3/5(月)
◆今日の気持ち
(脳外科 2週目)
●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
・低体温
・肋骨骨折
・CPK6000
・巨赤芽球性貧血
●今日の病院滞在時間
8時〜18時
●今日行ったこと・見たこと・知ったこと
・低体温 → 循環↓ → 臓器不全やK上昇など…
・硬膜下血腫。
カプセルができて血管がいっている。だからドレナージ後カプセルの内外膜がとじてくっつかないと、治らない。だから圧力必要。それで、高齢者はなかなか…
・ICUの患者は、診断がつくまでまつ、というリズムではだめ
・脳外科でアミラーゼを頻回に検査する理由。
エリルなど、膵炎がおきやすい薬を使うが、患者が痛みをうったえられないから診断が遅くなってしまうことがある…
・脳出血手術後、骨を戻さないとドレナージしすぎたり…。あと戻しておくと形成しやすい
・水頭症。
下角から腫れてくる。第三脳室が四角く腫れてきたら髄液循環の悪さを考える。そのあと前角が丸くなってくる
・胃全摘。B12を詳しく考えなければいけないのは1〜2割か?
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