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凌晨4点多一男子睡觉中右侧肢体偏瘫,发现及时6小时恢复
——陈 晨/文 济源市第二人民医院
▊ 病情危急 ▊
半夜匆忙送入医院
突然呼之不应、意识不清、恶心、右侧肢体偏瘫……
这些突如其来的危急症状,在凌晨4点多,发生在克井镇闫营村的刘刚(化名)身上。这下可把家人吓得不轻,赶紧拨打120电话,急匆匆地赶往医院。
神经外科值班医生李济舟接诊后迅速诊查:中度昏迷状态、鼾式呼吸、不睁眼、不发音、刺激右侧肢体肌力0级伴阵发性四肢抽搐。结合检查报告,诊断:脑梗死。
这一系列的检查说明,患者的病情就如同他突如其来的症状,紧急,凶险。
▊ 当机立断 ▊
迅速进行脑血管介入手术
当下,紧急通知科主任王敏波、二线医生郭军。两人从睡梦中惊醒,迅速来到医院,再次查看病情,与家属谈话,通知导管室主任刘祥其及手术室人员,准备立刻手术。
这是一台高难度手术,也是一台考验医生的脑血管介入技术的手术。在手术过程中,充满了对疾病的挑战和手术的未知。
手术情况
造影显示:右椎-基底动脉闭塞
取栓中
取栓成功
麻醉师韩振东迅速给予患者全麻后,王主任用seldering法行右侧股动脉穿刺,置入6F血管鞘,经鞘管分别送入6F猪尾导管及造影导管,分别置主动脉弓、双侧颈内动脉、双侧椎动脉进行造影,并多角度投射,显示:右侧椎动脉-基底动脉闭塞。随后,送入6F指引导管,路途引导进入右椎动脉,微导丝引导微导管进入基底动脉,造影显示:右椎动脉末端至基底动脉血栓狭窄严重,连续取栓3次,3小时后,“全脑血管+主动脉弓造影术+动脉溶栓+动脉取栓术”成功完成。
患者术中各项生命体征平稳,进行穿刺部位加压包扎,安全返回病房。
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