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Chapter 425 Wernicke's Encephalopathy

Wernicke's encephalopathy is a mental disorder caused by alcoholism.It is a common metabolic encephalopathy in chronic alcoholism.Due to long-term drinking, patients will have symptoms of malnutrition, and the lack of thiamine caused by malnutrition will aggravate the patient's chronic alcoholism.

Thiamine is vitamin B1. The main active form in the human body is thiamine pyrophosphate (TPP), and TPP includes pyruvate dehydrogenase and α-ketoglutarate dehydrogenase. An important cofactor in many important biochemical reactions.Cells need the reactions catalyzed by the above two enzymes to be able to convert glucose into adenosine triphosphate (ATP), an energy form that cells can use.It can be said that this substance whose total content in the human body does not exceed 30 mg is actually the basis for supporting the vitality of the entire human body.Lack of this important cofactor will lead to disturbance of energy metabolism in the brain and local accumulation of lactic acid.

The nutritional disease of vitamin B1 deficiency actually has a more widely known name - beriberi.Beriberi was recorded in "Zuo Zhuan" in 314 BC, when it was described as "indulging in heavy legs".But in as long as 2000 years, this disease has always plagued people.It was especially popular in the 18th and 19th centuries. At that time, in China, Japan, and Southeast Asia, about 10 people died of beriberi every year.It was not until 1926, when two Dutch chemists discovered and purified vitamin B1 from bran, that beriberi got a real "special medicine".

Vitamin B1 cannot be synthesized by the body itself, and as a water-soluble vitamin, it cannot be stored in the body and needs to be supplemented daily.Therefore, if the patient does not consume foods containing vitamin B1 at all for more than 18 days, the patient may develop symptoms of vitamin B1 deficiency.Brain lesions appear when the deficiency exceeds three weeks.Long-term lack of vitamin B1, after systemic disease occurs in the patient's body, he is even suffering from "beriberi".

"The main cause of Wernicke's encephalopathy is the patient's lack of vitamin B1." Sun Li'en's neurology department is actually pretty good, and he quickly grasped the point, "If you suspect that the patient has Wernicke's encephalopathy, Director Mei, give her intravenous vitamin B1 After a quick supplement, you can see the changes in the patient's condition, don't you know?"

"The patient and the patient's family must be informed before the diagnosis and treatment." Director Mei shook his head, "The child's parents died early, and there are no immediate family members, and..." She sighed, "She is not married yet."

"It means there is no agent who can make medical decisions for her?" Sun Lien frowned. This situation is the most troublesome and terrifying.When a person encounters this kind of thing alone, the doctors have no good way to save him. "Then how did you do these two days?"

Director Mei patted the bed, "If you can't diagnose and treat, then you can only make a diagnosis. But in the hospital..." She stopped suddenly, looked around habitually, and was about to make sure no one was there. Say something, but suddenly stopped.Director Mei stopped for a few seconds, stared at Sun Lien with a strange look for a while, and then asked suddenly, "I heard that your family bought this hospital?"

Sun Li'en didn't expect Director Mei to say this, so he nodded and didn't answer.

"That would be great!" Unexpectedly, Director Mei grabbed Sun Lien's arm excitedly, "Hurry up and ask the imaging department to turn on the MRI, and immediately ask the laboratory department to turn on the machine and check Look at the vitamin B1 concentration in her blood."

After hearing this request, Sun Lien asked back in surprise, "You didn't do these inspections?" He tacitly thought that Director Mei had already done all these inspection items.The reason why there is no diagnosis is because the indicators are normal.But now, according to what my senior sister said, she didn't test the patients at all.Just made a diagnosis based on my own experience.

This is wrong, very wrong.

"No way... Our obstetrics and gynecology department has limited reception capacity, and these contracted auxiliary departments have been ignoring us..." Director Mei was obviously a little depressed when talking about this topic, "What's more, she hasn't For the family members, the cost of the inspection has not been paid either.”

Sun Li'en frowned. In fact, with his current "identity", it is absolutely no problem for a certain department of the hospital to restart operation and provide corresponding services.The so-called "department contracting" is actually an illegal act defined by the Health and Medical Commission.It is not legally recognized and guaranteed, and it must be cleared.In other words, the current paper mill hospital is completely dominated by the Sun family.

But the real difficulty that stood in front of the rich second generation Sun Lien was the notice of suspension of business and rectification posted by the staff of the Health Commission when they came over in the afternoon.According to the requirements of the Health and Health Commission, the paper mill hospital was ordered to suspend operations for six months because it was suspected of embezzling national social security funds, using unlicensed personnel for diagnosis and treatment activities, and illegally contracting departments.

From the moment the notice of business suspension and rectification was issued, the Paper Mill Hospital could no longer carry out any type of medical activities.Imaging examinations and blood tests are also included in the scope of medical activities.

"The inspection fee is easy to handle. It doesn't cost much to have an inspection." After all, Sun Lien has money in his wallet now, and he has the confidence to speak, "It's really not possible, I can pay for it myself. But the problem is..." Sun Lien pointed helplessly Pointing outside the door, "The notice of business suspension and rectification has been posted, and now I can't do the inspection even if I want to."

The two fell silent at the same time, and Director Mei looked a little helpless.It is already difficult to be a doctor in this environment. Although I don't know why this senior sister Mei chooses to be a doctor here all the time, Sun Li'en still wants to help her and this patient.

"About this patient's diagnosis of Wernicke's encephalopathy..." Sun Lien first broke the silence and asked, "The main reason for your diagnosis is because she showed mental symptoms?"

"When she was sent here, she did have some mental problems." Director Mei lifted her spirits and replied, "Besides, she also has symptoms of ophthalmoplegia—when she looked at me, the movements of her right eye and The left eye is out of sync."

Sun Li'en nodded. Ophthalmoplegia and mental disorders appeared at the same time, which was indeed consistent with the symptoms of Wernicke's encephalopathy. "It is indeed very likely that it is Wernicke's encephalopathy." He was thinking about which hospital to transfer Liu Mei to.

"The most important thing is that my family lives quite close to hers." Director Mei added, "During this period, I have seen her several times. Two of them, I saw her throwing up on the side of the road. serious."

This is the main reason for judging Wernicke's encephalopathy.Sun Lien sighed.Severe morning sickness will indeed lead to Wernicke's encephalopathy in pregnant women-they can't eat and vomit, and the nutrition must not keep up.It's just that I still have such severe morning sickness at 26 weeks, which conflicts with what Sun Lien learned.Generally speaking, morning sickness is a kind of early pregnancy reaction. Because of the increase of HCG (human chorionic gonadotropin) in early pregnancy, the decrease of gastric acid secretion and the prolonged gastric emptying time, some pregnant women will experience severe vomiting.However, this reaction generally weakens or even disappears after 12 weeks of pregnancy.

"There is still such severe morning sickness at 26 weeks?" Sun Lien frowned and asked, "She is so serious that she has Wernicke's encephalopathy, should she have a therapeutic abortion?"

When asked here, Sun Lien and Director Mei sighed together.No family members, no spouse, even if the doctors want to save Liu Mei by terminating the pregnancy, no one can sign it, and they have no right to do so.

"I... I'd better call and ask." Sun Lien sighed, and took out the phone from his pocket, "I don't know if the blockade of the Maternal and Child Health Hospital has been lifted, but I hope it can accept patients. "

(End of this chapter)