When doctors have a simulated operating room

The food was so delicious that it was not easy to eat.

At noon, Zhang Yi, who was eating in the cafeteria, almost lost his chopsticks!

Oh my goodness!

It's finally here after two days of waiting!

And I got another million as a reward! !

Haha!

Now Zhang Yi has almost four million on his account~

Oh my!

I'm the millionaire, I'm the millionaire~!

So cool~!

"Zhang Yi? What are you grinning at? Are you in love?"

Chen Fang saw Zhang Yi was in a daze while eating, and poked him with his elbow.

Zhang Yi immediately put away his smile:

"In love? Haha, being in love won't make me laugh so loudly."

Hearing the words "in love"

The female colleagues who were eating together all pricked up their ears.

Su Jingjing, the nurse who had given chocolates, asked boldly:

"Doctor Zhang, you have been in the hospital for quite a while, why haven't you dated anyone?"

"That's right, if you want to date, I'm happy to accompany you!"

Another female nurse next to him said.

Zhang Yi quickly lowered his head to eat:

"I'm not interested in women."

Women:...

What? !

Could it be...? ?

Next to him, several male doctors immediately looked at Zhang Yi with surprised eyes.

Even their bodies and the plates in their hands quietly moved outward.

No way...

Zhang Yi doesn't like...

Don't think too much!

We are extremely straight men!

Zhang Yi rolled his eyes at several male doctors and said:

"What are you thinking about? I'm not interested in men either!"

At this stage, he is only interested in money.

Love and affection are not as solid as looking at the money in your bag.

"Huh~"

After hearing Zhang Yi's words, the men breathed a sigh of relief.

After lunch, Zhang Yi and Chen Fang worked in the emergency clinic.

As soon as he sat down, Zhang Yi received a WeChat message from Zhao Yuting:

"Doctor Zhang, I will take the college entrance examination in 20 days... I am a little nervous..."

Zhang Yi replied to her:

"Relax, you will definitely be able to get into a good school with such good grades."

"But I am still nervous, Doctor Zhang, can you encourage me?"

Zhang Yi was just about to send a simple word of encouragement.

A patient walked into the door of the clinic.

Zhang Yi put down his phone.

It was a high school boy in school uniform who was pushed in a wheelchair.

There was a middle-aged couple behind him, who should be his parents.

Zhang Yi took a closer look and found that his right thigh was swollen.

It turned out to be rhabdomyolysis syndrome!

He became serious in an instant.

"Does your leg hurt?" Zhang Yi asked.

The boy pointed to his right thigh and said:

"Yes, my leg hurts... It hurts a lot..."

Zhang Yi: "When did it start to hurt?"

The boy: "Yesterday."

Zhang Yi: "Try to lift your leg? Can you use some strength?"

The boy gritted his teeth and lifted his leg, but it took him a long time to lift it a little bit.

And his expression was very painful.

Zhang Yi quickly asked him to relax, and then asked:

"Did you do any strenuous exercise or get injured?"

The boy said with a sad face:

"I don't know, I played basketball with my classmates the afternoon before yesterday, and then I felt a little uncomfortable yesterday morning.

At first I didn't care, thinking that my legs might be a little sore after not playing for a long time...

But when I woke up this morning, I felt that the pain was not like the soreness after exercise at all...

It hurts too much! And... and... I..."

The boy suddenly became a little embarrassed.

"Just tell me if you have any questions. We are doctors and will definitely help you solve them."

"I... my urine is very dark."

Zhang Yi nodded, and now he understood.

Myalgia, muscle weakness, dark urine triad.

It can basically be diagnosed as rhabdomyolysis syndrome.

On the side, Chen Fang frowned and asked:

"How dark is the color? Is it as dark as soy sauce?"

"No, it's a little... a little lighter."

The boy was a little shy.

His father patted him gently and said:

"Don't be embarrassed since you have come to the hospital. If you have any discomfort, you must tell the doctor clearly, understand?"

The boy nodded: "It's just leg pain and dark urine, and I feel a little uncomfortable. There's nothing else."

Chen Fang understood at this time.

He glanced at Zhang Yi and said:

"Is it rhabdomyolysis caused by muscle damage after exercise?"

"Yes."

Family

She asked nervously:

"Doctor, what's wrong with my son? What's the dissolution? Is it a big problem? Will it have any impact on the future?"

"Don't be nervous, I'll explain it to you.

We initially suspect that your son's problem is rhabdomyolysis syndrome.

What does rhabdomyolysis syndrome mean?

It means that after strenuous exercise or infection, muscle damage dissolves, and a large amount of myosin in the muscle will enter the blood after dissolution.

Human blood needs to circulate, so this large amount of myosin will circulate through the blood. Then it came to the kidney.

Think about it, the renal tubules and glomeruli in the human kidney are very small.

They can only maintain normal metabolism. If you have too much myosin, the kidneys will definitely not be able to excrete it.

If it can't be excreted, it will naturally be blocked in the kidneys, increasing the burden on the kidneys.

So the color of your urine will become darker.

Fortunately, you came early, and it hasn't turned into soy sauce-colored urine.

If it's later, the protein in the kidneys will accumulate more and more, and the kidneys will be overloaded and easily cause acute renal failure, which will be dangerous. "

"Ah?!"

The family members were shocked when they heard it.

They didn't really understand the explanations before.

But they understood the last sentence.

If you come later, you may have acute renal failure.

They still understand renal failure.

So they were scared immediately.

"Doctor! How should my son be treated? Is it easy to treat? Does this... require surgery?"

The family members cherish their son tightly.

They keep asking questions if there is any sign of something wrong.

Zhang Yi was not annoyed. He patiently wrote out the checklist and handed it to them, saying:

"First draw blood and test urine to see if creatine kinase is high. Don't worry, as long as the treatment is timely, it can be cured."

The family member took the checklist with confidence and took his son out for a checkup.

More than half an hour later.

The family member came back with several checklists.

Zhang Yi took a look.

The white blood cells, neutrophils and so on were fine.

But creatine kinase was as high as more than 300,000!

Creatine kinase: 321946 (normal 25-200U/L)

Creatine isoenzyme: 2866 (normal 0-20U/L)

Lactate dehydrogenase: 13281 (normal 109-245U/L)

Myoglobin: 4003 (normal 28-72U/L)

Creatine kinase, creatine isoenzyme, and lactate dehydrogenase are all enzymes present in muscles.

Generally, they will not increase.

It will only increase if there is muscle damage, inflammation, drug reaction, etc.

It is a must-check item for rhabdomyolysis and myocarditis.

Myoglobin only exists in striated muscle and myocardium.

Generally, only necrotic muscle will release myoglobin into the blood.

After reading the examination form, Zhang Yi did not hesitate.

He immediately prescribed a large amount of infusion.

This disease requires a large amount of fluid to flush out the protein substances accumulated in the kidneys.