Back in 2002 as a doctor

Page 451

Hearing what Zhou Congwen said, Xiao Kai felt his heart burn, and immediately asked, "Professor Zhou, please briefly explain what the disease is."

"Congwen, suddenly getting old is because the body function can't keep up." Shen Lang interjected, "Is it premature aging? It doesn't seem to be the case, only the face changes, what is that?"

Chapter 0773 The old boy

"There is a disease called thick skin and thick periosteum syndrome, have you heard of it?" Zhou Congwen asked.

Xiao Kai looked bewildered, Shen Lang and Li Ran shook their heads, Peng Yiming didn't seem to notice this at all, he ate happily on his own.

Seeing their expressions, Zhou Congwen knew that Xiao Kai and others had never heard of it.

It is also a very strange and rare disease in itself, and I have never heard of it being normal.

"This disease is also called pachyderm periostosis, and it can be divided into primary type and secondary type.

The primary hair type is more common in men. The clinical manifestations are thick skin on the face, forehead, and head in wrinkled shape, hypertrophy of limb bones and phalanx joints, clubbing of fingers and toes, pain in limbs, and clumsy movements.

Secondary patients are more common in women after middle age, with insignificant skin changes and obvious bone lesions.Mainly symptomatic treatment. "

Listening to Zhou Congwen's explanation, Xiao Kai compared what he saw with what he saw, and suddenly slapped his thigh, "That's right, the child looks clumsy when walking, like a child who has just learned to walk, and it was said that someone stabbed him with a needle! So It makes sense to think about some weird things at home."

"Well, the pain in the limbs is basically a neurological symptom. Coupled with the clumsy movement, and what you said before, it can be roughly judged to be thick skin and thick periosteum syndrome."

Xiao Kai looked at Zhou Congwen speechlessly.

Zhou Congwen blurted out the difficult-to-pronounce disease of thick skin and thick periosteum syndrome, which made Xiao Kai inexplicable.

The key point is that Zhou Congwen is not talking nonsense, and the symptoms he said match the patient.

An extremely rare disease that has troubled himself, his patients, and their families for many years is actually so simple in Zhou Congwen's view.

Although Zhou Congwen was not very sure and insisted on seeing the patient before speaking, Xiao Kai knew that his diagnosis was definitely correct.

Because Zhou Congwen not only mentioned aging, which he said, but also mentioned limb pain and clumsiness.

It must be thick skin and thick periosteum syndrome.

The more Xiao Kai thought about it, the more he admired him, but every time his eyes fell on Zhou Congwen's young and energetic face, he would feel an unbelievable sense of astonishment.

Such a wealth of clinical experience, such a high level of diagnosis and such a young age...

Just now Zhou Congwen said that he was very tired when eating with Mr. Huang. Could it be that they usually talk about all kinds of weird illnesses?

This is too professional, there is no fireworks in the world.

Xiao Kai can't imagine such a life at all, and he has no interest in this kind of life at all.

Life is short, why spend your whole life on work.

"Dean Xiao, please comfort the family." Zhou Congwen said, "Since there is a diagnosis, don't panic."

"Professor Zhou, can this disease be cured?"

"Have you ever heard of a saying-if you don't make a decision, you will be immune to rheumatism."

"I heard..." Xiao Kai sweated profusely.

"Go to the Rheumatology and Immunology Department for treatment." Zhou Congwen smiled, "As for the creases on the face, they can be smoothed by surgery. It's not difficult."

"Can it return to normal?" Xiao Kai asked nervously, "Is the cost high?"

"Generally speaking, a large part of it can be recovered. As for the cost...it depends on who will do it. However, that is something to do later, and the diagnosis will be confirmed first. This disease is a disease that cannot be cured, but it will not continue when it reaches a certain age. If it gets worse, it can be maintained, so don’t worry too much.”

It won't get worse, it won't get worse, which is more or less good news.

Xiao Kai quickly stood up, apologized to Zhou Congwen, put on his clothes and walked out of the hotel with his mobile phone to make a call.

"Congwen, there is no diagnosis of this disease." Shen Lang looked at Zhou Congwen suspiciously and asked.

"A rare diagnosis, which is not included in the fourth edition of clinical diagnostics. Besides, there are so many diseases, and it is enough to learn some common diseases when you are in school. Why do you learn this if you have nothing to do. You may not see a case in your life. Why bother. "Zhou Congwen said lightly.

"But how do you know?" Shen Lang objected.

"I've seen something similar...it's written in the literature." Zhou Congwen smiled, "Generally speaking, getting old is just a change in appearance. In fact, the patient's own changes are not great, mainly in the tibia, fibula, radius, There were hyperplastic periostitis, diffuse periosteal thickening and other changes in the ulna and other parts."

