Chapter 981: Extrapyramidal Reaction
Translator: EndlessFantasy Translation Editor: EndlessFantasy Translation
The two live broadcasts of the surgery ended very quickly.
Mu Tao was very regretful. The time he had been back was still too short. He had taken in more patients than the Imperial Capital. Initially, he thought that six patients was already quite a lot, but now that he had tasted it, he really wanted to have 60 patients to practice on so he could mature as soon as possible.
Unfortunately, there was still plenty of time in the future.
Zheng Ren took off his lead jacket and changed his clothes. He looked at the time and said, “Old Mu, go down and take a look at the patients. I’ll be leaving soon. You can send me the information of the patients in this surgery after you’re done.”
“It’s really too rushed. I was going to treat you to a very authentic Cantonese dish,” Mu Tao said.
He knew that Boss Zheng did not like to eat. It was like this in Pengxi Village. Su Yun was picky and told Chief Jiang what he wanted to eat. Zheng Ren, on the other hand, seemed to have only eaten one meal. Su Yun even said that he was like a dog licking a plate.
Because of this, this Boss Zheng gave people a feeling that he was difficult to interact with. Teaching TIPS surgery was such a big deal, yet he did not even have the chance to express his gratitude.
Moreover, Mr. Zou from the Zou family in Xiangjiang was still waiting for him. He did not even show his face.
Mu Tao looked at Zheng Ren’s simple and honest face and was slightly stunned.
“It’s okay. I’ll just buy a few hamburgers on the way,” Zheng Ren said casually. “I’ll go down to take a look at the patients, and then I’ll leave. On your side, come and do the second-stage surgery again. I don’t think I need to come again.”
“Don’t!” Mu Tao quickly stopped Zheng Ren’s words. “It was just the first time. I’m still vague about some of the problems. In a while, I’ll do a few of them myself and gather more than ten patients. Please come again.”
“Think more about the key points of the second-stage surgery,” Zheng Ren exhorted. “You can’t be rough. You have to be skillful. I’ve already told you the main techniques, so the rest is just surgery practice.”
“Okay,” Mu Tao responded.
After changing their clothes, Zheng Ren, Mu Tao, and the Professor returned to the ward and prepared to check on the patients.
As soon as they entered the ward’s entrance, they saw a nurse pushing an ambulance gurney and running at full speed.
Zheng Ren’s heart suddenly tightened. Was this a rescue?!
Under normal circumstances, the Department of Interventional Medicine did not accept emergency treatment. If it was a rescue, it would be a patient who vomited blood due to portal hypertension after they had been hospitalized.
He forgot that he was going to the airport to return to the Imperial Capital after seeing the patient. Out of habit, he followed the nurse to the ward.
Elder Wu was in the ward directing the rescue. A doctor was doing a physical examination while the nurse was busy monitoring the ECG. Zheng Ren did not have an angle, so he did not see the System panel for the time being.
This patient was not one of the post-operative patients of the TIPS surgery. Mu Tao came in after him. He was stunned for a moment before he exchanged a few words with Elder Wu.
Zheng Ren heard about the patient’s condition from the side. It was two days after the liver cancer intervention. On the first day, he had a tremor in his right upper limb. He did a related check-up, but there was no problem. Today, the condition worsened and there was an acute dystonia.
Zheng Ren looked at an angle and saw the patient’s scan on the system panel.
It was red with a bunch of diagnoses written on it. Zheng Ren looked at them one by one and deleted the unimportant ones. He saw a very rare diagnosis; he seemed to have extrapyramidal reaction.
This is…
Extrapyramidal reaction is a part of the human body’s movement system. Its main function is to regulate the muscle tension and the coordinated movement and balance of the muscles.
This regulation function depended on the dynamic balance of the neurotransmitter dopamine and acetylcholine in the central nervous system. When dopamine was reduced or acetylcholine was relatively increased, the symptoms of cholinergic hyperactivity could appear.
