Chapter 980 Extrapyramidal Reaction

The two live broadcast surgeries will soon be over.

Mu Tao is very sorry that the time he came back is still too short, and the number of patients admitted is much less than that of the imperial capital. At first, I thought that 6 patients would be a lot, but now I really want to have 60 patients to practice and mature as soon as possible.

It's a pity that we have to come to Japan for a long time.

Zheng Ren took off the lead jacket, changed his clothes, glanced at the time and said, "Old Mu, go down to see the patient, and I'll be leaving. You can send the patient's information to my email after you finish it."

"It's too hasty. I was going to treat you to a very authentic Cantonese meal." Mu Tao said.

He knew that Boss Zheng didn't like eating very much, which was the case in Pengxi Township. Su Yun picks and chooses, and tells Director Jiang what he wants to eat. But Zheng Ren seemed to have only eaten one meal, and Su Yun said it was like a dog licking the plate.

Because of this, Boss Zheng seems to be very difficult to deal with. For such a big thing as teaching TIPS surgery, I didn't even have a chance to express my gratitude.

Moreover, Mr. Zou from the Zou family in Xiangjiang was still waiting for him, and he didn't even show his face.

Mu Tao looked at Zheng Ren's somewhat honest face, and was slightly taken aback.

"It's okay, just buy a few burgers on the way." Zheng Ren said casually: "I'll go down to see the eye patient, and I'll be leaving. On your side, come for another second-stage operation, and I guess I won't have to come again."

"Don't!" Mu Tao hastily stopped Zheng Ren's words, "Just once, I'm still vague about some questions. After a while, I'll make a few machines myself, and gather a dozen more patients. Please come here again."

"Let's think about the main points of the second-stage surgery." Zheng Ren warned, "Don't be rude, but be clever. The main techniques have been mentioned, and the rest is surgery practice."

"Okay." Mu Tao responded.

After changing their clothes, Zheng Ren, Mu Tao, and the professor returned to the ward, ready to check on the patient.

As soon as I entered the gate of the ward, I saw a nurse pushing the ambulance and galloping.

Zheng Ren's heart tightened suddenly, is there a rescue? !

The interventional department generally does not accept emergency services. If it is rescued, it is also a patient who vomits blood due to portal hypertension after hospitalization.

He forgot about the fact that the patient was going to the airport to return to the imperial capital after seeing the patient, and followed the nurse quickly to the ward out of habit.

Mr. Wu was directing the rescue in the ward, a doctor was doing a physical examination, and the nurse was busy with the electrocardiographic monitoring. Zheng Ren has no angle, and has not seen the system panel for the time being.

This patient was not one of the postoperative patients of the TIPS operation. Mu Tao then came in, was stunned, and exchanged a few words with Mr. Wu.

Zheng Ren was listening to the patient's situation, 2 days after liver cancer intervention. On the first day, the right upper limb trembled, and related examinations were performed, and no problems were found. The condition worsened today, with acute dystonia.

Zheng Ren looked for an angle and saw the patient's system panel.

Red, with a bunch of diagnoses written on it. Zheng Ren looked over one by one, deleted the unimportant ones, and saw a rare diagnosis - extrapyramidal reaction.

This is……

The extrapyramidal system is an integral part of the human motor system, and its main function is to regulate muscle tone, coordinate movement and balance of muscles.

This regulatory function depends on the dynamic balance of the neurotransmitters dopamine and acetylcholine in the regulation center. When dopamine decreases or acetylcholine increases relatively, symptoms of cholinergic hyperactivity may appear.

There are many symptoms of extrapyramidal reactions. Zheng Ren didn't think about this for the time being, but quickly searched for related diseases and drugs that could cause extrapyramidal reactions in his mind.

In general, neurological drugs can cause this reaction, but it is not common.

"Old Mu, did the patient take anti-anxiety drugs or drugs like Dongmianling before the operation?" Zheng Ren asked.

"No." Mu Tao frowned and watched the consulting physician doing a physical examination, "The patient took entecavir and antihypertensive drugs orally before the operation, nothing special. After the operation, he was given a group of magnesium isoglycyrrhizinate injection to protect the liver, and nothing else .”

"I'll go see the doctor's order," Zheng Ren said.

Mu Tao didn't dare to leave, and asked a doctor to take Zheng Ren to see the doctor's order, while he stayed in the ward to participate in the emergency treatment.

When he came to the office and clicked on the workstation, Zheng Ren began to look for drugs that might cause extrapyramidal reactions.

The doctor's order was very clean. Magnesium Isoglycyrrhizinate Injection was also a liver-protecting drug commonly used in clinical practice. It was cheap and easy to use. Zheng Ren also often used this drug.

As for other medications...

After the operation, sugar saline + VC was used, which is used for rehydration, urination, and to metabolize the contrast medium as soon as possible.

Metoclopramide?

Zheng Ren saw that the patient took metoclopramide on the first day after the operation, and he finally felt relieved. I read the course record again, which clearly recorded that the patient was given intramuscular injection of metoclopramide because of postoperative nausea.

Metoclopramide, the drug is called metoclopramide, and costs a few cents a piece. It also has a good effect on flatulence indigestion, loss of appetite, belching, nausea, and vomiting.

After interventional liver cancer, most patients will have similar symptoms, so metoclopramide is especially commonly used.

However, Zheng Ren searched for several related reports, all of which were cases of extrapyramidal reactions caused by metoclopramide.

The drug action process is due to the blockage of dopamine receptors, which makes the cholinergic receptors relatively hyperactive, leading to extrapyramidal reactions. This complication is uncommon, so some scratching my head over there, afraid to diagnose right away.

Zheng Ren closed the workstation, stood up and walked outside.

"Boss Zheng, have you finished reading? There are other information about the patient here." The little doctor who accompanied Zheng Ren asked.

"Yes." Zheng Ren said, "The reason has been found."

"..." The little doctor was taken aback, so fast? You don't even need to look at other laboratory tests?

Seeing that Boss Zheng is not very old, he seems to be younger than himself, could it be nonsense.

But he didn't say anything, just followed Zheng Ren's footsteps and began to introduce his condition.

"The patient had no problems before the operation. A CT scan of the head was performed yesterday, and no cavity was found."

"It's not a cavity stem, it's an extrapyramidal reaction."

"What?" The little doctor looked confused.

The interventional department rarely encounters this rare nervous system reaction, and it is normal not to know. The knowledge of the entire medical system is vast. Otherwise, the divisions are becoming more and more detailed, because it is difficult for normal people to fully grasp, and they can only go in the direction of detailed classification.

Zheng Ren didn't explain too much to him. After finding out the reason, he treated it normally, and he just talked to Mu Tao.

Walking quickly to the ward, the neurologist is also inquiring about the medication.

"Old Mu, stop metoclopramide, and the condition will be relieved," Zheng Ren said.

"I think it's an extrapyramidal reaction caused by metoclopramide?" The neurology doctor seemed to think so, and immediately asked.

"Yes." Zheng Ren nodded.

"I'll go see the doctor's order." The neurologist rushed to the office, Zheng Ren smiled slightly when he saw her hurrying.

"Boss Zheng, do you think it was caused by metoclopramide?" Mu Tao was still a little uncertain.