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湖南完成首例 无造影剂心脏介入手术
2017-09-20 08:02:12 中国青年网
长沙晚报讯(记者 唐江澎 通讯员 周蓉荣 范文娟)常规冠脉支架术,医生可以随时推注造影剂来看清“道路”。然而,如果患者肾功能不全,就无法使用造影剂。昨日,湖南省人民医院心内科的专家团队成功克服难关,在“盲操”的情况下,完成全省首例无造影剂心脏介入手术。
53岁的长沙市民易先生有多年高血压及糖尿病史,近日他出现了严重的心肌缺血改变,但因为慢性肾功能不全和大量蛋白尿,血肌酐极高,一直都不敢接受造影检查。据了解,如果进行检查,含碘的造影剂随时可能加重其肾功能恶化,引发尿毒症;不进行检查,严重的冠心病得不到治疗,随时都有生命危险。
在常规的冠脉支架术时,造影剂相当于一盏“灯”,医师可以随时推注造影剂显示血管的走向和导管、导丝的位置,也可以精确定位支架的位置,操作方便。没有了这盏“灯”,医师只能靠自己设定的标记目测进行定位,借助血管内超声提供的影像,一点点探索前面的“道路”。
昨日,潘宏伟团队开始了这台特殊的手术。此时距检查已有一周时间,患者病变的部位已经完全闭塞。常规造影条件下难度一般的手术此时变得异常困难,导丝每前进一步都要反复确定,专家们反复尝试了多条导丝才艰难地通过病变,之后精准地植入支架。业内人士表示,该手术的成功,为严重冠心病合并肾功能不全患者带来了新的希望。
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