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六旬大爷突发脑梗死 介入取栓“抢回”一命

2017-09-28 10:42:52   

央广网长沙9月28日消息(记者傅蕾 通讯员张维夏)68岁的李嗲嗲晚上突发脑梗死,紧急从浏阳连夜送至湖南省人民医院马王堆院区进行救治。医院卒中中心开通卒中绿色通道,为李嗲嗲实施了全脑血管造影术及左侧大脑中动脉支架取栓术,帮他“抢回”了一条命。

浏阳人李嗲嗲,前段时间因摔倒导致左腿骨折,在当地医院住院。晚上20时许,突发言语不清,口角歪斜,右侧肢体活动障碍。经医院初步诊断为大面积脑梗死。由于病情危重,限于当地医疗水平,要求紧急转往湖南省人民医院卒中中心进行救治。接到请求后,省人民医院卒中中心开通脑卒中绿色通道,值班医生立即通知科主任及护士长,应急人员火速就位。

入院时,李嗲嗲神志不清,右侧肢体完全瘫痪已有四个半小时了,情况十分危急。为争取在有效时间窗内进行抢救,卒中中心医护团队立马将李嗲嗲送入介入手术室。通过全脑血管造影术检查后发现,患者左侧大脑中动脉M2段闭塞。“要立即进行大脑中动脉取栓术。”神内四科副主任杨剑文说道,若不及时处理闭塞的血管,随着时间的推移,李嗲嗲脑细胞将大量死亡,就会留下严重后遗症甚至危及生命。

术中,杨剑文主任通过下肢股动脉的穿刺,建立起一条通向颅内的“高速公路”,将取栓装置放入颅内被血栓堵塞的血管,经过3次取栓后,成功将患者脑中闭塞血管中的血栓全部取出,闭塞血管开通,血管远端显影良好,凌晨两点,手术顺利完成。术后,经医护人员的精心护理,李嗲嗲神志清醒,语言清晰,右侧肢体功能逐渐改善,治疗效果显著。

杨剑文介绍,急性缺血性卒中,俗称脑梗死。抢救缺血性卒中黄金时间窗是4.5小时,像李嗲嗲这种超过了黄金时间窗的,通过支架取栓术可以延长救治时间窗,在6~8小时到达医院也有取出血栓的可能,取栓后有约60%的患者可以获得良好预后。

由于急性缺血性卒中病情发展迅速,处理稍不及时就可能给患者带来严重不可逆的危害。因此,应对急性缺血性卒中最重要的关键点在于“快”。一是尽快将患者送至有技术条件的医院;二是患者应配合医生尽快做出科学有效的治疗决定。而湖南省人民医院卒中中心专为患者开通“卒中绿色通道”,患者从被送到医院开始,5分钟内溶栓小组医务人员赶到,10分钟内完善头部CT排除脑出血,60分钟内完成静脉溶栓,90分钟内完成动脉穿刺及脑血管造影,在黄金时间窗内使患者得到支架取栓治疗。

目前,湖南省人民医院已实现空地一体化转运,形成了能辐射全省的一小时卒中急救圈。医院卒中中心也将成立湖南省脑卒中联盟,来推动区域脑卒中防治网络建设,推进脑卒中疾病的分级诊疗,为更多老百姓的生命健康保驾护航。

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