Chapter 1898 [1898] The Method Is Different
"After we came here in the morning, we heard that Yongzhe's younger brother had chest pains. The doctor on duty notified the patient's attending doctor to come and deal with it inside." Li Qi'an reported that his expression was as indescribable as the other boys. Because it was heard that the doctor in charge of the patient was the famous philandering carrot, no one would think that Chang Jiawei was reliable.
Fearing that Geng would be irritated, Ren Chongda took the students to rest in the doctor's office to wait for news.
Chest pain, the electrocardiogram did not show any abnormality such as myocardial infarction, but the heart rate was fast. The initial cause was suspected to be bronchitis and orthopedic problems, and no cardiothoracic surgeon was called. The situation actually looks better and is not life-threatening for the time being. But when the patient complained of pain, the family members must be anxious. What to do with the doctor. For this kind of neuralgia, in addition to surgery to remove the cause, drugs can only be administered with painkilling injections or even localized sealing (local anesthesia and other drugs are injected into the nerve-involved area for an analgesic and anti-inflammatory treatment).
Pain relief injections should not be given indiscriminately. Pain relief injections are basically addictive, and only temporary pain relief cannot eradicate the cause. Domestic clinicians have always used it with caution. The condition of the patients inside is worrisome.
"Cao Yong." Knowing that he was coming, Ren Chongda asked the squad leader to accompany him, and walked out of the office to call him.
Cao Yong turned around and asked his insider, "What's the condition of the patient?"
Ren Chongda said: "Chang Jiawei didn't call you, did he? He said last night that he might need to consult with a neurologist. He was going to send him for an additional brain CT today. After yesterday's film came out, what he can see now is There is a mass in the epidural of the spinal canal at the level of the thoracic 5th to 7th vertebrae, which is considered to be an epidural tumor. It may be for this reason that Chang Jiawei called for CT of other parts."
Like epidural tumors, most of them are metastases, and most of them are malignant. Doctors must have multiple minds. Surgery for malignant tumors is different from surgery for benign tumors. Like spine surgery, if it is judged to be malignant, the first thing to think about is not to remove the tumor, but how to reduce the pressure to prolong the physiological function of the patient's survival period and improve the happiness index of the survival period. Resection is of little significance. If it is benign, it should be removed as much as possible to prevent recurrence.
"Where is the film, I'll watch it again." Cao Yong said.
Ren Chongda took him to the office. The others all followed Cao Yong like little followers.
The films from last night were taken out again and hung on the light boards one by one. Since yesterday was far away, I couldn't see clearly. Today I finally had the opportunity to watch the patient's film up close, and Xie Wanying seized the opportunity to stand in front of her. Who makes orthopedic films look more complicated than those of other departments. Think of it as just one vertebra, as long as you have read anatomy, you will know that its shape and structure are already very complicated. Every bone in the human body has its special shape and its special physiological significance. It is as difficult to study the meaning of a bone as it is to study an organ.
"Here, here." Ren Chongda helped Cao Yong point out the lesion, so that Cao Yong could grasp the key points of the case faster in a short time.
Cao Yong watched the film in silence.
"If it's really a metastatic tumor, wouldn't it be better to do a whole body CT?" Ren Chongda asked his opinion.
Metastases do not necessarily come from outside the brain, and the majority of spinal metastases appear to come from the brain.
While waiting for Senior Brother Cao to express her opinion, Xie Wanying could hear the students in her class around her muttering and discussing in private.