When doctors have a simulated operating room

Chapter 286

The doctor said that the patient was very sick.

"Don't worry, some diseases are really hard to treat, and the effect of the medicine varies from person to person. Don't worry, I'll help you first."

After Zhang Yi comforted the family, he turned his head and glanced at the old lady in the wheelchair.

The old lady's hands were indeed in a state of tremor.

The shaking hands made the whole right half of her body restless.

"Where are the previous examination sheets and case materials? Let me see, and what medicine did she take?"

Zhang Yi asked Dr. Li in the clinic.

"Here are the data." The doctor handed a stack of medical records on the table to Zhang Yi and then continued: "I prescribed Madopar, Ciloxan, Amantadine, and Entacapone, all of which are the medicines for this disease."

This doctor Li was also confused.

The medicines he prescribed were all correct. Levodopa preparations, anticholinergic drugs, and Amantadine all have an improvement effect on hypokinesia, rigidity, and tremor.

There is nothing wrong with the medicine.

So he couldn't figure out why the old lady didn't see any effect from taking this medicine.

It just so happened that he heard from the emergency department a few days ago that Zhang Yi could even treat Parkinson's disease, so Dr. Li specifically asked Zhang Yi to come and see the situation.

At this time, Zhang Yi stared at the patient's medical records and examination forms in his hand, and combined with the list of medicines he prescribed, he found that the medicine he prescribed was indeed fine.

Since there was no problem with the medicine, the problem was probably with the old lady herself.

Only a very small number of Parkinson's patients were ineffective with the medicine, that is, the shock-reducing medicine did not work.

Levodopa preparations also cannot make patients produce more dopamine.

Therefore, for patients who are ineffective with drugs, surgery is the only option.

Zhang Yi put down the medical records and some examination sheets, turned around and examined the old lady again.

What a coincidence!

This old lady also has abnormal discharges of neurons in the lateral nucleus of the thalamus!

What a coincidence! !

It just so happens that he has already scored full marks in stereotactic surgery!

I don’t know... Is this family willing to perform surgery on the old lady? ?

After the examination, Zhang Yi raised his head and said:

"I looked at the examination sheets and the medicine. The medicine prescribed by Doctor Li is completely fine. Maybe the old lady has physical reasons and the medicine is not absorbed well, or the drug treatment is ineffective.

That's why her tremor symptoms have not improved.

And you said that she can't even go to the toilet independently now, right? This means that the old lady's condition is still getting worse."

The three family members looked nervous.

"What should we do, doctor? Will this disease make her completely unable to take care of herself in the future?"

"How can the medicine not work? I feed my mother medicine on time every day."

The family members were very emotional, and Zhang Yi quickly comforted them:

"Don't worry, everyone. In addition to medicine, there is another solution to this disease, that is, surgery."

As soon as this was said, everyone in the clinic looked at Zhang Yi.

"Surgery?!"

"Can this disease be operated on?"

The family members must not know that this disease can be operated on, because stereotactic surgery actually still has many sequelae.

There are very few completely successful examples in China.

Especially this kind of surgery involving cranial nerves.

Even if there are successful examples, they are only in those large hospitals ranked in the country.

And basically, a whole team of experts are involved to achieve success.

A small hospital like Tianhe, stereotactic surgery? ? Don't even think about it!

Chen Fang and Dr. Li from the Department of Neurology were stunned on the spot!

Chen Fang: Damn! When did you even perform Parkinson's surgery? ! ?

Doctor Li: Assistant Zhang, you mean he can do stereotactic surgery? ?

Just as I thought of this, I heard Zhang Yi say:

"I looked at the examination list. The old lady has a problem with the nerve cells in the subthalamus near the striatum, which causes abnormal discharge, so her hands keep shaking.

Originally, drugs can alleviate this symptom, but now the drugs are ineffective, so we have to consider surgery.

The name of this operation is stereotactic ventrolateral thalamic nucleus lesion for Parkinson's disease.

It means using multi-layer rays to find the specific location of abnormal discharge in the old lady's brain, which we also call the target point. Use modern medical technology to accurately find this target point, and then use micro-electrodes to shoot this target point.

In this way, the old lady's tremor will be relieved a lot, and it will last for at least five years."

The three family members opened their mouths slightly.

What the doctor said is so complicated! !

They are old and have never studied medicine, so how can they understand...

It was a man in his early fifties among the family members who asked:

"What are you talking about? Doctor, just tell me how much my mother's surgery will cost."

"Okay, let me tell you straight. The examination fee alone, that is, the machine to confirm the target, may cost five or six thousand.

The operation is also very difficult. In total, the surgery and hospitalization will cost about 60,000 yuan."

"Ah? 60,000 yuan!"

"60,000 yuan... Oh... So expensive."

Several family members were shocked and looked at each other, and no one spoke.

60,000 yuan is also a big burden for these children who already have families and even grandchildren.

Zhang Yi saw that the family members seemed to have some difficulties, so he said:

"You can take your time to think about this operation, and you don't need to rush. You can tell me after you have considered it."

The uncle nodded quickly:

"Okay, okay, let's... go out and discuss it for a while, you guys go do your own thing."

After that, the three family members pushed the old lady out to discuss.

In the clinic, Chen Fang came up impatiently as soon as the family members left:

"Oh my god! Zhang Yi, you can do stereotactic surgery?"

On the side, Dr. Li asked curiously:

"But I remember that our hospital seems to have never performed stereotactic ventrolateral thalamic nucleus lesion surgery. Even the director of neurosurgery may not be able to do this operation, and our hospital doesn't even have a stereotactic head frame, right?"

Zhang Yi looked at the two of them helplessly and said:

"No stereotactic head frame? Can't you just buy it now? Why worry about this?

The director of neurosurgery can't do it? I can do it!"

Hiss!

Doctor Li immediately gave a thumbs up: You are awesome, Zhang Yi!

"But Zhang Yi, this operation is very risky, and there are so many sequelae." Chen Fang was a little worried.

This operation involves deep in the brain.

It is easy to fail if you are not careful.

Although Chen Fang has never done this kind of operation.

But he has read a lot of papers and materials, and this kind of operation is very difficult.

The requirements for the radiation equipment are also very high.

It is best to find the target with an accuracy of more than 99.9%, otherwise it cannot be considered a precise strike.