Chapter 2159： Good intentions to do bad things

"Does menstruation have an effect on pneumothorax? Is it related to pneumothorax and menstrual period?" Su Yun looked at Zheng Ren with doubt.

Zheng Ren is also in a daze.

Menstrual pneumothorax has this statement, but most of them are related to endometriosis. If it is endometriosis...

Zheng Ren stunned, is it a menstrual pneumothorax? !

This disease is so rare that Zheng Ren did not think about it at all.

"Boss, if the endometriosis, will be based on the right pneumothorax, menstrual seizures, but ... Lao Shao, the patient has 7 operations, several times on both sides?" Su Yun asked.

"4 times on the left and 3 times on the right." Shao Jinghe replied immediately.

"That should not be." Su Yun frowned, said very quiet.

He has no bottom in his heart, and the subconscious is not sure that it is a spontaneous pneumothorax caused by endometriosis.

Zheng Ren suddenly stood up and went to the front of the reader and looked at the image.

Shao Jinghe was stupid, and he looked at Fang Lin with an eye-catching look and was at a loss.

Fang Lin has not encountered this disease, although knowing the menstrual period of pneumothorax, but that thing will not even test the exam.

If the examiner takes the test, it is estimated that he will be beaten.

"The endometrium migrates to the pleura and the surface of the lungs. When the menstrual cramps occur, they fall off. Because the pleura is very thin, it is easy to cause damage, causing air to enter the pleural cavity from the lungs, forming a pneumothorax, and symptoms occur." Zheng Ren said. I think about it.

It is like talking to himself, and it seems to be a conversation in one of the worlds.

"The diaphragm is fine."

"Well, unlike the problem of the diaphragm." Zheng Ren looked at the film. "General menstrual period pneumothorax is accompanied by diaphragmatic damage..."

After he said it, he asked him: "Old Shao, if I didn't understand it correctly, what you just said is that every time the patient is guilty of pneumothorax, it is menstrual period, and the menstrual period is still very long, the amount is relatively large, so is it? ""

Shao Jinghe nodded again and again.

Although he did not know what the boss of Xiao Zheng was thinking, he could still answer the most basic questions.

"Oh..." Fang Lin didn't look at the film, but looked at Zheng Boss, some speechless.

"Diagnosis of menstrual pneumothorax." Zheng Ren said with certainty, "There are four criteria for diagnosis."

"..." Fang Lin suddenly looked at Zheng boss, just said, is it wrong?

"First, the spontaneous rupture of the lung bubble."

"Second, the contraction of the menstrual period is uneven, which causes the gas to enter the uterine cavity and enter the abdominal cavity through the fallopian tube. At this time, the ectopic endometrium of the diaphragmatic muscle is detached, the diaphragmatic channel is open, and the gas enters the chest cavity and occurs."

"Third, the ectopic endometrial shedding of the visceral pleura causes the lungs to leak."

"Fourth, prostaglandin-induced bronchigioconstriction or alveolar rupture caused by a one-way valve mechanism due to bronchial endometriosis."

Zheng Ren began to tell the story of one, two, three, four, five, not only Shao Jinghe, even Fang Lin heard the clouds in the fog.

"There is endometriosis, diagnosed as menstrual pneumothorax, in line with the 1 and 3 criteria." Zheng Rendao.

"But..." Shao Jinghe wanted to say something, but in the end he did not say anything.

"The diaphragm has a problem." Su Yun added, "a small gap, only a small gap in the abdominal pressure will increase, resulting in ectopic endometrial recurrence."

"once again……"

"Going further, falling directly into the lungs. Finally, it erodes the visceral pleura during the physiological period, resulting in a spontaneous spontaneous pneumothorax."

"Yeah." Zheng Ren nodded. "Old Shao, have you observed the diaphragm during surgery?"

"No……"

Shao Jing and Hao Ran, doing pneumothorax surgery, nothing to observe what the diaphragm is doing.

"Well, during surgery, single-chamber ventilation, carefully look for the position of the diaphragm, it is estimated that there is a small gap. Forget it, or laparoscopic to pressurize, the pressure can be seen in the chest can see gas."

"Zheng boss, Yun Geer, go up and see together?" Fang Lin has no bottom.

"It's as if you don't have a second-line professor." Su Yun sprinkled a word.

That is to say, but to prevent him from coming to power, it is absolutely impossible. Such a rare menstrual period pneumothorax, do not go up to take a look, Su Yun has to fight with Fang Lin.

The patient has no problem with fasting water time, and the bill of lading is operated on. There was still half an hour of preparation time before surgery, and Zheng Ren and Su Yun went directly to the operating room.

"Boss, it is said that the muscles of the diaphragm are very developed, and there are few problems. Is it a congenital problem?" Su Yun asked.

"It is possible to go and see it." Zheng Rendao, "Repairing the diaphragm, and taking the chorionic hormonal release hormone after surgery, should be good soon."

Su Yun suddenly remembered one thing. He looked at Shao Jinghe and asked: "Is the previous surgery and postoperative pathology done?"

"..."

In a word, Shao Jinghe gave a foolish look.

It is said that all the cut things should be sent for pathological examination, such as the appendix, there may be 1-2 malignant changes in a thousand.

Because the period of pathological diagnosis is long, the cost is expensive for some families, so many of the pathological examinations are refused.

Doctors, especially those in lower-level hospitals, rarely force patients to do pathological examinations. The patient who came to 912 did not say this to the patient's family at all. After the pathological examination, it was natural.

This is a difference between the local small hospital and the top three hospitals in the Royal Capital.

This patient is a spontaneous pneumothorax. The diagnosis is very clear. There is basically no problem with the lung bullae that has been cut during the operation.

At least Su Yun has never seen it.

It is estimated that Shao Jing and Dr. Shao are also considered this way. He should not have a pathological examination.

Sure enough, Shao Jing and Yan said: "Nothing."

"Old Shao, your work is too indecent." Su Yun said, "Do it once, even if only once, this will not happen. You..."

"Cloud brother, not like that." Shao Jinghe almost cried, and quickly said: "The patient's home is not very rich, I did not dare to use titanium clips during the surgery, are hand-stitched. The pathology has paid back is also one - - I don't think it makes sense to change the bullae."

Zheng Ren sighed and shook his head slightly.

Checking is such that is unlikely to have problems. Once a problem occurs, such as the current situation, it may cause misdiagnosis and missed diagnosis.

This is the standard good deeds to do bad things.

But then again, even if Shao Jinghe did a pathological examination, the specimen was sent to the pathology department, and it was estimated that the doctor on the other side was crazy.

The pathological examination of the bullous bullae conforms to the microscopic condition of the endometrium, and no one in the local hospital dares to diagnose.

When I take the pathological slice to the higher level hospital for diagnosis, I still have a toss.

Basic hospitals can do the right diagnosis and treatment for common diseases, which is already very good.

As for rare diseases, there is no such thing as a decade or two. Even if you learn a dragon slaughter, it is useless.

......

......

(Seeking for the heart, asking for a monthly ticket.)