bookpower Chapter 254
Chapter 254
"Doctor Lin, what's wrong?"
The patient Li Shasha felt that something was wrong with Lin Feng's face.
Lin Feng: "I just thought of another disease, which is very similar to your symptoms." "
Lin Feng told Li Shasha about the "cat-scratch disease".
"Or, take a biopsy..."
This lump may not necessarily be a lymph node, it may also be a tumor, or it may be caused by cat-scratch disease...
No matter what the nature of the mass, pathological biopsy is the most reliable.
"What is a biopsy?"
Li Shasha asked with trepidation, it was not a simple matter when she heard this word.
"Biopsy means cutting a little tissue out for testing. Lin Feng explained.
"Ah? Does it hurt? Is it trouble? Surgery?" said Li Shasha worriedly.
"Just take a little tissue test, there will be anesthesia, there will be no pain. Lin Feng said with a smile.
"Doctor Lin, is this cat scratch serious?"
"Don't worry about this, it's basically benign diseases, most of them will get better slowly, a few months, it's really not okay to take antibiotics..." Lin Feng comforted.
Now,
Li Shasha breathed a sigh of relief.
This cat-scratch disease is more acceptable than tumors and HIV.
......
The next day,
The results of various examinations are coming out one after another.
The blood count is almost normal, and the white blood cell count is not significantly elevated, unlike common infections.
(Inflammation, which causes white blood cells to rise.) ）
R gland related tests came out, all negative, no signs of R adenocarcinoma.
・3 lymph nodes can be swollen in the armpit, the largest is 2 cm in size.
Then, there are only 3 possibilities:
Cat scratch disease
Lymphoma
·hiv
It is necessary to wait for further tissue examination and HIV pathogenic antigen test results.
This patient, Li Shasha, is just an ordinary patient of Lin Feng, and Lin Feng will not pay too much attention.
......
Afternoon.
Lin Feng went to class P.
Continue to receive medical appointments.
An uncle patient in his 40s knocked on the door and walked into Lin Feng's consultation room.
This uncle is very special at first glance.
Because he raised his right hand, he faced Lin Feng in an awkward posture.
Let people's attention be placed on his right hand at once.
His right hand, the abduction of the thumb, the flexion of the little and ring fingers.
"Claw-shaped hands?"
Lin Feng said subconsciously.
"Claw-shaped hands" are not martial arts such as dragon grippers and eagle graspers.
It's a medical term.
Because of the injury, most of the adductor muscles of the hand are paralyzed, resulting in weakened grip strength, unstable holding, and inflexible movements.
In addition, the ring finger and little finger cannot be flexed, and the little finger cannot be abducted. On the injured side, Tegawa shows thumb abduction.
The specific image is the type of grip claw.
It is the most typical manifestation of "ulnar nerve injury".
The patient sits down.
"Doctor Lin!" the uncle greeted the patient respectfully.
"Tell me, what's the problem?" asked Lin Feng with a smile.
"Since three months ago, my hand has been a little numb, even the chopsticks are unstable, until now, there is no sense at all, you help me see what the problem is." "
The uncle looked worried and worried.
You must know that this right hand has not been conscious for months, and he cannot work.
I thought it was just cramps, just rest for a while.
I never thought it would be more serious now.
He was really worried and would be crippled!
So you can only go to the hospital to see it.
"Show me..."
Reached
Lin Feng lifted the patient's right hand and gently shook it a few times.
Obviously, the muscles are already atrophied...
After checking for other symptoms, it is indeed very similar to a scratching hand.
"Have you been injured before?"
"Yes, I really work on the construction site, and I hit my hand again..."
"When?"
"Four months ago... My hand seems to have become like this 3 months ago..."
At this time, the patient reacted.
It must have been caused by the injury from last time!
But!
Where it hits the hand, it's on the upper right arm!
How did it hurt the running palm there?
Strange!
"I suspect it should be an open rupture of the ulnar nerve, but you have to go for an "electromyogram" test to confirm it. "
Lin Feng said truthfully.
"Ulnar nerve open rupture, is this serious?"
When the uncle heard this, he was taken aback.