"This is not called change!"

"It's okay." Zhou Congwen shrugged, "At least it won't continue to deteriorate, and people can still live. And the changes on the face can be restored with plastic surgery, which will affect some physical work, but... after all, they won't die. "

"Modern medicine is really weak." Shen Lang said contemptuously.

Zhou Congwen knew that Shen Lang belonged to the kind of owner who couldn't hold two taels of sesame oil in his dog's stomach, and when he saw a sickness, he subconsciously thought of healing.

However, with the current medical level, there are not many diseases that can be cured.

Soon Xiao Kai came back.

"Professor Zhou, they decided to come tomorrow."

"Okay." Zhou Congwen said, "Take a film and see if there is hyperplastic periostitis, you can make a diagnosis."

Xiao Kai hurried back and said.

"Okay, see the patient tomorrow. If you agree, I suggest going to Kong Zong, the plastic surgery technology there is very good."

"Professor Zhou..." Xiao Kai whispered, "Can you do it?"

"It might be a little troublesome." Zhou Congwen didn't directly refuse, but looked into Xiao Kai's eyes and said.

Xiao Kai knew that Zhou Congwen was not being polite, nor was he trying to shirk, but that it was really a little troublesome.

Although he has a general practice certificate, after all, he works in the academician workstation established by Mr. Huang, not plastic surgery.If it is bitten back, it will be meaningless.

"That's right, Professor Zhou." Xiao Kai thought for a while, and decided to take on this responsibility, "I and the patient's father are classmates, I just said that if there is any trouble, I will fight with him, please rest assured .”

"It's not that serious." Zhou Congwen smiled slightly, "It's just an operation, but the recovery time is relatively long, so it's best not to occupy our bed. And a cosmetic surgery patient lives in the thoracic surgery ward, what do you think? Kind of weird."

It turned out to be like this, Xiao Kai let out a long breath.

Ordinarily, his heart was already cold, and he didn't lack this little money.

But you have to follow the rules when you do things. Xiao Kai has seen a lot about Shengmi En fighting Michou, and he knows exactly what he should do.

"Thank you, Professor Zhou."

"You hook me up tomorrow, and you come to change the dressing after surgery."

A problem that has been unable to be resolved for a long time is settled.

……

……

Shen Lang kept listening with his ears up. What he was curious about was not the operation, but what the old boy looked like, and whether he could be cured.

At noon the next day, when Shen Lang saw the patient, his eyes straightened.

Chapter 0774 The old boy

For an old boy, if he just reads the text, there will be pictures of Japanese comics in Shen Lang's mind.

The long silver hair fluttered in the wind, but in fact, only the hair turned silver, and the face did not change.That kind of cool feeling arises spontaneously, which can make girls scream.

But in the real world, when the old boy came with difficult steps, a sense of desolation rose in Shen Lang's heart.

This is not the picture I imagined.

The distance between ideal and reality is hundreds of millions of light years.

If he hadn't made enough psychological expectations yesterday, Shen Lang would have directly thought that the few people who came were middle-aged sons taking their elderly father to see a doctor.

The shambling gait and piled up wrinkles, at first glance, it seems that only the eyes are clear to prove that he is still a young man in his 20s.

Zhou Congwen did not waste time, and directly asked for a doctor and had a physical examination.

The patient's scalp and forehead skin thickened and aged, forming folds and sunken grooves and ridges. There were 20 grooves and ridges ranging in size and asymmetrical in distribution.

The upper and lower eyelids were thickened, the eye fissure was small, the lower eyelid and the zygomatic arch formed an orbital sulcus about 6cm in length and 0.8cm in width, and bag-like skin bulges, saddle nose, and nasolabial fold deepened.

The skin of the palms, fingers, feet, and toes is thickened, thick and mallet-shaped; there is a lot of sebum secretion.

After checking the patient, Zhou Congwen was almost [-]% sure, but he still took the patient for an X-ray.

Just like what I said yesterday, the X-ray films of both hands showed that, except for the distal phalanx, the cortical bone was thickened, rough, and the density of the medullary cavity was high.

"Professor Zhou, is it okay?" Xiao Kai asked cautiously.

"Surgery can be done, but it only treats the symptoms but not the root cause." Zhou Congwen said to Xiao Kai after the diagnosis, "The periosteum problem may last for a lifetime, but the good news is that it will no longer get worse."

"Oh, it's good news. The child... as long as he can live. Let me talk to my classmates and see what the family thinks." Xiao Kai turned to communicate with the patient's family.

