3/12(月)
◆今日の気持ち
(脳外科 2週目)
・薬物歴を聞き出すことは重要…
・食道Ca 胸腔の中をカメラで見せてもらえた。普段想像ばかりしているものを直視できるのはおもしろいな
●目指す医師像
まずは、医者
●今の目標
・脳外科を味わいきる
●今日の新患・診断
・RA
・薬剤性の一時的構音障害
・肺よ胸腔が白くべったり…。なんだったのか??
●今日の病院滞在時間
8時半〜
●今日行ったこと・見たこと・知ったこと
・慢性硬膜下血腫ope
・食道Ca ope
・上部消化管穿孔 …保存的治療からopeにかえるポイント
汎発性腹膜炎 →下部消化管穿孔の可能性あり
高齢者 →急変する可能性あり
痛みをコントロールできなかったら →手術すれば確実によくなる
バイタルの悪化
内視鏡をすればわかりやすいが、痛みが強くなるという説も
高齢者なら胃切をした方がいいという説も。胃癌の可能性を考えて
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