"If it is diagnosed, you need to be mentally prepared for surgery, after all, an open rupture of the ulnar nerve will directly affect the function of your arm, and if the muscles are completely atrophied, even if you have surgery, you will not be able to fully recover... But you can't delay it!"
Lin Feng gave the patient a list.
When he heard that his arm might not be safe, the uncle hurriedly took the "electromyogram" list and ran to check it.
As for the cost of the operation...
This uncle is the captain of a company's engineering team, and his wife is also a middle-level white-collar worker for more than twenty years, and his savings are still a little.
An hour later,
The EMG results are in!
The examination results showed that the motor conduction of the right median nerve disappeared, and the CMAP amplitude of the ulnar nerve motor conduction decreased...
Translated: it is the damage to the lower trunk of the right brachial plexus, and the damage to the median nerve of motor conduction is heavier than that of the ulnar nerve...
(From the right arm, it starts to spread down!)
Diagnosed:
Ulnar nerve open rupture!
That is, surgery!
And still do it from the right arm.
Instead of the right palm.
"Do you want to find another doctor for surgery..."
"Dr. Lin, will you do this operation?"
"I will..."
This operation is not small, but for Lin Feng, so~easy!
"Then there is no need to find other doctors, I trust Dr. Lin!"
This uncle's eyes were full of trust.
Lin Feng Yile.
"Okay, go through the hospital, perfect the examination, and then let your family come over and arrange tomorrow's surgery..."
"Okay, thank you Dr. Lin!"
......
......
The next day
The patient Li Shasha tissue biopsy, the results came out.
Not a cat-scratch disease!
・ Not lymphoma either!
Now, all possibilities are ruled out!!
The original least probability of HIV has now become the highest probability!!
However, HIV testing is very slow... Even if it is urgent, it will not come out until tomorrow.
"Is it really HIV??"
"Impossible!"
At this moment,
Li Shasha almost had a psychological breakdown and regretted it.
She looked up the miserable situation of those HIV patients on the Internet, and she shuddered!
Angry, she called the man who had committed the unclean act and cursed for half an hour.
As a result, the man was also terrified.
Without saying a word, he quickly ran to the hospital for examination.
Both young men were anxiously awaiting the results.
It's just onenight, is this a win?
Waiting for results is painful and excruciating, especially for HIV-related results.
Li Shasha had trouble sleeping, especially after her knowledge of thousands of degrees, she found that this disease was also similar, that disease was also in line, and the mental pressure was great.
At this time, she did not dare to tell her family or her girlfriends...
He was hospitalized alone in the hospital.
......
At this point,
Dr. Lim didn't have much time to pay attention to this patient.
Because
The operation of "ulnar nerve open rupture" began today.
Ulnar nerve open injury is also a difficult operation in the fourth level of surgery.
To be precise, it is orthopedic, extrajudicial surgery.
So when Lin Feng was going to do this operation
Orthopedics, neurosurgery... The doctors came to watch.
......
3:00 p.m
The patient is pushed into the operating room...
Surgery:
Disinfect......
Anaesthesia......
After successful anesthesia,
Lin Feng walked onto the operating table.
"Let's go!"
"Scalpel!"
Step 1,
Open the surgical horizon...
Lin Feng made a longitudinal incision at the location of the lesion shown by the "electromyogram" of the patient's right arm...
The knife edge then ascends upwards along the medial side of the peck-humeral muscle...
The sharp scalpel flashed a little chill, and then cut the deep fascia longitudinally along the medial edge of the pecking humerus muscle...
Then both hands penetrate into the incision in the patient's arm, freeing the muscle tissue...
The musculocutaneous nerve clings to the distal end of the pecking brachial muscle...
"Pull the hook!"
Pull the pecking brachial muscle and the musculocutaneous nerve anterolateral ...
Cut the median nerve and a thin sheath around the ulnar nerve...
Surgical field of view, begin to be exposed!
The medial bundle located on the posterior medial side of the median nerve and the ulnar nerve are revealed!
This whole process is silky smooth.
Numerous onlookers: experience +100+100+100...
Lin Feng's hands, as if they had magical power, could fascinate them.
Every time I watch the process of Lin Feng's surgery, I have a feeling of empowerment!
Especially those new interns, they feel that countless clinical experiences are as if they have been stuffed into their minds.
......
Next
Free!
。