There were many symptoms of extrapyramidal reaction. Zheng Ren did not consider this for the time being. Instead, he quickly searched for related diseases and drugs in his mind that could cause extrapyramidal reaction.
Under normal circumstances, neurodrugs could cause this reaction, but it was not common.
“Old Mu, did the patient take anti-anxiety drugs or hibernation pills before the surgery?” Zheng Ren asked.
“No.” Mu Tao frowned as he looked at the physician who was consulting him. “The patient took entecavir and antihypertensive drugs before the surgery. There was nothing special. After the surgery, he was given a group of magnesium isoglycyrrhizinate injection to protect his liver. There was nothing else.”
“I’ll go check on the doctor’s orders,” Zheng Ren said.
Mu Tao did not dare to leave. He asked a doctor to take Zheng Ren to see the doctor’s orders while he stayed in the ward to participate in the emergency treatment.
When he came to the office and opened the workstation, Zheng Ren began to look for drugs that might cause extrapyramidal reactions.
The doctor’s orders were very clear and precise. A magnesium isoglycyrrhizinate injection was also a commonly used liver-protecting drug in the clinic. It was cheap and easy to use. Zheng Ren also often used this drug.
As for the other medicines…
After the surgery, he used sugar, salt water, and VC. This was used to replenish fluid, make the patient urinate, and let the contrast agent metabolize as soon as possible.
Could it be gastric remission?
Zheng Ren saw that on the first day after the surgery, the patient had gastric remission. He was finally relieved. He looked at the course of the surgery again. It clearly recorded that because of the patient’s postoperative nausea, gastric remission was injected into the muscle.
Gastric remission. The medicine was called metoclopramide. It was a few cents per dose. It also had a good effect on gastric distension dyspepsia, loss of appetite, belching gas, nausea, and vomiting.
After interventional surgery for liver cancer, most patients would have similar symptoms, so gastric remission was especially commonly used.
However, Zheng Ren found a few related reports. They were all cases of gastric remission causing extrapyramidal reaction.
The drug’s efficacy process was due to the blocking of dopamine receptor choline receptor, which caused extrapyramidal reaction. This complication was not common, so they all scratched their heads and they did not dare to diagnose it immediately.
Zheng Ren closed his work station, stood up, and walked out.
“Boss Zheng, have you finished reading? There are other information about the patient here,” asked the junior doctor who came with Zheng Ren.
“Yes,” said Zheng Ren. “The reason has been found.”
“…” The junior doctor was stunned. So fast? He did not even need to look at other laboratory tests?
Judging from Boss Zheng’s age, he seemed to be younger than him. Could it all be nonsense?
However, he did not say anything. He just followed Zheng Ren’s footsteps and began to introduce the patient’s condition.
“The patient did not have any problems before the operation. Yesterday, a head CT scan was performed, but there was no lumen infarction.”
“It’s not a lumen infarction. It’s an extrapyramidal reaction.”
“What?” The junior doctor looked confused.
The Interventional Department rarely encountered such a rare reaction of the nervous system. It was normal for them not to know. The entire medical system had a vast amount of knowledge. Otherwise, the division of the department was becoming more and more detailed. It was because it was difficult for normal people to fully grasp it. They could only walk in the direction of detailed classification.
Zheng Ren did not explain much to him. Once he found the reason, he would treat it normally. He could just tell Mu Tao about it.
He walked quickly to the ward. The doctors from the Department of Neurology were also asking about the medication situation.
“Old Mu, stop the gastric remission. The condition can be alleviated,” Zheng Ren said.
“Are you thinking that the extrapyramidal reaction was caused by the gastric remission?” the neurologist seemed to have made the same judgment and immediately asked.
“Yes.” Zheng Ren nodded.
“I’ll go take a look at the doctor’s orders.” The neurologist ran to the office. Zheng Ren saw that he was in a hurry and smiled.
“Boss Zheng, are you sure that it’s caused by gastric remission?” Mu Tao was still a little uncertain.