A hundred days after signing in, the first surgery shocked the world!

That's right!

This is what Lin Feng wants to say!

A young man, who had just finished running more than ten kilometers, suddenly fell to the ground and fell into a coma, and he had soy sauce urine, kidney damage, as well as Sun poisoning, shortness of breath and other conditions!

There is a high possibility of rhabdomyolysis!

After muscle dissolution, myoglobin will be exposed, enter the blood circulation, and also cause the appearance of soy sauce urine.

After strenuous and demanding exercise, it is easy to cause muscle damage, so it is not impossible for muscle lysis to occur.

Immediately, Lin Feng asked Xiaoru to quickly draw blood for the patient.

Examination of creatine kinase, creatine kinase isoenzymes, serum myoglobin, etc.

Creatine kinase is a relatively specific existence, a protein in human bone cells, if it is significantly elevated, it means that there are really bone cells destroyed.

If so!

Then rhabdomyolysis can be diagnosed!

While waiting for the results, the patient's family also arrived.

After learning about the condition from Lin Feng's mouth, it was very nervous.

It didn't take long.

Creatine kinase results are in.

Up to 8000 U/L, myoglobin is also significantly elevated.

Confirm that rhabdomyolysis is correct.

After explaining to the patient's family, Lin Feng began to give targeted treatment to the patient.

The purpose of giving large amounts of fluids, maintaining water-electrolyte balance, and alkalizing urine therapy is to prevent myoglobin from blocking the renal tubules and reduce kidney damage.

Finally, there is the top priority, blood purification treatment.

After about 3 days of treatment, the patient's sanity basically returned to normal.

By day 7 of treatment, all indicators were close to normal.

Creatine kinase also returned to normal levels.

Of course, this is all an afterthought.

By the time I left the ICU, it was already dark.

......

Lin Feng returned to the emergency room.

Just opened the door.

Lin Feng saw a mother with a small child appear outside the door.

Don't wait for Lin Feng to give way.

The mother said, "Doctor, show my child!

Seeing this, Lin Feng couldn't ignore it, and immediately said: "Come in, let me see!"

Immediately.

The mother led the child into the consultation room and sat down.

The doctor on duty saw that it was a child, and Lin Feng took over again, so he did not interject.

As soon as she sat down, her mother hurriedly said: "Doctor, the child can't turn his head in the morning, he doesn't say it hurts, and his neck can't turn left and right, I thought it was "pillow", I went to the downstairs community to see it, and also said that it was "pillow", and gave two needles. "

"But it never got better, so I came to the hospital quickly!"

Lin Feng nodded and walked next to the little boy.

While pressing the little boy's neck, he asked, "Little friend, does it hurt?"

"It doesn't hurt!" the little boy said softly.

I just can't turn around.

Lin Feng already knew what the situation was, and then spoke: "He is not a pillow, so the needle is ineffective!"

Without waiting for Lin Feng to finish speaking, the child's mother hurriedly asked, "Isn't it a 'pillow'?

According to my observations, your son should have atlantoaxial subluxation, but some tests are needed to confirm the diagnosis!"

I'll take him to do it now!" the child's mother said quickly.

Although Lin Feng said the name of the disease, where did she understand.

Let her not be nervous, how is that possible.

Children are the lifeblood of mothers.

Lin Feng also understood that he immediately asked his mother to take the little boy to do a cervical CT.

The child's mother hurriedly agreed.

Not for a while.

I came back with the CT results.

With a glance, Lin Feng knew that he was not mistaken, and the little boy was a atlantoaxial subluxation.

The next step is simple.

The treatment plan is also simple.

After Lin Feng used occipital and maxillary belt traction reduction, he was fixed with a cervical brace.

After getting it done, say to the child's mother: "In 4 weeks, take the child to check again!"

"Yes, Doctor. The child's mother nodded repeatedly, but did not leave, but continued to ask: "Doctor, what does this atlantoaxial subluxation mean?"

Lin Feng began to explain to the child's mother.

First of all, it is necessary to clarify where the atlantoaxial vertebrae are, which refers to the first and second joints of the cervical spine.

The stability of the atlantoaxial joint is mainly maintained by the apical ligament of the dentition, pterygoid ligament, atlantoaxial cruciate ligament, and covering, under normal circumstances, the muscles and ligaments are mutually restrained, and the joint is in a balanced and stable state, once the balance is broken, subluxation is likely to occur.

Atlas subluxation, that is, the normal alignment of the joints between the atlantoaxial and central vertebrae disappears.

If early treatment of atlantoaxial subluxation in children, the dislocation gradually worsens and may develop into atlantoaxial rotational dislocation.

Depending on the time from dislocation to diagnosis, atlantoaxial dislocations in children are also divided into acute, subacute, and old dislocations.

Acute dislocation refers to less than 1 week from onset to diagnosis.

Subacute dislocation refers to the time from occurrence to diagnosis of 1~3 weeks.

Aged dislocation is defined as more than 3 weeks from onset to diagnosis.

After listening to Lin Feng's explanation, the child's mother nodded, and she understood what kind of disease this was.

Although he understood, he still had some doubts in his heart, and immediately opened his mouth and continued to ask: "Doctor, why is my child dislocated here?"

For the child's mother's problem, Lin Feng also understood, and immediately continued to explain: "The joint surface of the atlanto-vertebral block is relatively flat, there is no intervertebral disc, the joint capsule is large and relaxed, and it is often in a state of force in various victorious sports states, and the range of motion is large. "

"For children, the body structure has not yet been fully formed, the cervical ligaments of children are more relaxed than adults, and the bilateral block facets are more horizontal than adults, resulting in the upper and lower joint surfaces are not easy to effectively restrict, and this situation is very easy to occur!"

After a pause, Lin Feng continued: "In addition to these, some external factors can also cause this situation. "

"For example, trauma, violent blows to the head and neck, head force during exercise, or head and face injuries, etc., resulting in neck muscle ligament damage. "

"There is also spontaneity, because various inflammations lead to congestion and edema of soft tissues and ligaments around the changing vertebral joint, resulting in instability of the atlanto-axial joint, coupled with inflammation and painful stimulation, so that the coordination function of muscles or ligaments in activity is disrupted, in which case sudden rotation of the neck will also occur subluxation." "

"There is also a congenital malformation, such as torticollis, cerebellar tonsillar hernia malformation, flat skull base and so on. "

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