Chapter 1759

"It's all right, old man." Zheng Ren pulled out the old man's vein channel and helped him up from the ground.

"Sit down and have a rest. Your disease has been diagnosed." Zheng Ren said with a smile.

"What disease is diagnosed?" The old man was a little careful and confused.

It seems that he is really afraid to diagnose himself as a mental disease. So that his eyes at Zheng Ren were wrong, with a faint hostility.

"Swallowing or swallowing syncope is a rare type of nerve-mediated syncope associated with life-threatening bradyarrhythmia and hypotension, which is usually difficult to diagnose in time." Zheng Rendao: "after tilt test, it is proved that it is a problem of vagus nerve."

"...." the old man didn't understand a word.

"Don't say what disease it is, first say how to treat it." Zheng Rendao.

"Lao Luan, did you say you were hurt?" Su Yun came to Luan Yingjie, helped him up, and said with a complaining tone, "give your old man a diagnosis. What chaos are you adding there?"

"Er..." Luan Yingjie covered his wound in pain, unable to laugh or cry.

"You almost killed your father. You didn't see the situation just now. It's really nothing to make trouble." Su Yun continued to stab.

"That... I'm sorry." Luan Yingjie didn't know why he was kicked, but wanted to say sorry.

But the old man of his family was sitting on that side. It seemed strange that he had just acted.

It's not a thing to bow your head and admit advice!

"This disease needs the next pacemaker." Zheng Ren said: "double chamber pacemaker, after you finish, you can eat freely."

"My heart is OK." The old man wondered, "where's the ECG? What pacemaker?"

"Your heart is OK, but when you eat, your esophagus expands and involves the vagus nerve, there will be cardiac arrest for a few seconds." Zheng Ren smiled.

The old man still didn't believe it, but because Zheng Ren didn't say it was mental illness, his attitude was much better.

Some old people at this age believe everything and some don't believe anything. It is obvious that Luan Yingjie's father belongs to the latter.

After all, it is an operation. No matter how small the operation of pacemaker is, it is also an operation.

Zheng Ren smiled. Obviously, he considered this.

"Old man, why don't we do this." Zheng Ren said gently, "if you don't agree with the pacemaker, let boss Luan take you to the hospital tomorrow and carry your 24-hour ambulatory ECG."

"Huh?"

"In one day, you can find the problem." Zheng Ren said, "how about looking for some experts and you make a decision?"

This makes the old man feel very comfortable.

I definitely said the diagnosis opinion, but I didn't force myself to make a decision, but let me check again and carefully find others to see more. This little doctor is good at being a man.

"Well, I think it's better." The old man immediately agreed with Zheng Ren.

"If it's all right, we'll go." Zheng Rendao said, "boss Luan, if you decide to have an operation, come to me. Unlike ordinary surgery, you should test the effect of esophageal inflation on the heart."

"OK, OK." Luan Yingjie saw Zheng Ren and Su Yun get up. He quickly stood up.

When his leg was soft, he fell to the ground.

"Look at you, you can't be careful. How old are you? What if you break a bone?" Su Yun didn't help, but sprayed it.

Luan Yingjie smiled bitterly. You kicked him.

"You're welcome. Let's go." Zheng Ren saw the nanny go to help Luan Yingjie up, turned and left.

"Boss Zheng, what happened just now?" Asked Zhou Litao.

"Mr. Zhou, take your ambulance back to the hospital and pull us some way." Su Yun said with a smile.

"It's all right. What happened just now?" Zhou Litao has been struggling with the patient's disease of coma after eating.

"The inhibitory response of esophageal dilation to the heart is the underlying pathophysiological mechanism of syncope. This case is reported on BMC Cardiovasc disord." Zheng Rendao: "the author also combed and summarized 101 cases of swallowing or swallowing syncope reported since 1793."

1793... 101 cases, Zhou Litao speechless.

"This syncope is common in men and the elderly. The average age of case reports is 57.5 years. 54.5% of patients will cause syncope when they eat anything, whether it is water or solid food." Zheng Rendao: "generally, it is caused by esophageal diseases."

"So it is." Zhou Litao silently wrote down the patient's situation. He felt that the paper recording boss Zheng's diagnosis and treatment was emitting heat, which made him a little excited.

"Pacemaker implantation is the most commonly used treatment. 98.1% of patients implanted pacemakers and reported remission of syncope symptoms, and more than half of patients implanted permanent pacemakers." Zheng Rendao: "so it is highly probable that the pacemaker is still useful."

"Remove the pacemaker..." Zhou Litao pondered over the role of the pacemaker.

"The second is the treatment for gastrointestinal diseases. For example, four patients repaired hiatal hernia. Other patients underwent successful vagal ablation, long-term application of proton pump inhibitors and radical surgery for esophageal cancer."

"Just scared me." At this time, Zhou Litao felt his chest and still had lingering palpitations.

"Not afraid." Zheng Ren said with a smile, "look, there's atropine in your first aid kit. With this medicine, there's no big problem."

"Huh?"

"Atropine was commonly used before the pacemaker came out. Limited data show that the curative effect can reach 90%." Zheng Rendao said, "if it weren't for observing for five minutes and seeing how low the patient's blood pressure can be reduced, push an atropine directly and it will take 15 seconds."

"But the blood pressure is too low." Zhou Litao said.

"Well, my psychological bottom line is 35 mm Hg. If it is lower than this value, I must inject atropine." Zheng Rendao, "the patient's condition is quite cooperative, very good."

"Boss, you can really calm down. My psychological bottom line is 40mm Hg. I can bear it when I see you don't speak." Su Yun said, "but I was anxious. I kicked Lao Luan and felt much better."

"Don't be so violent." Zheng Renyou said, "aren't you afraid of an accident?"

"I also saw atropine. With atropine, how could something happen? Besides, I'm a doctor with heart. I can get him back by defibrillation and compression. What are you afraid of!" Su yundao.

Zhou Litao was a little ashamed.

I was really a little flustered.

Although I know that tilt table test may be dangerous if it is positive, I haven't encountered it after all, and the diagnosis is much worse than boss Zheng and Brother Yun.

The basic level is still not enough. If you have nothing to do, you should read more books. Zhou Litao thought to himself.