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男子挤破上嘴唇一颗"痘" 医生连下两次病危通知书

2017-09-20 14:20:20   新民网

据都市快报9月20日报道:脸上长“痘子”,忍不住挤一下,生活中很多人都有这样的习惯。但有人挤“痘”却差点危及生命,医生连下了两张病危通知书。

“患者姓张(化名),50岁,家住嘉兴,中等身材,从事体力劳动,半个多月前急诊转到我们医院,来的时候情况很凶险,整张脸基本上都是肿的,尤其是眼睑部、嘴巴,张口受限,已经不能自主呼吸,高热,有39.5℃。”浙大一院口腔科副主任汪国华主任医师说。

进一步检查后,张先生的主管医生、浙大一院口腔科主任刘建华主任医师发现,张先生的左侧口角肿胀、光亮,有个直径约1.5厘米的组织发黑,且有少量脓血性液体流出,便追问病史。

张先生患糖尿病多年,平时血糖控制得还可以。入院前几天,发现自己左侧上嘴唇长了颗“痘子”,开始他没在意。两天后,“痘子”逐渐长大,约米粒大小,有点痛,他觉得难受,就用手挤了一下,挤出一些白白的东西。

半小时后,张先生就发现自己挤过的“痘子”肿了,但因为身体没有其他不适感,也就没放心上。第二天下午,张先生发现整张嘴都肿了,且越肿越大,还出现头痛,浑身难受等症状,家人慌了神,立即送往当地医院就诊。

“开始,当地医生也没查出具体的病因,只是对症处理,给他挂盐水。”汪医师说,然而,张先生的病情进展得远比大家预料的要快,并出现了高热、呼吸困难等症状,血糖也高上去了。

当晚8:19,张先生被转到浙大一院。经检查,被诊断为上唇疖肿并发左侧颌面部多间隙感染,一种若不及时处理会危及生命的口腔疾病。

两次下病危通知书,抢救5天才脱离生命危险

尽快切开排脓是治疗间隙感染的主要方式,但由于张先生患有糖尿病,治疗难度大大增加。

“他在好几天没吃东西的情况下,随机空腹血糖竟然也达到了15.3(正常人在7.1以内),血酮体很高,有2个‘+’。临床上,一个‘+’就算严重,有发生酮症酸中毒(内科急症,有致命的危险)的风险。”汪国华医师说,“我们先后给他下了两张病危通知书。”

考虑到张先生病情的危重性、复杂性,刘建华主任及其团队请来了ICU、五官科、内分泌科等多学科专家联合会诊。确定治疗方案后,张先生接受了切开排脓手术,刘主任在张先生的左上颌部切开一个小口子,切除了一块约8厘米大小的坏死组织,并伸入引流条直到脓腔,让脓液流出来,术中流出脓液约100毫升。

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