Chapter 1759： Esophageal dilatation

"Nothing, old man." Zheng Ren pulled the old man's vein channel and lifted him from the ground.

"Sit down and have a break, your illness is diagnosed." Zheng Ren said with a smile.

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

Look at that, he is really afraid to diagnose himself as a mental illness. So that he looked at Zheng Ren's eyes are not right, faintly hostile.

"Swallowing or swallowing syncope is a rare type of nerve-mediated syncope that is associated with life-threatening slow arrhythmias and hypotension, and is often difficult to diagnose in time." Zheng Rendao: "After tilt test, it is a problem of vagus nerve." ""

"The old man did not understand a word.

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

"Daddy, you said you, hurt?" Su Yun came to Qi Yingjie and helped him up. He said in a complaint: "Give your father a diagnosis, what mess you have there."

"呃" 栾 Yingjie painfully licked his wounds, crying and laughing.

"You almost killed your dad. Just now, you didn't see it. It's okay to add anything." Su Yun continued to scythe.

"I am sorry." Ying Yingjie did not know why he was kicked, but he said sorry.

But my father, who is sitting on the side, seems to be a bit strange.

It’s not a bad thing to look down and recognize you!

"This disease, the next pacemaker." Zheng Rendao: "Double-chamber pacemaker, you can eat whatever you want after you finish."

"I have no problem with my heart." The old man wondered, "Where is the ECG? What is the pacemaker?"

"Your heart is no problem, but when you eat, the esophagus expands, involving the vagus nerve, there will be a few seconds of cardiac arrest." Zheng Ren smiled.

The old man still does not believe, but because Zheng Ren did not say that he is mentally ill, his attitude is much better.

The elderly in this age, some believe in everything, some do not believe, it is obvious that Ying Yingjie's father belongs to the latter.

After all, it is surgery, the surgery of the lower pacemaker is small, and it is surgery.

Zheng Ren smiled and apparently he considered this.

"The elderly, do not want us to do this." Zheng Ren said very gently: "If you do not agree with the pacemaker, you can do it tomorrow, let the boss take you to the hospital tomorrow, take a 24-hour dynamic ECG."

"Ok?"

"One day, you can find the problem." Zheng Rendao, "Let's find some experts to see, let's make a decision, how?"

This said, the old man feels very comfortable.

I definitely said the diagnosis, but I didn't force myself to make a decision. Instead, I asked for another check and carefully looked for other people to see more. This little doctor, will be a good person.

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

"If that's okay, then we will leave." Zheng Rendao, "Hey boss, if you decide to operate, come to me. Unlike normal surgery, you should test the esophageal swelling and the impact on the heart during surgery."

"Okay, okay." Yan Yingjie saw Zheng Ren and Su Yun get up, and he quickly stood up.

The legs were soft and fell to the ground.

"If you look at you, you can't be careful. How old is it, if you have a broken bone, what should you do?" Su Yun did not help, but sprayed it.

Yan Yingjie smiled, this is not what you are jealous of.

"You are welcome, we are gone." Zheng Ren saw the babysitter to help Qi Yingjie, turned and left.

"Zheng boss, what was the situation just now?" Zhou Litao asked.

"Zhou Zong, take your ambulance back to the hospital and pull us for a while." Su Yun said happily.

"Nothing is ok, what was the situation just now?" Zhou Litao has been entangled in the disease of patients who are comatose when eating.

"The inhibition of esophageal dilation on the heart is a potential pathophysiological mechanism of syncope in patients. This case is reported on rssr." Zheng Rendao: "The author also reported 101 cases of swallowing or swallowing syncope reported since 1793. The combing summary."

In 1793101 cases, Zhou Litao was speechless.

"This kind of syncope is common in men and the elderly. The average age of the cases is 575. The 545 patients will cause syncope if they eat anything, whether it is water or solid food." Zheng Rendao: "Generally, it is an esophageal disease." Induced."

"It turned out to be like this." Zhou Litao silently wrote down the patient's situation. He felt that the paper on the chest that recorded Zheng's just-conceived paper exudes heat and makes himself a little excited.

"The implanted pacemaker is the most commonly used treatment. Patients with 981 have a pacemaker and report a reduction in syncope symptoms. More than half of the patients have a permanent pacemaker." Zheng Rendao: "So proof of high probability , pacemakers are still useful."

"Lower pacemaker" Zhou Litao pondered the role of the pacemaker.

"The second is the treatment of gastrointestinal diseases, such as 4 patients with repaired hiatal hernia. There are also patients with successful vagus nerve ablation, long-term use of proton pump inhibitors and surgical radical surgery for esophageal cancer."

"I just scared me." Zhou Litao turned against the smell at this time, touched his chest, and he was still worried.

"Not afraid Zheng Ren smiled: "Look at your first aid kit with atropine, there is no big problem with this medicine. ”

"Ok?"

"Atropine is commonly used before the appearance of pacemakers. Limited data indicates that the efficacy is up to 90." Zheng Rendao, "If you want to observe the five minutes, and see how low the patient's blood pressure can be lowered, push a team directly. Atropine, 15 seconds effective."

"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 make atropine." Zheng Rendao, "The patient's condition is still a good fit. It's good."

"Boss, you can really hold your breath. My psychological bottom line is 40 mm Hg. I can't help you if you don't speak." Su Yundao, "but I was anxious, and I felt a lot better."

"Don't be so violent." Zheng Ren said, "You are not afraid of something going wrong?"

"I also saw Atropine. There is atropine in, how can something happen. Besides, I am a doctor, defibrillation, pressing, one hundred ways to save him back, afraid of swearing!" Su Yundao.

Zhou Litao is a little bit small.

At the time, I was really confused.

Although it is known that the tilt test is positive, it may be dangerous, but it has not been encountered after all, and the diagnosis is much worse than Zheng Bo and Yun Geer.

Still the basic level is not enough. Going back to nothing is going to read more books. Zhou Litao thought of it.