sbdcsierra Chapter 256
Chapter 256
Chapter 256
“Doctor Lin, what’s the matter?”
The patient Li Shasha felt something wrong with Lin Feng’s face.
Lin Feng: “I just thought of another disease, which is very similar to your symptoms.”
Lin Feng told Li Shasha about “cat scratch disease”.
“Or, do a biopsy…”
This mass may not necessarily be a lymph node, it may also be a tumor, or it may be caused by cat scratch disease…
Regardless of the nature of the mass, pathological biopsy is the most reliable.
“What is a biopsy?”
Li Shasha asked tremblingly, as soon as she heard this word, it was not a simple matter.
“Biopsy means cutting a bit of tissue for testing.” Lin Feng explained.
“Ah? Does it hurt? Is it troublesome? Surgery?” Li Shasha worried.
“Just take a little tissue test, there will be anesthesia, there will be no pain.” Lin Feng laughed.
“Doctor Lin, is the cat scratching disease serious?”
“Don’t worry about this. Basically, they are benign diseases. Most of them will get better by themselves. For a few months, it is really impossible to take antibiotics…” Lin Feng comforted.
This time,
Li Shasha breathed a sigh of relief.
This cat scratch disease is easier to accept than tumors and HIV.
…
the next day,
The results of various inspections are coming out one after another.
·The blood routine is almost normal, and the white blood cell count has not increased significantly, unlike ordinary infections.
(Inflammation will cause the white blood cells to rise.)
· The r gland related examinations are all negative and there is no sign of r adenocarcinoma.
· There are 3 swollen lymph nodes in the axillary area, and the largest one is 2cm in size 970.
Then, there are only 3 possibilities:
·Cat scratch disease
·Lymphoma
·Hiv
Need to wait for further tissue inspection, HIV pathogenic antigen inspection results.
This patient Li Shasha is just an ordinary patient of Lin Feng, and Lin Feng will not pay much attention.
…
afternoon.
Lin Feng goes to P class.
Continue treatment.
A patient in his 40s knocked on the door and walked into Lin Feng’s clinic.
This uncle is very special at first glance.
Because he raised his right hand, facing Lin Feng in an awkward posture.
People’s attention was placed on his right hand at once.
His right hand, thumb abduction, little finger and ring finger flexion.
“Claw hand?”
Lin Feng said subconsciously.
“Claw hands” are not martial arts such as dragon grasping hands or eagle grasping hands.
It is a medical term.
Because of the injury, most of the adductor muscles of the hand are paralyzed, resulting in weakened grip, unstable holding, and inflexible movements.
In addition, the ring finger and the end of the little finger cannot be flexed, and the little finger cannot be abducted. The injured hand showed thumb abduction.
The specific image is the shape of the gripper.
It is the most typical manifestation of “ulnar nerve injury”.
The patient sits down.
“Doctor Lin!” Uncle patient greeted respectfully.
“Tell me, what’s the problem?” Lin Feng asked with a smile.
“Since three months ago, I started to feel a little numb in my hand, and I couldn’t even hold the chopsticks securely. Until now, I have no sense at all. You can help me see what the problem is.”
The uncle looked worried and worried.
You must know that for a few months without sensation in his right hand, he couldn’t do any work.
I thought it was just a cramp, so I should rest for a while.
Never thought, it is getting worse now.
He is really worried that he will be disabled!
So I can only go to the hospital to see it.
“show me……”
Reach out,
Lin Feng grabbed the patient’s right hand and shook it slightly.
Obviously, the muscle is already in a state of atrophy…
I checked the other symptoms again, and it was indeed very similar to the grasping hand.
“Have you been injured before?”
“Yes, I really work on the construction site and hit my hand again…”
“when?”
“Four months ago… my hand, it seems that it became like this 3 months ago…”
This time, the patient reacted.
It must be caused by the last injury!
but!
The place where it hits the hand is on the upper right arm!
How did the injury go where the palm went?
Strange!
“I presume that it should be an open rupture of the ulnar nerve, but you have to do an “EMG” check before you can confirm it. ”
Lin Feng said truthfully.
“An open rupture of the ulnar nerve, is this serious?”
When the uncle heard this, he was taken aback.