Shen Lang glanced at Zhou Congwen, and vaguely heard him sigh.

"Congwen, did you sigh?" Shen Lang was familiar with Zhou Congwen, and he was very straightforward, so he asked when he heard it.

"There are still few studies on similar recessive genetic diseases." Zhou Congwen shook his head, "I don't know how many years it will take to conquer them."

conquer?

Shen Lang had never thought of similar words.

In the past in the Third Hospital of Jianghai City, when encountering such patients, there was no need to use their brains. There was only one sentence - go to the higher-level hospital to see.

Although in Shen Lang's heart he wanted to see if he could be cured no matter what disease he was suffering from, but he knew his own weight.

Unexpectedly, what Zhou Congwen wanted was conquest.

Shen Lang didn't know what to say, he thought about that old boy, mixed with the novels he had read, and the definition of old in his heart changed again and again.

The patient did not go through the hospitalization procedures, but the relevant preoperative examination was done in the outpatient clinic. The next day, Zhou Congwen took Xiao Kai to operate on the patient in the treatment room.

Shen Lang has always been curious about how to do the surgery, so he followed suit to see.

The patient's hair is shaved as part of the preoperative skin preparation step.

Without hair, the patient looks extremely old, as if the years have passed quietly, and the old man's hair has already fallen off naturally. (Note)

Xiao Kai warmed the salt water in advance and used it to wash the patient's face.

The inside of the deep folds was full of dirt, and Shen Lang was fascinated by it.

If I am old, will it be the same?Mountainous wrinkles... It's just that the patient is not due to the traces left by the years, but because of the disease.

Zhou Congwen's sigh seemed to come from Shen Lang's ears again, vaguely present, like an old man who had experienced many vicissitudes.

Zhou Congwen is regretful, but isn't it normal for a disease that cannot be cured? What is Zhou Congwen regretful about?

After cleaning the deep folds in the surgical area, Zhou Congwen used Meilan to design an incision line at the front edge of the hairline and mark the folds.

Routine disinfection, local infiltration anesthesia with 2% lidocaine + 0.75% bupivacaine suspension, incision of the skin along the incision line to the periosteum.

Shen Lang put on gloves to act as an equipment nurse, and Xiao Kai acted as Zhou Congwen's assistant.

A large operation was actually performed in the treatment room. Xiao Kai pulled himself together, holding sterile gauze in his hand, ready to press on the bleeding point anytime and anywhere.

This is the head, which is very rich in blood supply.In the emergency department, there were many people whose faces were covered with blood. After cleaning, the wound was checked. In fact, there was only a 1-2cm hole, and two stitches were enough.The hole is not big, but it looks scary.

Once the bleeding couldn't be stopped, it would affect the operation, Xiao Kai didn't want Zhou Congwen to scold him on the operating table for such a small matter.

In addition, Xiao Kai was not familiar with the local anatomical structure, so he concentrated on Zhou Congwen's hand.

However, all the unexpected things that Xiao Kai expected did not happen.

Zhou Congwen's movements are very gentle, the key is that he can see the slightly larger blood vessels in advance, no matter how deep or blocked by something, the two pliers in his hand can directly clamp the blood vessels like a living thing, Cut off, ligate.

Until the galea was separated, there was only a little blood on the sterile gauze in Xiao Kai's hand, which was stuck by him actively pressing.

As for the imaginary scene where several pieces of gauze were completely soaked, the treatment room was full of bloody smell, and the operator was anxious, it didn't happen at all.

What kind of local anatomy must be familiar with to achieve this level!

Xiao Kai knew why this happened, and felt that Zhou Congwen was really omnipotent.

Zhou Congwen injected swelling anesthesia solution into the galeal layer, continued to subtly separate the periosteum and subgaleal until it was completely separated, and cut off part of the corrugator supercilii between the two eyebrows.

随后在眶上缘水平1cm以上平面沿三条垂线横行切断帽状腱膜和额肌，形成6个断面；于额肌浅层平行分离1.5cm宽肌条2条，间隔3~4cm，而后将分离的腱膜和额肌一并剪除。

Looking at part of the galeal aponeurosis and frontalis muscle being removed, looking at the clean operation area, and seeing the patient who feels no pain under local anesthesia, Xiao Kai has already started to feel numb.

The principle of the operation is very simple, and Zhou Congwen's technique is also quite meticulous. Xiao Kai is too lazy to think about why Zhou Congwen can do this kind of operation so well.

Some people are born evildoers, there is no need to think too much about it, why make things difficult for themselves.

No matter how much you think about it, why bother?