who vomited blood due to portal hypertension after being hospitalized.
He forgot about going to the airport to return to the imperial capital after seeing the patient, and followed the nurse quickly to the ward as a habit.
Mr. Wu was directing the rescue in the ward, a doctor was doing a physical examination, and the nurse was busy monitoring the ECG. Zheng Ren had no angle and could not see the system panel for the time being.
This patient was not one of the post-operative patients of Tips surgery. Mu Tao then came in, was stunned for a moment, and exchanged a few words with Mr. Wu.
Zheng Ren heard about the patient's condition on the side, 2 days after the interventional operation for liver cancer. On the first day, I developed tremors in my right upper limb. I did relevant examinations and found no problem. Today my condition worsened and I developed acute dystonia.
Zheng Ren found an angle and saw the patient's system panel.
Red with a bunch of diagnoses written on it. Zheng Ren looked over one by one, deleted the unimportant ones, and saw a rare diagnosis of extrapyramidal reaction.
This is…
The extrapyramidal system is a component of the human movement system, and its main function is to regulate muscle tension, coordinated muscle movement and balance.
This regulatory function depends on the dynamic balance of the neurotransmitters dopamine and acetylcholine in its regulatory center. When dopamine is reduced or acetylcholine is relatively increased, symptoms of cholinergic hyperactivity may occur.
There are many symptoms of extrapyramidal reactions. Zheng Ren did not consider this for the time being, but quickly searched in his mind for related diseases and drugs that could cause extrapyramidal reactions.
Typically, neurological drugs can cause this reaction, but it is uncommon.
"Old Mu, does the patient take anti-anxiety drugs or drugs like hibernating spirit before surgery?" Zheng Ren asked.
"No." Mu Tao frowned and looked at the consulting physician who was doing a physical examination. "The patient took entecavir and antihypertensive drugs before the operation. There was nothing special. After the operation, he was given a set of magnesium isoglycyrrhizinate injection to protect the liver, and nothing else. .”
"I'll go check the doctor's orders," Zheng Ren said.
Mu Tao did not dare to leave and asked a doctor to take Zheng Ren to see the doctor, while he stayed in the ward to participate in emergency first aid.
When he came to the office and clicked on the workstation, Zheng Ren began to look for drugs that might cause extrapyramidal reactions.
The doctor's order was very clean. Magnesium isoglycyrrhizinate injection is also a commonly used liver-protecting drug in clinical practice. It is cheap and easy to use. Zheng Ren also uses this drug frequently.
As for other medications…
After the operation, sugar saline + vc was used, which was used to replenish fluids, urinate, and metabolize the contrast agent as quickly as possible.
Metoclopramide
Zheng Ren finally felt relieved when he saw that the patient had received metoclopramide on the first day after surgery. I also looked at the course record, which clearly recorded that the patient received an intramuscular injection of metoclopramide due to post-operative nausea.
Metoclopramide, a drug called metoclopramide, costs a few cents a piece. It also has good effects on flatulence-induced indigestion, loss of appetite, belching, nausea, and vomiting.
After interventional surgery for liver cancer, most patients will have similar symptoms, so metoclopramide is particularly commonly used.
However, Zheng Ren searched for several related reports, all of which were cases of extrapyramidal reactions caused by metoclopramide.
The pharmacodynamic process is due to blocking dopamine receptors and causing relatively hyperactive cholinergic receptors, leading to extrapyramidal reactions. This complication is not common, so I was a bit scratching my head and didn't dare to diagnose it right away.
Zheng Ren closed the workstation, stood up and walked out.
"Boss Zheng, have you finished reading? There are other information about the patient here." asked the young doctor who accompanied Zheng Ren.
"Yes." Zheng Ren said, "The reason has been found."
"..." The little doctor was startled for a moment, so fast? You don’t even need to look at other laboratory tests
Seeing that Boss Zheng is not very old, he seems to be younger than himself. Could this be nonsense
But he didn't say anything, he just followed Zheng Ren's footsteps and started to introduce the condition.
"The patient had no problems before the operation. Yesterday, he had a head CT scan and no cavity obstruction was found."
"It's not a cavity, it's an extrapyramidal reaction."
"What?" The little doctor looked confused.
Interventional departments rarely encounter this rare nervous system reaction, and it is normal if we don’t know. There is a vast amount of knowledge in the entire medical system. Otherwise, the divisions are becoming more and more detailed, because it is difficult for normal people to fully grasp it, and they can only go in the direction of detailed classification.
Zheng Ren didn't explain too much to him. If he found the cause, he would treat it normally and just tell Mu Tao.
I quickly came to the ward, and the neurology doctor was also asking about the medication.
"Old Mu, if you stop metoclopramide, your condition will be relieved," Zheng Ren said.
"Think it's an extrapyramidal reaction caused by metoclopramide?" The neurology doctor seemed to have the same conclusion and asked immediately.
"Yeah." Zheng Ren nodded.
"I'm going to take a look at the doctor's orders." The neurologist rushed to the office. Zheng Ren saw her hurry and smiled.
"Boss Zheng, do you think it was caused by metoclopramide?" Mu Tao was still a little unsure.