Chen Wenqiang was on the night shift, and Li Min showed him all the tests for pituitary adenoma that he got in the afternoon."
Teacher, if this patient is not operated on in our department, there is no point in her continuing to be hospitalized."
Chen Wenqiang carefully looked through all the examinations and said, "I'll take the time to talk to them again tonight."
If they are still hesitant, they will be discharged tomorrow morning.Hmm, these inspection materials can be made by Lu Qing to give them a copy to take away. ”"Yes."
It was probably the effect of Chen Wenqiang talking to the couple again, and the two came to Li Min at about eight o'clock in the evening."
Dr.
Li, we have decided to operate.My daughter-in-law will leave it to you and Dean Chen. ”"It's decided?""
yes.We won't hide it from you, Dr.
Li, we have been to these hospitals in the province that can open the craniotomy.The danger of craniotomy is too great, so we put it off again and again. ”"The Affiliated Hospital of the Medical University can't be a craniotomy, right?""
It's not.But we have to queue up, and whoever is in charge of the bed is the one who does the surgery. ”Li Min smiled knowingly.For the general public, hospitalization is not a doctor who is randomly assigned to manage the bed, and then the person who is in charge of the bed is in charge.Of course, there are special cases - that is, the condition is so critical that the doctor in charge of the bed can't take it down, so he can only ask the senior doctor or even the director to help.This is also the fundamental reason why the chief of surgery can say everything in Cory."
Since you want to have surgery, I'll explain the dangers of surgery to you first.""
Doctor Li, you say.""
Any operation requires anesthesia, and the first hurdle is that anesthesia may cause accidents.""
Accident?""
yes."
Li Min accidentally told the couple about the anesthesia, and the two of them obviously retracted again."
If you go to any hospital for surgery, the surgeon will ask you to sign a consent form.The first is anesthetic accidents.It's very rare, but I can't help but tell you.Well, you will come to me in half an hour, and I will write a written opinion of all the accidents that may arise during the operation and all the circumstances that should be communicated to you.If you sign your consent to the surgery, I will let Dean Chen know.It is estimated that the surgery will be scheduled for the day after tomorrow.If you are still hesitant before 11 o'clock tomorrow morning, I will discharge you.Although you husband and wife should think about it, her illness can't be delayed.Besides, living in a hospital like this costs a lot of money, doesn't it?
”"Yes, yes."
The couple helped each other and left.
*"Mr.
Li, do you think the patient will be discharged from the hospital?"
”Fu Yunxiang asked boldly.Yang Yu and the four interns all followed Li Min at this time.Because Li Min obviously protected Fu Yunxiang, the boy did not reject her in front of Li Min."
That's not exactly.However, the patient's condition was almost at the point where surgery was necessary.Fu Yunxiang, why do you have to do it?
”Fu Yunxiang hesitated for a moment and said: "The patient has a headache, a loss of vision, and the symptoms have worsened significantly. ”"Yes.So two months ago, she could go to other hospitals to be hospitalized and discharged.Now the disease is not allowed to progress.If she tosses for a while, once she has intratumor hemorrhage, necrosis leads to pituitary apoplexy......
By the way, what do you mean by pituitary stroke?
”Li Min asked, pointing to another intern.The intern hesitated and said, "If there is an infarction or hemorrhagic necrosis in the pituitary gland, it is a pituitary apoplexy, right?"
”"You add it."
Li Min pointed to another intern."
I think it's a pituitary apoplexy if there is infarction or hemorrhagic necrosis on the basis of a pituitary adenoma."
The student was clever enough to take the patient's profile into account.Li Min nodded and didn't ask Yang Yu.She was afraid that Yang Yu was not as good as these two boys."
When we are in neurosurgery, let's talk about the specialty.Acute infarction or hemorrhagic necrosis occurs on the basis of a pituitary adenoma, resulting in hypopituitarism with headache and neuroophthalmic symptoms, which may be called pituitary apoplexy.But pituitary apoplexy is not limited to pituitary adenoma. ”Yang Yu raised his hand.Li Min gave him a chance."
Yang Yu, you say.""
Obstetric hemorrhage can also cause pituitary infarction, which is also a pituitary apoplexy."
After all, Yang Yu has gone through clinical practice, and his horizons are much broader than those who have just started their internship."
Yes.Massive obstetric bleeding can cause pituitary apoplexy.Some vascular lesions can also be caused.As for which vascular lesions are, you can go to the library and check it yourself.In fact, pituitary adenomas are the most common cause of pituitary stroke.Pituitary apoplexy based on pituitary adenoma is often characterized by acute onset, often accompanied by headache, vomiting, visual field defects, oculomotor nerve palsy, sellar enlargement and other manifestations, which is called acute hemorrhagic syndrome of pituitary adenoma. ”"Is this patient at risk of pituitary apoplexy?"
Fu Yunxiang asked again.Li Min nodded slightly."
The patient's condition is dangerous, and Dean Chen has repeatedly informed himself and his family in the past few days.Fu Yunxiang, I didn't let you meddle in writing this medical record, because I was afraid that you would make something wrong and neglect something when you recorded it.It's also worried that she will have an accident when she is dangling on this edge. ”Li Min said and worried about the patient: "The patient and her husband are indecisive.This kind of personality will also be encountered in the clinic in the future.When I was an intern, my instructor told me that I can't make ideas for people with such a personality.Because once there is a result that is not what they expect, whoever takes the idea for them will have to bear all the complaints.and even being complained. ”Several of the interns' eyes widened."
Isn't this kindness not rewarded?
I have seen all the examinations of that patient, and she is really the case that Teacher Li said should be operated on immediately. ”"It's okay to look at her just now.""
