Shenzhen Business Daily Reading Client Reporter Zhao Hongfei Correspondent Chen Yueer Wu Can
Every year in autumn and winter, the number of patients with cardiovascular diseases increases. For example, aortic dissection is a condition that occurs frequently in autumn and winter. It is one of the most complex and dangerous cardiovascular diseases caused by a break in the lining of the aortic wall, through which blood enters the middle layer of the arterial wall, forming a dissected hematoma. If the patient is not treated after the onset of the disease, the mortality rate in the first 48 hours reaches 50%, which is called the "winter killer".
Recently, 63-year-old Aunt Liu, who was enjoying a peaceful retirement life, suddenly felt breathless, dizzy, sweating, and had a brief fainting, and was rushed to a nearby hospital by her family. After examination, Aunt Liu had an aortic dissection in the large blood vessels of her heart and was in critical condition. After going to several hospitals, Aunt Liu was transferred to Shenzhen People's Hospital for further acceptance**. Under the joint diagnosis and treatment of the hospital's neurologist and extracardiac experts, Aunt Liu underwent aortic dissection surgery, and her body has gradually become active.
11-10 aortic CTA
The patient does not wake up and heart surgery cannot be performed
Previously, the specialized hospital where Aunt Liu visited performed related treatments such as pericardiocentesis, catheterization, catheterization, and drainage for her, but Aunt Liu did not wake up for a long time. After consultation with other hospitals, he was diagnosed with ischemic-hypoxic encephalopathy and locked-in syndrome. Holding on to the last glimmer of hope, Aunt Liu's family found Guo Yi, director of the Department of Neurology of Shenzhen People's Hospital, for consultation, and after careful medical history inquiry, physical examination, and film reading, Guo Yi thought that Aunt Liu still had hope of waking up. The day after changing the ** plan, Aunt Liu began to gradually recover consciousness. On the fourth day, at the request of her family and the hospital, Aunt Liu was transferred to the NICU of the Department of Neurology of Shenzhen People's Hospital for further **. When she was transferred to the hospital, Aunt Liu was drowsy to a comatose state, her breathing was assisted by being connected to a ventilator through endotracheal intubation, her left hand did not respond to stimuli such as tingling, her right hand could only contract her fingers, and her legs could not be lifted off the bed.
In the ** process of the neurology department of Shenzhen People's Hospital, Aunt Liu's consciousness is getting better and better day by day. However, her aortic condition changed, the aortic dissection was larger than before, and the most fatal type was Stanford A, which required immediate surgery. However, if surgery is performed in a poor state of consciousness, can the ischemic brain tolerate the blows of cardiopulmonary bypass?Postoperative results are not possible**.
Guo Yi, director of the Department of Neurology at Shenzhen People's Hospital, said, "At first, Aunt Liu's family was worried about anesthesia and another blow after surgery, and was ready to give up the operation. However, from a professional point of view, the prognosis of aortic dissection is extremely poor, and the weakness of the limbs may also be related to spinal cord ischemia, so the surgery is worth the effort." Aunt Liu is a typical ischemic-hypoxic encephalopathy, in order to ensure that she can have the opportunity to do the next major surgery, so that the brain that has just come from a coma has a certain brain reserve, the doctor team and the director of the Department of Cardiac Surgery of Shenzhen People's Hospital Zheng Qijun discussed, and decided to postpone the operation for a few days, and use TMS to promote awakening and other symptoms**. Under the guidance of Director Guo Yi, Aunt Liu's consciousness became more and more sober, and her physical activity was significantly improved, laying a good foundation for the next operation.
Relay race inside and outside the heart, doctors and patients trust each other and break through together
At first, I was quite hesitant, my mother is so old, can her physical condition bear it, what should I do if I fall unconscious again?Aunt Liu's daughter, Ms. Chen, said. Later, Ms. Chen learned that Director Zheng Qijun was originally the chief physician and professor of cardiovascular surgery at Xijing Hospital of the Fourth Military Medical University, and in 2018, he was introduced to Shenzhen People's Hospital as the director of the Department of Cardiac and Vascular Surgery. Zheng Qijun also serves as a member of the Minimally Invasive Cardiovascular Surgery Professional Committee of the National Cardiovascular Disease Expert Committee, and a standing member of the Cardiovascular Surgery Branch of the Guangdong Medical Association. After Ms. Chen communicated with Zheng Qijun and Guo Yi, she gained confidence in the team and the operation. After repeated discussions and judgments, Director Zheng Qijun's team formulated a detailed surgical plan, and Ms. Chen did not hesitate to give 100% trust and support to the doctor team.
On November 15, Director Zheng Qijun's team performed surgery for Aunt Liu. The operation lasted 6 hours and was successfully completed. Aunt Liu returned to the cardiac and vascular surgery unit, and under the careful care of the cardiac surgery medical team, she was able to wake up and cooperate with the medical staff to do the instructions 3 hours after the operation, and was taken off the ventilator the next morning. At present, Aunt Liu has successfully survived many difficulties and can get out of bed with the support of her family.
Thank you so much to the two directors for giving my mom a new lease on life!Ms. Chen said, "Previously, the doctor in another hospital had issued a critical illness notice, but I didn't expect that after this operation, she would regain her freedom of movement."
To prevent aortic dissection, five points need to be done
According to epidemiological investigations, the incidence of aortic dissection is obviously seasonal;It is more common in middle-aged and elderly people, and the incidence rate in men is higher than that in women;The incidence rate is increasing year by year. Zheng Qijun, director of the Department of Cardiac and Vascular Surgery, also said that in recent years, there has been a trend of younger patients with aortic dissection, and most of the patients were over 50 years old in the past, but in recent years, many young people around 20-30 years old have sudden aortic dissection.
When the following symptoms appear in the body, it is necessary to be vigilant: sudden severe pain in the chest, back, waist or abdomen, tearing or knife cuts, sweating profusely, and a sense of impending death;In severe cases, it can cause shortness of breath, palpitations, chest tightness, coughing up pink frothy sputum, inability to lie flat, angina, myocardial infarction, coma, etc.
How can aortic dissection be prevented?
1. Control blood pressure.
Hypertensive patients learn to self-manage their blood pressure:
Learn the method of measuring blood pressure at home, that is, four fixed - fixed time, fixed position, fixed limbs, fixed blood pressure monitor;
Take antihypertensive drugs according to the doctor's instructions, understand the purpose of the medication, the name of the drug, the dosage, and the usage, and observe the common drugs
Always carry blood pressure medication and nitroglycerin medication with you when you go out in case of emergency
Understand the emergency medical service system, and call for help in time if you feel unwell.
2. Prevention and treatment of arteriosclerosis.
Actively improve your lifestyle, quit smoking and limit alcohol, control calorie intake, eat more fruits and vegetables, and increase exercise.
3. Reduce some sudden force movements.
In life, you should try to avoid sudden and large twisting or stretching of the upper body. If you wake up slowly;When something falls on the ground, don't lean over to pick it up, but approach and squat down to pick it up.
4. Avoid trauma.
Avoid injuries such as car accidents, fall injuries, etc.
Fifth, pay attention to physical examination.
For example, cardiac ultrasonography and X-ray can help to identify aortic dissection early, and MRI and CTA can make a clear diagnosis.