Chapter 2063

"Boss Zheng, I thought about looking for you a few days ago." Zhang Weiyu said, "but director Wei said it's better to do almost all the inspections, otherwise it won't take you too much time."

"Yes." Zheng Ren nodded. Director Wei was right.

"The patient is a guy from the head office of my long shop. It's far away from Fengxian County."

"Hmm? The head office? You're not the head office?" Su Yun was surprised.

Generally, the head office is set up in super first tier cities such as imperial capital and magic capital, and the normal business model is that the branches are blooming all over the country.

However, the head office of this store is in Fengxian County.

Since ancient times, Xuzhou has been one of the world's Kyushu. Fengxian is also an ancient city with some historical legends.

"The old store is inherited from my family. My old man refused to move the store to the imperial capital." Zhang Weiyu said, "old man, the Centennial plaque at home is more important than life. I said it twice and was almost kicked out of the house."

This is also conceivable. Zheng Ren nodded. That's the tradition.

"A distant relative in the family had a cerebral hemorrhage last autumn and recovered well after operation, but the child didn't want to go to school and went to work in the store." Zhang Weiyu said, "it was OK to take medicine to control blood pressure after operation, but the blood pressure became higher and higher after a few months."

The patient was an 18-year-old boy who suddenly had headache and disturbance of consciousness six months ago. He was treated in a local hospital and underwent head CT to find left basal ganglia lateral ventricular parasomatic intracerebral hemorrhage.

The blood pressure measured at admission was 220 / 110 mmHg. Considering intracranial hypertension, intracranial hematoma resection was performed immediately.

Enalapril maleate 10mg was taken orally once a day.

At the beginning, oral antihypertensive drugs were taken for antihypertensive treatment, and the blood pressure was controlled at 110-120 / 70-80 mmHg, which was still good. But over time, blood pressure is getting higher and higher.

But after all, is it a young man? He still doesn't pay enough attention to his body. It's good to take medicine on time every day. As for taking blood pressure every day, he only insisted on taking it for about one month, so he didn't continue to take care of it.

He felt uncomfortable again a few days ago and took his blood pressure, 180 / 120 mmHg. As for the intermediate process, the patient himself did not describe it clearly.

This frightened him so much that he hurriedly looked around and found Zhang Weiyu in the imperial capital.

This is the whole story.

The medical history is not complicated. The patient has a family history of hypertension at home, but others take an oral antihypertensive drug, and the blood pressure is well controlled.

There is no such thing as his stubborn and uncontrollable blood pressure.

Because of his family history, Zheng Ren ruled out many genetic diseases.

"Director Wei took me to Director Zhang. At that time, director Zhang suspected that it was a problem with the adrenal gland, so he did the relevant examination." Zhang Weiyu said.

Director Zhang Lin said: "later, the patient changed the dressing and dosage, took amlodipine besylate orally, 5mg twice a day, and terazosin hydrochloride orally, 4mg every night. After controlling the blood pressure for a few days, he went back."

"I thought it should be the adrenal gland, but the side had an MRI of the adrenal gland and a renal angiography. It was all right."

This examination is very detailed, almost excluding the possibility of renal hypertension.

Hypertension is mainly divided into primary and secondary, each of which has many branches. Director Zhang Lin's consideration is very comprehensive and her tendency is clear. It is considered to be secondary hypertension.

The most common secondary hypertension are nephrogenic hypertension, endocrine hypertension and other rare inducing factors.

"How tall and how heavy is the patient?" Zheng Ren asked.

"One meter eight, more than 230 kilograms." Zhang Weiyu said.

His body was a little fat. Zheng Ren thought about it and asked, "is snoring serious?"

"It's terrible. I don't dare to sleep with him. I snore and feel that the bed is shaking." Zhang Weiyu said with a smile, "when he was hospitalized, he had a single room, and all the people in the ward were snored and run away by him."

"Do you suspect obstructive sleep apnea hypopnea syndrome?" Su Yun asked.

"This problem can be considered for stubborn hypertension." Zheng Rendao.

"Well, I also suspect obstructive sleep apnea hypopnea syndrome." Director Zhang Lin said, "the patient has been asked to do enhanced renal MRI, but the hospital on that side is very strange to OSAHS examination and won't do it."

This is also normal. Although obstructive sleep apnea hypopnea syndrome is common, many people snore all night, and Yin and Yang falter, like singing an opera.

However, induced hypertension can be basically controlled as long as appropriate medication. Difficult to control, or relatively rare.

"Boss Zhang, tell me about his snoring." Zheng Ren is more interested in snoring.

"Don't mention boss Zheng." Zhang Weiyu sighed and said, "I came home for the new year. I only lived for two days and ran back because he snored."

"During the Chinese new year, the store was open all the time because its business was good. The neighbors came to treat them when they were too lazy to cook. I thought about drinking and chatting with my family when I went back. But I could hear his snoring through a wall."

Zheng Ren listened quietly.

"The snoring made me feel the walls sway." Zhang Weiyu complained, "it doesn't count. When he snores, it's like he's out of breath. Once I heard him snore, there was no sound in the middle, and he stopped for 50 seconds... It takes about a minute."

According to Zhang Weiyu, Zheng Ren has basically made clear the situation of the patient.

"I was afraid that he would have another cerebral hemorrhage and that others would die in bed without knowing it, so I got up and prepared to have a look. When I came to the door, the snoring started again, and I went back to sleep."

"You say snoring is not enough. Who can stand such a scare in the middle of the night. I stayed at home for two days during the Chinese New Year and ran back."

People who sleep in the same room or bed find that patients have apnea. They often worry that they can't recover their breathing and push them to wake up. Apnea usually ends with wheezing, suffocating or loud snoring.

This condition is called apnea and is a manifestation of sleep apnea hypopnea syndrome.

Most people can start breathing on their own because of hypoxia when snoring, but in front of us, we hold our breath for too long.

Because there is no way to check the body, Zheng Ren can only guess. It's hard to say whether it's right or not.

"Boss Zhang, are you still busy on the other side of Fengxian old store?" Su Yun suddenly asked.

"Small county, close early, there is little nightlife." Zhang Weiyu doesn't know why the topic is changed here, but he still has something to say.

The young man around boss Zheng can't be ignored. Even slighted boss Zheng. People have a lot of adults and won't be angry. But it's hard for me to serve you. Maybe something will come out at that time.