“If the diagnosis is confirmed, you must be prepared for the operation. After all, the open ulnar nerve ruptures will affect the function of your arm. If the muscles are completely atrophy, even if the operation is performed, it will not be able to fully recover… However, it cannot be delayed. of!”
Lin Feng opened a list to the patient.
As soon as he heard that his arm might not be protected, the uncle hurriedly took the “EMG” sheet and ran for the examination.
As for the cost of surgery…
This uncle is the captain of a company’s engineering team, and his wife is also a middle-level white-collar worker for more than 20 years, so he still has a little deposit.
after an hour,
The result of the EMG test is out!
The examination results suggest that the motor conduction of the right median nerve disappears, and the CMAP amplitude of the motor conduction of the ulnar nerve decreases…
Translated: damage to the lower trunk of the right brachial plexus, and damage to the median nerve of motor conduction is heavier than that of the ulnar nerve…
(From the right arm, it starts to spread!)
Confirmed:
Open ulnar nerve (aicc) rupture!
In other words, surgery is to be done!
And start from the right arm.
Instead of the right palm.
“Would you like to find other doctors for surgery…”
“Doctor Lin, will you do this operation?”
“I will……”
This operation is not easy, but for Lin Feng, it is so~easy!
“Then you don’t need to find other doctors, I believe Doctor Lin!”
The uncle’s eyes were full of trust.
Lin Feng is happy.
“Okay, go to the hospital, complete the examination, and then ask your family to come over and arrange the operation tomorrow…”
“Okay, thank you Doctor Lin!”
…
…
the next day
The result of a tissue biopsy of the patient Li Shasha came out.
·Not cat scratch disease!
·Not a lymphoma!
Now, all possibilities have been ruled out! !
The HIV, which was originally the least probable, has now become the most probable! !
However, the HIV test is very slow… Even if it is urgent, it will be out tomorrow.
“Is it really HIV?”
“impossible!”
this moment,
Li Shasha almost broke down and regretted it.
She checked the tragic condition of those HIV patients online, and she shuddered!
Angrily, she called the man who had acted uncleanly and cursed for half an hour.
As a result, the man was also frightened.
Without further ado, rush to the hospital for an examination.
Both young men anxiously awaited the result.
It’s just onenight, is this winning?
Waiting for results is painful and painful, especially waiting for HIV-related results.
Li Shasha had trouble sleeping and eating, especially after her knowledge of Thousand Degrees, she found that her disease was similar, and that her disease was also compatible, and she was under a lot of mental pressure.
But at this time, she didn’t dare to tell her family or her girlfriends…
Only oneself was hospitalized in the hospital.
…
at this time,
Dr. Lin didn’t have much time to pay attention to this patient.
Because,
The operation of “open rupture of the ulnar nerve” began today.
Open injury of the ulnar nerve is also a more difficult operation among the fourth-level operations.
To be precise, it is an orthopedic and surgical operation.
So when Lin Feng had this operation
Orthopedics, neurosurgery… Doctors all came to watch.
…
3:00 pm
The patient is pushed into the operating room…
·Operation:
disinfect……
anaesthetization……
After successful anesthesia,
Lin Feng stepped onto the operating table.
“let’s start!”
“Scalpel!”
first step,
Open the surgical field…
Lin Feng made a longitudinal incision at the location of the lesion shown on the “EMG” of the patient’s right arm…
The incision is immediately upwards along the inside of the pecking brachialis muscle…
The sharp scalpel flashed a little bit of cold light, and then the deep fascia was cut longitudinally along the medial edge of the pecking brachialis…
Immediately afterwards, both hands were inserted into the incision in the patient’s arm, freeing the muscle tissue…
The musculocutaneous nerve is close to the distal end of the pecking brachialis…
“Retractor!”
Retract the pecking brachialis muscle and the musculocutaneous nerve anteriorly and laterally…
Cut the median nerve and the thin sheath around the ulnar nerve…
The surgical field of vision is beginning to be exposed!
Expose the medial tract and ulnar nerve located behind the medial nerve!
The whole operation process was as smooth as silk.
Many onlookers: experience +100+100+100…
Lin Feng’s hands seem to be magical and fascinating.
Every time I watch Lin Feng’s operation, I feel a sense of enlightenment!
Especially for those new interns, they feel countless clinical experiences, as if they were stuffed into their minds forcibly.
…
Next step,
free!
. .