Chapter 909： Interview consultation

"Yes." Zhao Yunlong said.

He then picked up the phone and sent a WeChat to the doctor on duty, letting the echoed pictures and reports come over.

After a few minutes, the phone rang, he glanced and handed the phone to Zheng Ren.

In the CDFI report, the patient's tricuspid regurgitation beam area was greater than 8 square centimeters and was a severe tricuspid regurgitation.

Pulmonary arterial pressure and other indicators are abnormal, but not consistent with tricuspid regurgitation.

This is indeed a bit strange.

Generally speaking, the heart valve is like the door arch of the old house door. When it is opened, it will be pulled back to avoid blood reflux.

In this case, because the elderly are weak due to muscle atrophy, the arch of the door is aging, resulting in the most prolonged valve closure.

If young people are common, they are common in congenital heart disease, infection, intravenous drugs, and so on.

Zheng Ren also asked about the patient's medical history, without any of the above related medical history. This is also the strange point of Zhao Yunlong, so I am going to discuss the interior of the department tomorrow.

A disease that cannot be understood cannot be brought directly to the stage.

Once on the operating table, if there are any diseases that are not found, the surgeon will face more trouble. This point as an old surgeon, Zhao Yunlong will not understand.

I would rather not go to the stage, but also to understand all the circumstances.

Therefore, he is very cautious.

Su Yun also looked at his eyes, and countless questions wandered around his heart. This patient is really abnormal.

I don't want Zhao Yunlong not to drink too much. If it is tomorrow's rounds of ward rounds and department consultations, Zhao Yunlong is a hangover, and he can't be blamed by the big director.

"Is the other test sheets coming out?" Zheng Rentuo meditated and suddenly asked.

"I let the other side pass all the pictures." Zhao Yunlong said.

This time, Zhao Yunlong directly built a group, and the doctor on duty sent the pictures to the group.

Looking at the test list, Zheng Ren and Su Yun are finally honest.

Especially Su Yun, the forehead black hair is faintly moving without wind, as if the brain is running at high speed, resulting in a slight change in air flow.

Zheng Ren took a look at the report and immediately found the problem.

Patients not only have changes in cardiac steatosis, but also severe fatty liver, and the liver is larger on the B-mode than the normal one.

This is strange.

The patient is only in his thirties. Even if he drinks alcohol and eats a lot of fat meat, it is difficult to have severe fatty liver and cause the liver to become bigger.

This is the same as the tricuspid regurgitation, which is not a problem for young people of this age.

Zheng Ren thought hard, compared with various data, after a small ten minutes, he slowly said: "Check a blood acyl carnitine spectrum test tomorrow."

"Well?" Zhao Yunlong stunned.

"According to the patient's test value and your clinical symptoms, I suspect it is a primary carnitine deficiency." Zheng Rendao: "Myocardial disease, lipid deposition myopathy, fatty liver, plus the patient's blood sugar is only 3mmol / L, can be approximated."

Zhao Yunlong is somewhat confused. This disease is known, but he has never seen it in the clinic.

Su Yun thought thoughtfully, after thinking for a few seconds, he asked: "Can the SLC22A5 allele be detected in the hospital?"

"Yes, but it takes time."

"Is there a similar situation in the patient's home?"

"When asked about the medical history, the patient's narrative is unknown. I have already let the patient's father and mother come over. I will ask you face to face tomorrow." Zhao Yunlong's clinical work has done a few meticulous, Su Yun can think of it, he can also think of it, and early Just arranged.

"The boss said yes, consider the primary carnitine deficiency, do not recommend surgery, intravenous left a card for a period of time, and then have been oral can be. Yes, the boss." Su Yun asked.

"Yeah." Zheng Ren nodded.

This is a fatal disease, but as long as it is discovered in time, supplemented by diet and L-Carnitine, the quality of life will not be affected.

"Free carnitine is significantly reduced, if less than 10μmol / L, plus a variety of acylcarnitine reduction, it can be basically judged." Zheng Rendao: "When the return of the isogenic test, it began to supplement the left card, the symptoms will be alleviated. ”

Listening to Zheng Ren and Su Yun, I have a sentence to solve the doubts of Zhao Yunlong’s heart. Fang Lin has some emotions.

Emperor's cardiothoracic surgery tomorrow's star, it is not white. Su Yun can diagnose, he is not surprised. However, this diagnosis was given by Zheng Zongxian, and then Su Yun reversed and found a few basis.

General Zheng is indeed very strong.

Regardless of right or wrong, it is enough to be able to ask for the next step, and to try and solve it step by step. Many people, including themselves, look at these test sheets, all of which are dew.

"Old Zhao, I will go to Tibet, will you drink or not?" Su Yun asked.

"There are things in Minger." Zhao Yunlong insisted.

"Cut, disappointing."

"Who knows that such a patient is coming up today." Zhao Yunlong simply did not pay attention to Su Yun's contempt, and it seems that he is used to it. He is pondering the patient's condition, the more he wants Zheng Ren to say the more right.

It is highly likely that there is a deficiency of primary carnitine. After the use of L-carnitine, the symptoms of tricuspid regurgitation will be alleviated and no surgery is needed.

This is early detection, if it is a few years or ten years, or an acute outbreak of the patient, metabolic acidosis plus hyperammonemia, it may be that people directly disappeared even if not No, if you do treatment later, the possibility of cure is not great.

This disease is similar to diabetes and requires long-term medication. However, long-term use of L-Carnitine seems to be nothing compared to complications.

After eating for a while, after a "seat consultation", everyone's interest was also low. In particular, Zhao Yunlong refused to go to a Tibetan drink, Su Yun felt boring, and talked about it, and it was scattered.

They each called the car home.

The night was shrouded and the lights were dim. Zheng Ren sat in the car and took out his mobile phone. He reported to Xiaoyi that he was going to go back.

The Xie Yi and Chang Yue have been lying down, and they are in the water.

Chu Yuran was on duty tonight, Haicheng received a car accident and was being rescued in emergency surgery. She didn't have time to water, it was Chu Yuzhi who told everyone.

"Boss, tomorrow, guess how many people will come to see you doing TIPS surgery?" Su Yun suddenly asked.

"Who knows." Zheng Ren does not matter.

"I guess someone will invite you to the lecture tomorrow. Are you ready?"

"I don't need it at all, I need to go. You are on the other side, it is true to prepare the agreement."

"The agreement is no problem, the lecture fee and the money of the flying knife, what do you think?"

"Oh..." Speaking of money, Zheng Ren is really not prepared. But he knows that free things are generally not cherished.

Want to promote the learning of TIPS surgery as soon as possible, there are still several nodes on his side that did not get through. Then there must be detailed measures to improve the enthusiasm of other hospital doctors, so that they can apply TIPS surgery to the clinic as soon as possible.

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