The two live broadcasts of the surgery ended very quickly.
Mu Tao was very regretful that his time back was still too short. The number of patients he received was much fewer than in the Imperial Capital. He originally thought that six patients was already a lot, but now he really wanted to have 60 patients to practice and mature as soon as possible.
Unfortunately, there was still a long way to go.
Zheng Ren took off his lead apron and changed his clothes. He looked at the time and said, "Old Mu, go down and take a look at the patient. I'll be leaving. Just send me the patient's information when you're done. "
"I was really in a hurry. I was going to treat you to a very authentic Cantonese meal," Mu Tao said.
He knew that Boss Zheng did not like to eat very much. It was like this in Pengxi Village. Su Yun was picky and told Chief Jiang what he wanted to eat. However, Zheng Ren seemed to have only eaten one meal and was even said by Su Yun to be like a dog licking the plate.
Because of this, Boss Zheng gave people a feeling that it was very difficult to deal with. Teaching him the TIPS surgery was such a big thing, but he did not even have the chance to express his gratitude.
Moreover, Mr. Zou from the Zou family in Xiangjiang was still waiting for him, but he did not even show his face.
Mu Tao looked at Zheng Ren's honest face and was slightly stunned.
"It's okay. I'll just buy a few hamburgers on the way," Zheng Ren said casually. "I'll go down and take a look at the patient. If you come here for another second-stage surgery, I don't think I need to come again. "
"Don't!" Mu Tao quickly stopped Zheng Ren. "Just now, I was still confused about some of the questions. After a while, I'll do a few myself and save up a dozen more patients. I'll invite you to come again. "
"The main point of the second-stage surgery is to think about it more," Zheng Ren reminded. "You can't be rough. You have to be skillful. I've already explained the main techniques. All that's left is to practice the surgery. "
"Okay," Mu Tao replied.
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 they entered the ward gate, they saw a nurse pushing a rescue cart and running.
Zheng Ren's heart suddenly tightened. Was there a rescue?!
Under normal circumstances, the Department of Interventional Medicine did not accept emergency cases. If there was a rescue, it would be a patient who vomited blood due to portal hypertension after being hospitalized.
He forgot that he had to go to the airport to return to the Imperial Capital after seeing the patient. He habitually followed the nurse to the ward.
Old Wu was directing the resuscitation in the ward. A doctor was examining the patient, and the nurse was busy monitoring the patient's ECG. Zheng Ren had no angle to look at the System panel for the time being.
This patient was not one of the patients who had undergone TIPS surgery. Mu Tao came in after him and was stunned for a moment before he exchanged a few words with Old Wu.
Zheng Ren listened to the patient's condition. Two days after the liver cancer interventional surgery. On the first day, his right upper limb began to tremble. He did a related examination, but no problems were found. Today, his condition worsened and he developed acute dystonia.
Zheng Ren found an angle and looked at the patient's System panel.
It was red with a bunch of diagnoses written on it. Zheng Ren looked at them one by one and deleted the unimportant ones. He saw a very rare diagnosis — extrapyramidal reaction.
This is …
The extrapyramidal system is a component of the human motor system. Its main function is to adjust muscle tension, coordinate muscle movement and balance.
This regulatory function depends on the dynamic balance of the neurotransmitters dopamine and acetylcholine in the regulatory center. When dopamine is reduced or acetylcholine is relatively increased, the symptoms of cholinergic hyperactivity may appear.
There were many symptoms of extrapyramidal reaction. Zheng Ren did not consider this for the time being. Instead, he quickly searched in his mind for related diseases and drugs that could cause extrapyramidal reaction.
Under normal circumstances, neurological drugs could cause this reaction, but it was not common.
"Old Mu, did the patient take anti-anxiety drugs or drugs like hibernation spirit before the surgery?" Zheng Ren asked.
"No." Mu Tao frowned as he looked at the physician who was examining the patient. "The patient took entecavir and antihypertensive drugs orally before the surgery. There was nothing special. After the surgery, a group of magnesium isoglycyrrhizinate injection was given to protect the liver. That's all. "
"I'll go and see the doctor's advice," Zheng Ren said.
Mu Tao did not dare to leave. He asked a doctor to take Zheng Ren to the doctor's advice while he stayed in the ward to participate in the emergency treatment.
When he arrived at the office, Zheng Ren clicked on the workstation and began to look for drugs that could cause extrapyramidal reaction.
The doctor's advice was very clean. Magnesium isoglycyrrhizinate injection was also a commonly used clinical drug to protect the liver. It was cheap and easy to use, so Zheng Ren often used it.
As for other drugs …
After the surgery, sugar saline and VC were used. This was used for fluid replacement, urination, and metabolism of the contrast agent as soon as possible.
Metoclopramide?
Zheng Ren was finally relieved when he saw that the patient had been given metoclopramide on the first day after the surgery. He then looked at the course of the disease. It clearly recorded that the patient had been given intramuscular metoclopramide because of postoperative nausea.
Metoclopramide, a drug called metoclopramide, cost a few cents per dose. It also had a good effect on flatulence, indigestion, loss of appetite, belching, nausea, and vomiting.
After liver cancer interventional surgery, most patients would have similar symptoms, so metoclopramide was especially commonly used.
However, Zheng Ren found a few related reports. They were all cases of metoclopramide causing extrapyramidal reactions.
The process of the drug was due to blocking the dopamine receptor, causing the cholinergic receptor to be relatively hyperactive, causing an extrapyramidal reaction. This complication was not common, so they were a little scratching their heads and did not dare to make a diagnosis immediately.
Zheng Ren closed the workstation, stood up, and walked out.
"Boss Zheng, are you done looking? There's other information about the patient here, "the junior doctor who accompanied Zheng Ren asked.
"Yes," Zheng Ren said, "I've found the cause."
"…" The junior doctor was stunned. So fast? He did not even need to look at other tests?
Boss Zheng didn't look very old. He seemed to be younger than her. Could it be nonsense?
However, he did not say anything. He just followed Zheng Ren's footsteps and began to introduce the patient's condition.
"The patient had no problems before the surgery. He did a head CT yesterday and did not find any luminal infarction.
"It's not a luminal infarction. It's an extrapyramidal reaction.
"What?" The junior doctor looked confused.
The Department of Interventional Medicine rarely encountered such a rare nervous system reaction, so it was normal for them not to know. The entire medical system system knowledge was vast. Otherwise, the division of departments was becoming more and more detailed because it was difficult for normal people to master it comprehensively. They could only go in the direction of detailed classification.
Zheng Ren did not explain too much to him. If he found the cause, he would treat it normally. He would just tell Mu Tao.
He quickly walked to the ward. The neurology doctor was also asking about the medication.
"Old Mu, stop the metoclopramide. The condition can be relieved," Zheng Ren said.
"Do you think it's an extrapyramidal reaction caused by metoclopramide?" The neurology doctor seemed to have the same judgment and immediately asked.
"Yes." Zheng Ren nodded.
"I'll go take a look at the doctor's orders." The neurologist ran to the office in a flash. Zheng Ren smiled when he saw her in a hurry.
"Boss Zheng, do you think it's caused by metoclopramide?" Mu Tao was still a little uncertain.
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