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14岁男孩胸闷咳嗽到医院,检查结果一出来,在场的人都哭了

2017-06-08 14:09:30   

小鸥的病情相当复杂,涉及心脏、呼吸、肝病等等多个领域,在前面7家医院都无法给他最终确诊。在中山大学附属第一医院入院后,为了明确诊断以及更好的对症治疗,小鸥先后住了普内科、呼吸科、心脏外科以及MICU,经过了详细的检查和多学科疑难病例讨论,终于明确诊断为:

1、缩窄性心包炎

2、瓣膜松弛综合征,二尖瓣重度关闭不全,三尖瓣中度关闭不全

3、双肺结核伴双侧胸膜炎,双侧胸腔积液,右上肺无壁空洞形成,双肺下叶节段性肺不张4、左下肺动脉栓塞

5、静脉血栓形成

6、慢性淤血性肝损害。

7、重度营养不良。

(治疗后正在恢复的小鸥)

不耐受手术却又必须手术 多学科专家制定手术方案

虽然给予积极的内科治疗,但由于病情复杂且多器官功能受损,小鸥病情仍然反复甚至恶化,心功能持续恶化,反复出现心衰需要抢救。内科治疗无明显效果,外科手术治疗成了唯一救命稻草了。此时的小鸥营养状态日趋变差,体重从100多斤降到了70斤,身体情况异常糟糕:喘得厉害、睡不好、吃不下、脚也反复肿胀,根本无法承受手术。

并且,手术的风险也巨大:术后会不会引起结核播散?会不会爆发肝功能衰竭?同时肺部实质性病变严重,术后能否顺利脱离呼吸机?肺部有空洞形成,心脏手术体外循环抗凝过程中极有可能出现大出血……一系列的难题都摆在面前。可是,患者和家属并没有放弃、医护人员更没有放弃。吴钟凯教授牵头成立多学科专家诊疗小组进行讨论制定详细的手术及术后治疗方案。在控制结核菌和营养补充到一定程度后,吴钟凯教授为小鸥实施心包剥脱手术。

“虽然计划详尽但所有人包括我自己心里面都没有底,不过所有人都在努力” 主刀医生吴钟凯教授回忆道:术中发现他的心包增厚缩窄像鸡蛋壳一样硬,最后的地方竟达到1cm,普通人做这个手术一般只需要半小时,小鸥这个手术我却做了3个小时。原本计划分两期手术,可是剥除心包后小鸥情况一度好转,但维持不久就出现了血压下降,心率增快,需要加大血管活性药物用量,考虑瓣膜病变对心功能影响严重,医疗团队讨论决定马上调整手术方案,同期行体外循环下二尖瓣置换术。

经过多学科的合作,手术非常成功!术后心脏外科ICU、MICU曾勉教授团队、呼吸科联手治疗,小鸥在ICU住了2个月后,逐渐康复,心肺功能在恢复,但肺部病变严重、全身营养状态极差目前仍无法长时间脱离呼吸机,仍需在医院住院治疗。

度过最大难关后续治疗仍在继续 少年加油!

从去年10月发现患病到现在,小鸥的治疗不但花光了家里所有的积蓄,而且债台高筑欠下了80多万的债务,小鸥爸爸是一名泥水工人,收入微薄却是一家人唯一的经济来源。小鸥爸爸说:为了救孩子,借遍了身边所有亲戚朋友的钱,还贷了款,我自己贷不了款,是亲戚帮忙贷,这里的医护人员很热心,还为我们筹款。非常感谢他们!据了解,中山一院的医护人员了解情况后纷纷伸出援助之手慷慨解囊,还帮忙在网络上转发,扩大求助范围,为小鸥筹得10多万的善款。

虽然闯过了一个大大的难关,小鸥日后还需要维持长时间的治疗,预计仍需要一笔后续费用。希望社会热心人士能给予他捐助!疾病无情,社会的正能量能带我们走出黑暗。真心希望,小鸥的未来一路阳光。小鸥加油!

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