She can, too, spinning on the edge of a cliff.How long can I stand on the cliff, I don't dare to pack a ticket.Maybe a month or two, maybe a week or two. ”Fu Yunxiang took a deep breath and said with emotion: "It's not just a day or two, an hour or two. ”"That's what I hope so too.If she really has emergency symptoms, we will be busy with her tonight's night shift. ”Li Min nodded in agreement with Fu Yunxiang's words.Yang Yu reminded: "You can't say this on the night shift." ”"I'm not afraid.Her name is good, good luck.I don't know if a few of you have noticed, Puwai's work has been going well in the past six weeks, otherwise how could Director Liang look at her differently. ”The two boys looked at each other, good luck!
That's a good name, but what does it have to do with the success of general surgery in the past six weeks?
Fu Yunxiang blushed and lowered her head embarrassedly.* The boy who began to answer the question said, "Mr.
Li, the pituitary apoplexy we just talked about, even if it happens, it may not have clinical symptoms. ”"Yes."
Li Min nodded as she wrote the consent form for the surgery."
But it's been delayed for a long time, and when she wants to have surgery, she must do an MRI again."
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Fu Yunxiang was approved by Li Min just now, and she spoke boldly."
I know that they have a very strict control over their medical expenses.If it weren't for the tumor in her head, the employer would not have allowed her to be admitted to the hospital three times a year, and she would have to do a full set of examinations every time. ”Fu Yunxiang said this because she had done a lot of communication with patients and their families in the past two days.Yang Yu finished writing the consent to the operation while they were talking."
Teacher Li, do you see what I wrote?"
Li Min's own share has just begun.She took the one written by Yang Yu, read it carefully, added a line of words, and handed it back to Yang Yu."
Very nice.Neurosurgery is basically about informing the patient about this. ”Then Li Min emphasized: "You don't have to call me a teacher. ”Yang Yu insisted: "I learned a lot from you, and it is right to be called a teacher."
There are a lot of things you talked about that I didn't come into contact with during my internship. ”Li Min smiled and said nothing, Yang Yu argued, and lowered his head to write his share.As for Yang Yu saying that he had a lot of things that he didn't come into contact with during his internship, this is also normal.The provincial medical school is a junior college, and the internship teaching point hospital that can be selected is naturally not as good as the internship point of the medical university.Yang Yu seems to have worked really hard for the past month and a half.But no matter how comprehensive he writes, there will be no handwriting of anyone other than himself and Chen Wenqiang in this medical record.I am a total hospitalizer and live in Corey 24 hours a day.At present, there are very few patients in neurosurgery, and it is perfectly possible to do all the work by yourself.Even if the interns wanted to keep a record of the course of their illness, Li Min asked them to write another medical record.She will carefully check and revise them, and will not let them leave traces on her official medical record.
*Li Min prepared the surgical consent form and sat in the office while reading the book and waiting.Wait until the lights are about to go out in the ward.The couple came to Li Min."
Dr.
Li, we agree to the operation.Can you sign it now?
”"Don't worry.You two read this first.If there's anything I don't understand, I can explain it to you. ”The man smiled bitterly and said, "Doctor Li, we were hospitalized in the first hospital of the city at the beginning of the year, and they also wrote so.We all get it. ”"Oh.Then you write the following sentence: I have been informed of all the above-mentioned surgical accidents and postoperative complications, and I agree to the operation.Write your spouse, your name here. ”The man hesitated again with the pen."
Doctor Li, are these all accidents impossible to happen?""
It's an accident, it can happen.Otherwise, it wouldn't make sense for me to write this for you to sign. ”Li Min didn't urge him, he had been waiting all night, and he couldn't really encounter any accidents in the end, so they complained that they were urging him to sign and didn't think about it at all.Minutes and seconds passed.The second hand of the electronic clock outside, combined with their breathing, became very clear in the still night.The man looked at Li Min who was silent with blank and helpless eyes, and then looked at his wife who trusted him with a face full of trust, and he felt that the pen in his hand weighed a thousand pounds.Pick it up, put it down.Pick it up again, put it down again.He turned his eyes to look at Li Min again, but saw Li Min hanging his head, and his eyes should have fallen on the lock of the drawer.He closed his eyes and gritted his teeth, and finally put down his pen, shaking his hands to finish writing what Li Min requested.Then he turned around and took his wife's hand and said, "I signed it at the beginning of the year, and you will suffer less for half a year."
It's all my fault, it's all me, it's all me. ”His wife remained silent and allowed him to clench her hands.After standing for a long time, she silently turned to leave, and the man finally took his futile and continuous string of "blame me, blame me." ”Left the office.Li Min put the surgical consent form in the medical record with mixed feelings.※※※※※※※※※※※※※※※※※※※※* Cowardly people, indecisive people, they don't know what's right, they just lack the **pituitary gland size of about 1.3x0.9x0.6 cm and the weight of about 0.6 grams, which is the size of a medium dehydrated kidney bean.It is the most important endocrine gland in the human body.The function is to secrete a variety of hormones, such as growth hormone, thyroid-stimulating hormone, adrenocorticotropic hormone, gonadotropin, oxytocin, prolactin, melanocytostimulant, etc., and can also store antidiuretic hormone secreted by the hypothalamus.It is the key to regulating the healthy balance of the body.Once a functional pituitary tumor or hypofunction of the pituitary gland appears, the secretion of the above-mentioned hormones will be changed, and the human body will also have corresponding pathological changes.Such as: diabetes insipidus; postpartum hypopituitarism; galactorrhea and amenorrhea-galactorrhea syndrome; dwarfism (too little secretion of growth hormone in childhood); gigantism (excessive secretion of growth hormone in juvenile years); There is also acromegaly (excessive secretion of growth hormone in adults) and so on () which is a bit far away