Two live surgeries, soon over.

Mu Tao regretted that the time for his return was still too short, and he received many fewer patients than the imperial capital. Originally, I thought that 6 patients was a lot, but now I really want to have 60 patients to practice and mature as soon as possible.

It's a pity, so I have to come to Japan for a long time.

Zheng Ren took off his lead clothes, changed his clothes, glanced at the time and said, "Lao Mu, go down and see the patient, and I'll leave." For the information of the surgical patient, you can get it and send it to my mailbox. ”

"I'm in such a hurry, I was going 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 picked and chose and told Director Jiang what he wanted to eat. But Zheng Ren seemed to have only eaten one meal, and was said by Su Yun to be like a dog licking a plate.

Because of this, this Boss Zheng gives people a feeling that it is difficult to deal with. Teaching TIPS is such a big thing, and I don't even have a chance to express my gratitude.

And Mr. Zou of the Xiangjiang Zou family 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 burgers on the way. Zheng Ren said casually: "Go down and see the patient, and I'll leave." On your side, if you come for another second-stage surgery, I don't think you need to come again. ”

"Don't!" Mu Tao hurriedly stopped Zheng Ren's words, "Just once, I was still vague about some questions. After a while, I will make a few of them myself, and save a dozen more patients, please come once. ”

"The main point of the second stage of surgery, think about it more. Zheng Ren advised, "Don't be rude, be skillful." The main techniques have been mentioned, and the rest is surgical practice. ”

"Good. Mu Tao responded.

After changing their clothes, Zheng Ren, Mu Tao, and the professor returned to the ward, ready to check on the patient.

As soon as I entered the gate of the ward, I saw a nurse pushing an ambulance and running.

Zheng Ren's heart suddenly tightened, is this a rescue?!

The interventional department is generally not admitted to the emergency department. If it is rescued, it is also a patient who vomits blood due to portal hypertension after hospitalization.

He forgot about the fact that the patient had to go to the airport to return to the imperial capital after reading it, and habitually followed the nurse to the ward quickly.

Wu Lao was directing the rescue in the ward, a doctor was examining the body, and the nurse was busy pressing the ECG monitoring. Zheng Ren has no angle and does not see the system panel for the time being.

This patient was not one of the postoperative patients of the TIPS operation, Mu Tao then came in, paused for a moment, and exchanged a few words with Wu Lao.

Zheng Ren heard the patient's situation on the side, 2 days after the liver cancer intervention. On the first day, he had tremors in his right upper limb, and he did a relevant examination and found no problems. Today the condition worsens, acute dystonia develops.

Zheng Ren found an angle and saw the patient's system panel.

Red, with a bunch of diagnoses written on it. Zheng Ren looked at them one by one, deleted the unimportant, and saw a rare diagnosis - extrapyramidal reaction.

This is......

The extrapyramidal system is an integral part of the human locomotor system, and its main function is to regulate muscle tone, coordinated movement and balance of muscles.

This regulatory function depends on the homeostasis of the neurotransmitters dopamine and acetylcholine, which can be symptomatic when dopamine is decreased or acetylcholine is relatively increased.

There are many symptoms of extrapyramidal reactions, and Zheng Ren did not consider this for the time being, but quickly searched for related diseases and drugs that can cause extrapyramidal reactions in his mind.

Neurologic drugs can cause this reaction, but it's also uncommon.

"Lao Mu, does the patient take anti-anxiety medication or use drugs like hibernation before surgery?" Zheng Ren asked.

"Nope. Mu Tao frowned and looked at the consulting physician examining the body, "Before the operation, the patient took entecavir and antihypertensive drugs orally, there is nothing special." After the operation, a group of magnesium glycyrrhizinate injections was given to protect the liver, and there was nothing else. ”

"I'll go to see the doctor's order. Zheng Rendao.

Mu Tao did not dare to leave, and asked a doctor to take Zheng Ren to see the doctor's order, while he stayed in the ward to participate in the emergency first aid.

Arriving at the office and clicking on the workstation, Zheng Ren began to look for drugs that could cause extrapyramidal reactions.

The doctor's order is very clean, and magnesium isoglycyrrhizinate injection is also a commonly used liver protection drug in clinical practice, which is cheap and easy to use, and Zheng Ren often uses this drug.

As for other medications......

Postoperatively, sugar saline + VC was used, which was used to rehydrate, urinate, and metabolize the contrast agent as soon as possible.

Metroclopramete?

Zheng Ren saw that on the first day after surgery, the patient used metoclopramide and was finally relieved. I also looked at the course of the disease, which clearly recorded that the patient was injected with metoclopramide intramuscularly because of postoperative nausea.

Metoclopramide, the drug is called metoclopramide, a few cents a piece, and it also has a good effect on gastric distention indigestion, loss of appetite, belching, nausea, and vomiting.

After liver cancer intervention, 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 metoclopramide triggering extrapyramidal reactions.

The drug process is caused by blocking dopamine receptors, making cholinergic receptors relatively hyperactive, which in turn leads to extrapyramidal reactions. This complication is not common, so I scratched my head and did not dare to diagnose it immediately.

Zheng Ren closed the workstation, stood up and walked out.

"Boss Zheng, have you finished reading it? There are other information about the patient here. The little doctor who came with Zheng Ren asked.

"Hmm. Zheng Ren said, "The reason has been found." ”

"......" The little doctor was stunned for a moment, so fast, and he didn't even need to look at other laboratory tests?

Seeing that this Boss Zheng is not very old, it seems that he is younger than himself, will it be.

However, he didn't say anything, just followed Zheng Ren's footsteps and began to introduce his condition.

"The patient had no problems before the operation, and yesterday I checked a head CT and found no cavity infarction. ”

"It's not a luminal peduncle, it's an extrapyramidal reaction. ”

"What?" the little doctor looked confused.

It is rare for interventional departments to encounter this rare neurological reaction, and it is normal not to know. The knowledge of the entire medical system is vast, otherwise the subdivisions are becoming more and more detailed, because it is difficult for normal people to fully grasp them, and they can only go in the direction of detailed classification.

Zheng Ren didn't explain too much to him, and when he found the reason, he treated it normally, and he just talked to Mu Tao.

Walking quickly to the ward, the doctor in the neurology department was also asking about the medication.

"Lao Mu, stop gastric revulite, and the condition can be relieved. Zheng Rendao.

"Think it's an extrapyramidal reaction caused by metoclopramide?" the neurology doctor seemed to judge the same way, and immediately asked.

"Hmm. Zheng Ren nodded.

"I went to look at the doctor's order. The neurologist ran to the office, and Zheng Ren smiled slightly when he saw her hurried appearance.

"Boss Zheng, do you judge that it is caused by metoclopramide?" Mu Tao was still a little unsure.

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