bookmarkrole Chapter 480
Chapter 480
Chapter 480
If you consider “adrenal tumors”,
The whole case of this patient, the reasoning is as follows:
·When an adrenal tumor is “excited”, the “adrenal gland” will secrete a large amount of hormones including dopamine, epinephrine, norepinephrine and so on. In turn, it triggers sympathetic nerve excitement -> the heart becomes excited, leading to an increase in blood pressure.
·Conversely, when the adrenal adenoma is not ‘excited’, the secretion of hormones is greatly reduced, which then affects the sympathetic nerves -> the heart’s ‘rest’, resulting in lower blood pressure.
this,
It just perfectly explained the patient’s blood pressure, like a roller coaster, up and down.
However, everything remains to be verified.
Need to check:
·Urine, to detect the level of related hormones and their metabolites
·CT, or B-ultrasound, to see if there are changes in the adrenal glands.
While the patient’s condition is still stable,
Push to do CT now!
The urine halfway was sent to the laboratory.
Lin Feng returned to the clinic and continued to diagnose other patients.
…
20 minutes later,
The CT results were fed back to Lin Feng.
really!
·130CT results show: there are signs of tumor!
Next, continue to wait for urine results.
After another hour, the urine test results came out.
·Urine methoxy adrenaline, 2 times! Other hormones have also been greatly improved!
confirmed!
It must be an adrenal tumor!
And based on Lin Feng’s experience, there is a high probability of pheochromocytoma.
Pheochromocytoma is the most obvious because of changes in dopamine, epinephrine, and normethyl.
“Doctor Lin, the patient’s blood pressure has risen again, 185!”
“Calm…”
Now that Lin Feng has determined what the cause is, he will not fall into a dazed panic, and everything becomes confident.
“Guanethidine to the patient…”
This is an inhibitor of sympathetic nerves, which can effectively inhibit the excitement of sympathetic nerves and control the heart…
soon,
The response from the emergency room showed that the patient’s blood pressure was quickly under control.
At this time, the patient’s parents rushed over and learned that their son had been rescued on the road. They went to see the patient (aicd) son who was still in a coma, and then ran to Lin Feng’s clinic and told Lin Feng. En Wanxie.
“Thank you Doctor Lin!”
“If it weren’t for Doctor Lin, my son would be gone! Thank you!”
The old father and mother said happily.
However, Lin Feng did not dare to tell them the fact that although cardiopulmonary resuscitation is timely, it is difficult to say whether the patient will suffer from cerebral hypoxia and cause various sequelae. The patient is so young, hoping to be able to bear it.
He only told this fact, the patient’s wife.
“Doctor Lin, then why does my son only have a headache and then his heartbeat disappears?”
The patient’s father asked in horror.
“It’s because of a tumor in your son’s adrenal gland…”
“Huh? A tumor?”
The two old men almost had a heart attack without being scared.
Lin Feng had no choice but to comfort him again.
In fact, adrenal tumors are generally benign, and they will be fine if they are removed.
Next,
The male patient needs to be hospitalized and then undergo surgery.
“Laparoscopic Tumor Resection”!
Only when the tumor is removed can this ‘roller coaster’ blood pressure be completely cured.
One hour later, the patient woke up and was able to get up and walk. When he knew he was almost dead, he was shocked.
I rushed to Lin Feng’s clinic, thanked Lin Feng for his life-saving grace, and apologized to Lin Feng for his ignorance.
…
Conclusion: If the effect of antihypertensive drugs is not effective, it may be due to the use of the wrong drug, or high blood pressure caused by other reasons, try to find out clearly.
…
…
at this time,
The sixth floor, hand surgery,
A quarrel between family members and doctors is going on fiercely.
“Doctor, my son’s fingers, when they were sent, they brought the fingers, and the fingers are no problem. Tell me now that they can’t be sutured. How do you deal with this? I won’t leave today if I don’t lose money!”
“Don’t get excited. Now that we don’t connect our fingers, we are also uncomfortable, but you have to understand that our doctor is not a god, and it is not that the patient comes to our hospital and we can heal…”
The cause of the matter is because,
When the 25-year-old patient was working in the workshop, his finger was broken (disconnected state).
Then he was sent to the Hand Surgery Department of Harmony Hospital.
This kind of surgery is best completed within three hours, otherwise it will be difficult, because blood vessels and the like will shrink and tissues will become necrotic. The longer it is, the more difficult it will be.
Moreover, what is even more terrible is that the patient is strangulated, not severed.
There is a huge difference between the two.
If it is cut, the section will be very neat and easy to sew.
If it is strangulated, the section will be blurred and the blood vessels and nerves will be thin, making it more difficult to suture.
In addition, there is an even bigger trouble:
Because this patient was strangulated, the tendon of his finger was pulled out, and the length of the pulled out was as long as 20cm!
so,
The difficulty of this operation is very high.
Then, the chief physician of the hand surgery performed the surgery in person.
If the finger is broken, the operation focuses on the blood vessels, muscles, and nerves. The rest of the bones, flesh, and skin are easy to deal with.
result,
I searched for the operation for 2 hours, but failed to find a suitable finger artery.
Artificial blood vessels can be used for heart surgery.
However, there is no artificial blood vessel in the finger artery. On the one hand, the finger artery is too thin, and on the other hand, it is not as valuable as the heart. Therefore, there is no artificial blood vessel for the finger artery on the market.
Finally, the operation had to be declared over.
However, this result makes the family’s parents very dissatisfied.
The severed finger of the son is the index finger, which is very important, and the son is only 23 years old and young. If he will lose this finger in the future, he is afraid that it will be difficult to find a wife.
Therefore, the parents quarreled with the doctor.
“I don’t care, it’s your fault anyway, I also believe that your harmonious hand surgery sent him…now my son can’t suture his hands, you must be responsible!”
“Yes, it would be better to call Dr. Lin Feng over if you knew it…”
When talking, it seems that the two parents have more trust in Lin Feng, perhaps fragile trust.
When the doctor outside his hand heard it, there was a big fire.
Although Lin Feng is very good, he is not as capable as the department of hand surgery.
“You can go to Lin Feng, and I can call you now.”
“Hit it!”
…
. .