When doctors have a simulated operating room

The boy's mother was stunned: "What? Hyperthyroidism or paralysis?" She obviously couldn't believe it.

"My child eats well and sleeps well at home, how could he have hyperthyroidism?"

Zhang Yi explained: "It's not entirely because of food. Poor rest or trauma, cold, infection, mental stress, etc. can all be inducing factors, but You have hyperthyroidism hypokalemic periodic paralysis, which is more serious and complicated than hyperthyroidism. This disease is divided into primary and secondary.

Primary means hereditary, and someone in the family has had this type of potassium-deficient periodic paralysis. Paralysis, so your son also has it.

Secondary means that hyperthyroidism causes hypokalemic periodic paralysis. Your case belongs to the latter. You can take potassium supplements and anti-thyroid treatment at the same time. "

"Doctor, is my son's problem serious? Ah? Will it affect his studies? "

The boy's mother asked worriedly.

"It's okay, it's a mild case, just take potassium supplements to fight acetylcholine, and it will be fine after it's cured, don't worry. "

Zhang Yi began to give medical advice:

C Thiouracil is taken three times a day, 100 mg each time. (Inhibits the peroxidase system in thyroid cells)

Methimazole 10 mg three times a day. (Inhibits the synthesis of thyroxine (T4) and triiodothyronine (T3))

The best and safest way to supplement potassium is oral administration. (A large amount of potassium supplementation in a short period of time will cause high blood pressure and cardiac arrest, which can be fatal!)

However, in order to relieve the boy's symptoms of weakness as soon as possible.

In addition to prescribing medication, Zhang Yi also gave him an order for intravenous potassium supplementation.

Take half of a 10 ml tube of 10% potassium chloride and take 5 ml, add 500 ml of 5% glucose, and drip it with a micro pump.

The uniform drip time for each gram of potassium chloride is more than 30 to 40 minutes.

While supplementing potassium, closely observe the urine Measure and test blood potassium concentration.

As long as the drip rate and amount of intravenous potassium supplementation are controlled and the patient's vital signs are observed, it will be fine.

Of course, Zhang Yi also told him to eat more foods containing potassium, such as kelp, mushrooms, and celery. , leeks and so on.

The boy's mother took the infusion order and went to the infusion room next door with the boy.

…

At noon.

Zhang Yi went to the cafeteria to eat and came back to see that the boy was already full of energy.

As expected, once the blood potassium level went up, the whole person became energetic. After a short lunch break, I continued to see patients in the afternoon.

The first patient at noon was a pregnant woman.

Zhang Yi saw that her belly was about 25 weeks.

But her problem had nothing to do with obstetrics, but a problem with her appendix.

Pregnant women The husband carefully helped her to the stool and said:

"Doctor, my wife has a stomachache, I want to check her quickly to see if there is anything wrong with the baby."

Appendicitis during pregnancy is also a very tricky thing.

Zhang Yi asked After a few words, he immediately wrote a prescription and asked the pregnant woman to do B-ultrasound and blood draw.

After a while, the two came back with the examination list.

B-ultrasound showed: the appendix was swollen and thickened, the wall was thickened by 2mm, the serosal layer was rough, and the echo was enhanced.

Blood routine showed that both white blood cells and neutrophils were high.

These two high levels indicate inflammation.

"It's appendicitis, but you're more than six months pregnant now. If the appendix is ​​not resolved, it may cause you to have a threatened miscarriage or premature birth. If it's more serious, it may endanger your life.

So my suggestion is to have surgery to remove it as soon as possible. Appendectomy, otherwise the baby can't be saved.

However, the operation requires anesthesia, which will also harm the baby.

Of course, our doctors must first ensure the safety of the mother, and then consider the fetus. "

Hearing Zhang Yi say this, the pregnant woman hurriedly shook her head: "No! I finally got pregnant... I can't do it! Doctor, please help me, I want to keep the baby, I want to keep the baby no matter what, do you think there is any way to avoid surgery? Or... Or can we do the surgery without anesthesia?"

Before Zhang Yi could say anything, his husband behind the pregnant woman frowned and said firmly:

"Doctor, don't listen to my wife! I want to save the adult, the child is fine I will think about it later, but I must ensure my wife's safety first!"

Zhang Yi thought that a bloody drama of saving the young but not the older would be staged.

But I didn't expect to meet true love?

Zhang Yi nodded: "Don't worry, the doctor's purpose is to ensure the life of the mother first in critical situations."

"No! No no! I don't want it! I want the baby!"

The pregnant woman Say while picking up

She hammered the man behind her.

Zhang Yi interrupted the two:

"The question now is not whether to have a child or not, but you must do the appendectomy. If you don't do it, it will easily lead to miscarriage, and you will also be in danger.

And this operation must be done under general anesthesia. You said you don't want anesthesia?

Do you know how painful it is? Severe pain will cause uterine muscle contraction, which will aggravate miscarriage.

Anesthetics do have an impact on children, but there is no other way at present.

You can only do it under general anesthesia to remove the appendix."

The pregnant woman's husband comforted her:

"It's okay, my wife. If it doesn't work, the child will be gone. We will try to have another one. But if you delay it any longer, you will be in danger. If I let you choose, I will definitely choose you. You are more important than anyone else!"

"Woo woo...husband...but I don't want to lose the child...it has been in my stomach for so long...it kicked me a few days ago...husband, I don't want to lose the child...what should I do?"

The pregnant woman started crying as she spoke.

"Don't cry, my wife, I will always be with you!"

The two snuggled together.

Completely ignoring Zhang Yi and Chen Fang, two singles...

Chen Fang: I'm not a single! I have a wife~

Zhang Yi: ...I'm OK!

For a mother, a child is a part of her life and a piece of her heart.

For the surgery to affect the child, but not having the surgery will make you lose the child, which is a tangled and dilemmatic choice.

It really makes the pregnant woman not know what to do.

Is there no way to save the child without affecting the child?

She wiped her tears, looked up at Chen Fang and Zhang Yi and asked:

"Doctor, is it really necessary not to use anesthesia? I don't want to lose my child and I don't want the anesthesia to affect the child. Is there any other way? I am willing to do anything as long as it is possible!"

Chen Fang looked at the young couple and sighed:

"There is no other way. You'd better do the operation as soon as possible, otherwise the child may not be saved."

"But...but anesthesia will affect the child...what if it is born with deformities in the future..."

As the pregnant woman spoke, crystal tears flowed from her eyes.

Both results were what she didn't want to see.

"Doctor, I was born with a thin uterine wall. This is my first child and may also be the last...I really love my husband and I really want to have a child for him.

I beg you to help me. Is there any other way for me to have the operation and ensure that the child is not affected?

Please, think of a way...please...

This may be the only child in my life...I beg you..."

The pregnant woman's voice became hoarse as she spoke.

Revealing a deep despair.

Just then.

Zhang Yi, who had been frowning, suddenly became enlightened.

He thought of a way!

A way to save the child and minimize the impact of anesthesia on the child!