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3/23(金)

◆今日の気持ち
(脳外科 4週目)
・久々GF。ひさびさだったけれど、だからこそ一例一例自分の手の動きがよくなるのがおもしろかった
・来週はGFの卒業試験だ!
・MRI、指示が不足していた…。ついつい、最終確認すべきところをしないことは、おきてしまうな…

●今の目標
・脳外科を味わいきる

●今日の新患・診断
・AGML
・食道癌
・EMR
・EMR後潰瘍
・ulcer scar
  十二指腸のscarはひだになる
・胃癌
・ジルベール症候群

●今日の病院滞在時間
8時〜17時

●今日行ったこと・見たこと・知ったこと
・GF
 つい右によってしまう…。左にいれるのだ、と意識をつよめねば。勢いを手ごろなかんじにしないと突っ込みすぎるし…
 speedがたりない。手際よく、苦しみ少なく
 stageの記載忘れるな…

・脳造影MRI
 せっかく、お金かかりリスクのある造影をするのなら、きちんと3方向とらなければいけない
 梗塞後、tumorのように見えることも
・L-Pシャント前のCTC
 脳室と脊椎のつながりをチェック。造影剤(180mgイオパミド6ccとか)脊髄投与後、3時間、6時間、24時間、48時間、とチェック。血腫で閉塞しているところをシャント造設し、閉塞性水頭症になるのを防ぐ

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