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技术赢得信任

2017-08-25 08:27:02   中国青年网

不久前的一天,家住长春、不到3岁的小硕感到头痛,没多久便开始抽搐,随后昏迷。事发突然,一家人吓坏了,立刻把孩子送到附近医院。经过详细检查,诊断为脑内出血,血管畸形,由于出血量大,病情十分危重。

次日凌晨,家人抱着一线希望来到了吉大二院神经外一科。小硕的遭遇牵动着神经外一科每一位医护人员的心。刚上班,科主任关文明就召集全科进行会诊,分析病情。头部CT检查发现:小硕右侧颅内形成了巨大硬脑膜下血肿,右侧脑半球已经被血肿压向了对侧,并且颅内存在脑动静脉畸形团和巨大血管瘤。症状是出血引起的,病因却是脑动静脉畸形和巨大血管瘤。因此,小硕的手术并不是简单的清除血肿手术,而是需要先行在介入下做脑血管动脉造影及畸形病变栓塞治疗。预计手术将会出现多重困难:如孩子年幼,身材瘦小,近两天不能进食,身体状态差,体内血量储备不足等等;脑血管畸形开颅手术易出现大出血,如果术中失血稍多,后果不可预料;介入造影剂栓塞材料都是成人的,尺寸较大,并无幼儿专用。

全科会诊后,由杜志君教授和刘占川教授带领的神经外一科血管组担负起了救治小硕的重任。神经外一科、麻醉科手术室、新生儿科、儿科等多科会诊后为小硕制定了一系列方案。手术前,刘占川教授与小硕家属进行了详细的沟通,使患者家属对手术难度、风险、可能出现的并发症以及术后的治疗等情况有了深刻了解,医疗团队获得了患者家属充分的信任。

在小硕被推进手术室那一刻,手术室已经做好了充分的准备,复合手术室准备就绪,这里将是小硕最先进行介入血管内治疗的第一步,随后进行开颅手术。麻醉科金善爱教授、宋志敏医生完美地完成了麻醉插管、动脉压监护和深静脉置管。介入手术开始,造影结果发现,小硕右侧脑内存在一个较大的动静脉瘘,动脉直接与静脉交通,形成了一个巨大的静脉瘤,静脉瘤承受不了压力后破裂,形成脑内巨大血肿。

经过两个小时的努力,成功栓塞瘘口,小硕手术的第一步成功收官。在之后的开颅手术中,过程也非常顺利,术中出血不多,血肿全部清除。此时,新生儿科医生和护士已经做好准备,接小硕进入新生儿科进行术后监护治疗。

在患者家属期盼的目光中,手术室大门打开了。当被告知手术成功时,小硕妈妈流下了激动的泪水,一遍遍感谢医护人员。

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