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8年“超长待机”住院总医师 造就一个“全能医生”

2017-08-23 09:52:42   中国青年网

武汉儿童医院心内科主任张勇在看诊

一根小导管直通心脏祛“心病”

心血管内科主任张勇当了15年医生,其中8年是住院总。科室里几乎所有的急、难、危重病人,都需要住院总来处理。

他回忆,自己曾在大年三十飘雪的夜里,连续三次被紧急叫回医院处理患儿;也曾经深夜狂奔500公里山路去山区接患儿……“一开始是想磨练磨练,没想到后来却爱上了这个岗位。”张勇笑着说,正是这“超长待机”的8年,让自己处理病人的应急能力大大提高。

2008年,张勇决定选择心脏介入作为专业方向。要当好介入医生,不光要会看心电图、熟悉影像学,还要懂操作,能成为今天的“全能专家”,张勇总结为“打基础、下功夫,积累和磨练”。

2016年5月,心血管内科独立成科,血管介入技术迅速发展。短短1年时间,完成110多例心血管介入手术,涉及各种先心病的介入封堵、复杂先心和肺动脉高压的心导管检查及急性肺血管扩张试验、肺小动脉造影、先心病术后残余畸形的介入诊疗、临时起搏器的植入术等。

紧急植入临时起搏器

为“怠工”心脏“接棒”救命

10岁的然然家住汉口,今年6月他“感冒”了,在家吃了感冒药。没想到,上课时他突然胸闷气短晕了过去。 被送到武汉儿童医院后,确诊为暴发性心肌炎,合并高度房室传导阻滞。

张勇说,心脏的正常传导系统被阻断,导致心脏“消极怠工”,心跳缓慢,孩子不仅心脏缺血,全身脏器也会血供不足衰竭。“借用”临时心脏起搏器给心脏“加油”,待心脏缓过气后,就能逐步恢复,死亡率从90%降至10%。

孩子血管细,麻醉风险高,加上手术刺激,随时可能心脏骤停,目前国内能植入儿童临时心脏起搏器医院很少。然然的病情没有让医生犹豫的时间。张勇带领团队将起搏器植入到了然然体内,怠工的心脏当即“满血复活”。术后第三天,临时起搏器“功成身退”。

“临时起搏器等到心脏心律失常恢复之后即可取出,不影响孩子以后的生活。”张勇介绍,暴发性心肌炎在临床上并不少见。最常见的是急性上呼吸道感染和肠道感染导致的心肌炎,一般在病毒感染后的一周内发生。他提醒,6岁以上的孩子,特别是平时体质好、很少生病的孩子,病毒感染后更易患上暴发性心肌炎。

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