Chapter 981： Extrapyramidal reaction

Two live radio operations soon ended.

Mu Tao is very sorry that the time he came back is still too short, and the number of patients received is much less than that of the emperor. Originally thought that there are already a lot of 6 patients, but the marrow is known. Now I really want to have 60 patients to practice and mature as soon as possible.

It’s a pity that I had to come to Japan.

Zheng Ren took off the lead clothing, changed clothes, and took a look at the time: "Old Mu, go down to see the patient, I will go. This patient's information, you can send me a mailbox."

"It was so rushed, I was prepared to invite you to eat authentic Cantonese cuisine." Mu Tao said.

He knows that Zheng Bo is not very fond of eating. This is the case in Pengxi Township. Su Yun picked and picked three and told Director Jiang what he wanted to eat. Zheng Ren seems to have only eaten a meal, and Su Yun said it is like a **** plate.

Because of this, this Zheng boss gives people a feeling of being difficult to deal with. To teach such a big thing about TIPS surgery, I didn’t even have the opportunity to express my gratitude.

And Mr. Zou, who is from the Zou family of Xiangjiang, still waited for him, and he did not even show up.

Mu Tao looked at Zheng Ren’s face, and he was slightly stunned.

"Nothing, just buy a few burgers on the road." Zheng Ren said freely: "When I look down on the patient, I will leave. You will do another second operation, I don't think I will come again."

"Don't!" Mu Tao quickly stopped Zheng Ren's words. "Only one time, I am still confused about some problems. After a while, I will do a few of them myself, and then I will have more than a dozen patients. Please come once."

"The main points of the second phase of surgery, more pondering." Zheng Renxuan, "can not be rude, have to be smart. The main skills have been said, the rest is the surgical practice."

"Good." Mu Tao should have a voice.

After changing clothes, Zheng Ren, Mu Tao, and the professor returned to the ward and were ready to see the patient.

Just entering the gate of the ward, it is like a nurse pushing a rescue car and flying.

Zheng Ren’s heart is awkward, is there a rescue? !

Interventional department, under normal circumstances, no emergency. If it is rescued, it is also a patient who has hematemesis due to portal hypertension after hospitalization.

He forgot to read the patient to go to the airport to return to the emperor, habitually followed the nurse to the ward.

Wu Lao commanded rescue in the ward, a doctor was checking the body, and the nurse was busy with ECG monitoring. Zheng Ren has no angle and has not seen the system panel for the time being.

This patient was not one of the postoperative patients with TIPS surgery. Mu Tao then came in and stunned and exchanged a few words with Wu Lao.

Zheng Ren heard the patient's condition on the side, and the liver cancer was treated 2 days after the intervention. On the first day, the right upper limb trembled and I did a related examination and found no problems. Today, the condition worsens and acute dystonia appears.

Zheng Ren looked for an angle and saw the patient's system panel.

Red, written a bunch of diagnoses. Zheng Ren looked at the past one by one and removed the unimportant ones and saw a rare diagnosis - extrapyramidal reaction.

this is……

The extrapyramidal system is part of the body's motor system and its main function is to regulate muscle tone, coordinated movement and balance of muscles.

This regulatory function relies on the homeostasis of the neurotransmitters dopamine and acetylcholine in the central nervous system. When dopamine is reduced or acetylcholine is relatively increased, symptoms of cholinergic hyperactivity may occur.

There are many symptoms of extrapyramidal reactions. Zheng Ren did not consider this for a while, but quickly looked for related diseases and drugs that could cause extrapyramidal reactions in his mind.

In general, neuropharmaceuticals can cause this reaction, but it is not common.

"Old Mu, do patients take anti-anxiety drugs or drugs like hibernation before surgery?" Zheng Ren asked.

“No.” Mu Tao frowned at the doctor who was in the consultation. “The preoperative patients took entecavir and antihypertensive drugs. There was nothing special about it. After giving a group of magnesium glycyrrhizinate injection to protect the liver, nothing else. ""

"I am going to see a doctor's advice." Zheng Rendao.

Mu Tao did not dare to leave, let a doctor take Zheng Ren to see a doctor, and he stayed in the ward to participate in emergency first aid.

When I came to the office and opened the workstation, Zheng Ren began looking for drugs that might cause extrapyramidal reactions.

The doctor's order is very clean. Magnesium glycyrrhizinate injection is also a commonly used liver-protecting drug in the clinic. It is cheap and easy to use. Zheng Ren also often uses this medicine.

As for other medications...

After the operation, sugar saline + VC was used, which was used to replenish and urinate, and to metabolize the contrast agent as soon as possible.

Metoclopramide?

Zheng Ren saw the patient on the first day after surgery, and he was relieved. Also looked at the course record, which clearly recorded the patient's stomach due to postoperative nausea and intramuscular injection.

Metoclopramide, the drug name is metoclopramide, a few cents a lot, for bloating dyspepsia, loss of appetite, belching, nausea, vomiting also have a good effect.

After liver cancer intervention, most patients will have similar symptoms, so metoclopramide is especially used.

However, Zheng Ren searched several related reports, which are cases of extrapyramidal reactions caused by metoclopramide.

The drug process is caused by blocking the dopamine receptor, causing the cholinergic receptor to be relatively paralyzed and causing an extrapyramidal reaction. This complication is not common, so there is some scratching on the face and I dare not diagnose it immediately.

Zheng Ren shut down the workstation and stood up and went outside.

"Zheng boss, have you read it? There are other information about the patient." The little doctor who came with Zheng Ren asked.

"Yeah." Zheng Rendao, "The reason has been found."

"..." The little doctor snorted, so fast? Don't even look at other tests?

Look at this Zheng boss is not very old, seems to be smaller than himself, will it be nonsense.

However, he did not say anything, just keep up with Zheng Ren's footsteps and start to introduce the condition.

"There was no problem before the patient. I checked a head CT yesterday and I didn't find the cavity."

"It is not a cavity stem, it is an extrapyramidal reaction."

"Hey?" The little doctor looked confused Interventional department rarely encountered this rare nervous system reaction, I don't know it is normal. The knowledge of the entire medical system system is vast, or else the division is becoming more and more detailed, because normal people are difficult to fully grasp, and they can only go in the direction of careful classification.

Zheng Ren did not explain too much with him, found the reason, and treated it normally, and he and Mu Tao said it.

Quickly came to the ward, the neurology doctor is also asking about medication.

"Old Mu, stop the stomach, and the condition can be alleviated." Zheng Rendao.

"Considering the extrapyramidal reaction caused by metoclopramide?" The doctor of neurology seems to judge this too, and immediately asked.

"Yeah." Zheng Ren nodded.

"I went to see a doctor's advice." The neurologist ran to the office as a smoker, and Zheng Ren saw her hurriedly, smiling slightly.

"Zheng boss, do you judge that it is caused by metoclopramide?" Mu Tao is still somewhat uncertain.