I can see the status bar

Chapter 711
Today is really good at reciting characters.After Sun Lien returned to his consulting room, it took him a while to get out of the depression brought about by the two police comrades and the overstretched mother.

The following outpatient clinics were relatively easy, and most of the patients had problems that were relatively easy to solve-sprains, fever, and abdominal pain.Anyway, the emergency procedures of the fourth hospital are quite perfect, and diseases that require quick response, such as chest pain and stroke, will not send patients to Sun Lien's emergency clinic for treatment.

The emergency department is the main channel for dealing with non-critical grade [-] and grade [-] patients.And this kind of department is usually busy when there is a large influx of patients in the emergency department-such as weekends when the outpatient department does not work, or after get off work.Sun Lien really didn't have too many things to do during working hours on a normal working day like today.

"That's right, just take your medicine on time and drink more water than usual after you go back." After sending away a common flu patient who was transferred from a fever clinic, Sun Lien shook his head again and pressed the button on the computer Press the button and wait for the next patient to enter the consulting room.

It was [-]:[-] in the afternoon, and the white-collar workers and outpatient doctors were off work.Usually from this time period, Sun Lien can see many young people in professional attire in his consulting room—these are all migrant workers who have just got off work.

After practicing medicine for several years, Sun Lien gradually had a feeling.Today's young people are in a way similar to those old people who have retired and don't want to come to the hospital.When they feel unwell, their first reaction is never to come to the hospital.The elderly will choose to carry it or take some folk remedies or even take empirical medicine, while the young... They choose to carry it and then carry it again. If they can’t bear it, they may ask netizens who don’t know them at all Or simply Baidu.

Where do the social animals of 996 have time to come to the hospital?I can't even ask for leave. Usually my rest time is so precious, how can I use it for things like seeing a doctor?
And deep down in their hearts, there is a little deeper fear.

What if it is a serious illness?What if it is an illness that requires hospital leave?What if... What if I was pushed out by my colleagues and fired by my boss because I was hospitalized and delayed my work?
Young people living in big cities are under much more pressure than others may seem.The current working environment is very different from that of my parents' generation, and the pressure of life is also many times higher than that of my parents' generation.Under the triple pressure of life pressure, emotional pressure and work pressure, today's young people live extremely miserable lives - the office workers who often collapse in the news are just the tip of the iceberg.

Entering the consultation room was a female patient who looked about the same age as Sun Lien, wearing a small business suit and high heels about six centimeters.When she walked into the ward, Sun Li'en was keenly aware of a strange stiffness.After a little more observation, Sun Li'en suddenly found something different - her head was always kept at a slightly left-handed angle, and she basically couldn't turn.

If nothing else, it was probably a stiff neck.Sun Li'en quickly made a judgment based on his own experience, then frowned slightly, feeling that there might be something wrong with his judgment.

Would a young man who looked like a white-collar worker go to the emergency room because of a stiff neck...?
"Doctor, my neck hurts." The young female patient stated her problem directly. "It hurts badly."

The content displayed on the status bar is basically consistent with the chief complaint of the female patient, "Wang Li, female, 28 years old, neck pain is progressively aggravated (68.14.33), and neck movement is limited (65.05.21)".However, there is a somewhat interesting content behind it, "Horner's Syndrome (54.44.39)".

Horner syndrome?Sun Lien twitched his eyebrows slightly, which should be a symptom of Shennei.Could it be that Ms. Wang's neck pain is related to some neurological diseases?
"How long has it been in pain?" Sun Lien decided to ask the patient's medical history completely before making a decision.After he has a more complete grasp of the patient's condition, it will be easier for him to decide whether to transfer Ms. Wang first to the inside of the spine or to the outside of the spine.

"About three days, right? I went swimming three days ago. I probably twisted my neck while swimming... But it didn't help after putting on plasters these days." Wang Li seemed a little helpless, "Originally, the purpose of exercising is to reduce illness. , It turned out to be a good one—he insisted on exercising himself to make him sick."

Sun Lien took a closer look at Wang Li's face and found that her right eyelid was slightly lowered.And it looked like her eyeballs were a little more deflated on one side than on the other.

This should be the Horner syndrome indicated in the status bar.

Horner's syndrome is also called "children's cervical sympathetic nerve paralysis syndrome", which is more common in children.However, there are many such symptoms in adults. The main external manifestation is drooping of the upper eyelid on one side, the pupil on the drooping side is narrowed but the response to light is normal, and there may be symptoms such as retraction of the eyeball on the drooping side.

Horner's syndrome has a very clear indication of the lesion area-when any segment of the pathway from the sympathetic nerve center to the eye is compressed and damaged, such symptoms will appear.That is to say, the lesion area should be located between the T2 segment of the cervical vertebra to the T1 segment of the cervical vertebra and then to the eyes.

Considering that the patient complained of obvious and severe neck pain, Sun Lien was more inclined to think that there was a problem with the T1~T2 joints.But what exactly is the problem remains to be clarified-after all, the status bar does not clearly show the location of the lesion.Horner syndrome is classified into three types according to the location of the injury.

The central type is more common in hypothalamic lesions, and patients generally have contralateral hemiparesis or dysesthesia, and thalamic lesions usually have problems such as ataxia, vertical gaze paralysis, and dyspnea.

If it is a central type, then Wang Li is unlikely to be able to walk into the consultation room wearing high heels - she should be found out by her family or colleagues, and then sent directly to the emergency room by 120.

Preganglionic is more common in interpulmonary lesions, usually with ipsilateral shoulder pain, inner arm, forearm, paresthesia of the fourth and fifth fingers, and muscle weakness.Considering that Horner's syndrome had been present for less than three days, and the patient himself did not mention paresthesias, this possibility was not great.

The postganglionic type mainly occurs in lesions far away from the bifurcation of the common carotid artery.Such Horner syndrome is often accompanied by symptoms such as trigeminal neuralgia, facial paralysis, and nerve deafness.

The nervous system is a very delicate system, oppression, disease, injury may cause a series of symptoms.What Sun Lien has to do now is also very simple - clarify the type of lesion, and then judge whether the patient needs referral, hospitalization, or emergency surgery.

"Well, I'll give you an examination first, take a CT to see if there is any damage to the bones of the cervical spine." Sun Lien thought about it, and decided to start with the simple one.If the patient complains of neck pain after exercise, then muscle, ligament and bone injuries are all possible.Eliminate these first, and then think about it neurologically, which is easier for patients to accept.

(End of this chapter)