Chapter 2072

"In the end, Dr. Auckland didn't make much progress." Zheng Rendao.

"No, I remember she experimented with mice, cutting off one side of the nerve, and the other side was necrotic a few weeks later." Su Yun retorted.

"I think this is a special event and there is no universal significance." Zheng Rendao, "clinically, doctors in Canada conducted a large-scale sample survey on kidney stones and found that mirror pain exists.

But in terms of probability, I have observed in Haicheng first hospital that the so-called incidence of 0.48% seems to be a little high. "

"Oh?" Su Yun didn't expect that his boss had begun to study mirror pain in the broken place of Haicheng.

"The data in Canada is that there are 3 mirror pain in more than 600 patients," Zheng Rendao said. "The data I observed are more than 400 patients with urinary calculi, none of them is mirror pain. Clinically, this patient is the first case I have encountered."

Clinical research is like this. Whether 600 or 400 cases are small samples, it is normal to have deviation.

However, from the observation of boss Zheng renzheng, mirror pain should be regarded as a very rare disease in China.

"What about the hospital? And then?" Yu is always confused.

"Admission, lithotripsy. If your director doesn't approve of mirror pain, you can check an intravenous pyelography." Zheng Ren's finger pointed to the X-ray standing flat film inserted on the film reader and said, "this should be some stress change of the body. When the stones are broken and eliminated from the body, there should be no pain, and this should be better."

"Boss Zheng, can you be more detailed?" President Yu has no good way. He can't say that when reporting his medical history to the director.

"Well... That's how you report to the director." Zheng Ren looked at the film and said, "the pressure of the right renal collecting duct increased due to hydronephrosis, followed by the extension of nerve endings in the lamina propria, spasm and contraction of smooth muscle, trying to move the stone."

"Lactic acid production increases, stimulates mucous membranes and activates chemoreceptors. After the afferent nerve reaches the spinal cord, it is connected to the spinal cord at t11-l1 level, and then transmitted to the central nervous system to produce the illusion of contralateral pain."

"Yu Zong was silent and speechless.

If I tell the director like that, I'm afraid I'll be the chief inpatient for another year.

But although boss Zheng gave a diagnosis, he couldn't say a particularly persuasive point of view. He could only nod his head.

"As for the image of the left ureter near the lumbar 2-3 vertebral body, intravenous pyelography can be ruled out. Whether it is mirror pain or not, the right urinary calculi should be treated later." Zheng Ren finished, took down the film, put it in a bag and handed it to president Yu.

Then the two inpatients always began to get busy.

It is a relatively huge project to persuade patients who resolutely refuse to be hospitalized to be hospitalized for diagnosis and treatment.

But after all, they had rich clinical experience and severe pain. With a relatively reasonable but mysterious explanation, he reluctantly accepted it.

The pain of kidney stones is really painful. It feels like the end of the world. Even if there is a sea of swords and fires in front, you have to break through.

Su Yun took advantage of this time and ordered breakfast.

Zhou Litao was busy and breakfast had just been delivered.

"Boss Zheng, Brother Yun, the patient was sent to the hospital." Zhou Litao reported on the closing work.

"Well, gravel is OK. If it doesn't break, urology has some ways to solve it." Su Yun said while eating steamed stuffed buns.

"It's also my first time to experience mirror pain in the urinary system." Zhou Litao is still very interested in this. "There are several cases of contralateral pain in patients with orthopedic amputation, but I think it's hysteria."

"It's not hysteria, but the scientific principle has not been found yet." Zheng Ren smiled. "The existing science has no clear statement on the diagnosis and treatment of many diseases."

"I think we can solve this problem with central nervous system remodeling." Su Yun said, "unfortunately, I don't do this research. I don't have a clue for the time being."

"There's no need to do it. When you meet similar patients, you know that there is such a possibility. It's enough not to misdiagnose." Zheng Ren is very accurate in his positioning and has always been a clinician.

Before Dr. Charles persuaded him to engage in theoretical research, Zheng Ren thought very clearly at the moment when he decided to give up.

While eating breakfast, the three chatted a few guesses.

Zhou Litao has some feelings. No wonder boss Zheng has been rising all the way. When he was the chief inpatient of the emergency department in Haicheng, he knew something about this kind of side door.

There's no time for pie to fall in the sky.

Zhou Litao was wrong about boss Zheng's speculation from the beginning.

Zheng Ren began to reflect and recall the similar patients he met in his career as a doctor after meeting the patient with mirror pain this morning.

Therefore, the thinking of hanging force is different from that of others. Zhou Litao can only go farther and farther on the wrong road when he thinks about boss Zheng with normal people's thinking.

Boss Zheng never... Seldom push forward. He always push backward after knowing the answer. Pushing backwards is easy, but it is also based on Zheng Ren's strong memory.

"By the way, why hasn't Cui been at work recently?" Zheng Ren asked after dinner.

Zhou Litao sighed and said, "it has been more than half a month since old Cui was ill last time. He has been good and bad again and again. There is no big problem when he comes to the hospital."

Zheng Ren was stunned and knew that Cui was always old and that some things could not be solved by manpower.

"Where is Cui's hometown? I'll have a look when I have time." Zheng Rendao.

"Tomorrow is my day off. I'm going to have a look at Cui's hometown." Zhou Litao said, "boss Zheng, if you have time, let's go together?"

"OK, tomorrow... Afternoon." Zheng Ren said, "there are more things in the morning."

Speaking of Cui Lao's illness, the atmosphere in the duty room was a little depressed.

But after all, I'm almost 80, and some small problems are normal.

Not to mention Cui, who is almost 80, Zheng Ren sees the doctor's system panel in each doctor's office, which is more or less red.

This is the law of nature. Zheng Ren wants to go once. First, he misses Cui Lao. Second, take a look at the system panel. Mr. Cui is misdiagnosed because he has other problems.

Although the latter is unlikely, Zheng Ren still thinks it is more appropriate to have a look.

After breakfast, Zheng Ren and Su Yun left the emergency department and returned to the intervention department for early handover.

Lin Yuan is still sitting in front of the computer, busy writing medical records. Chang Yue chatted with the patient's family in the ward. Everything in the Department looked the same as usual.

Plain and light, but rich and colorful.

……

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Note: when I wrote about mirror pain, I recalled that there was a patient after amputation in the front door emergency department, who always said that the amputation position was related to the contralateral pain. I've been saying behind my back that people pretend to be ill... I'm a little ashamed. Mirror pain, really know for the first time.