Friday, December 15th Cloudy
In May 2023, as a member of the 10th batch of Hunan Chenzhou Medical Aid Team, I embarked on the road of aiding Xinjiang with enthusiasm. I am the third batch of doctors from the Department of Neurology of the Affiliated Hospital of Xiangnan University to assist the People's Hospital of Tuoxun County, Xinjiang, and how to make the stroke patients in Tuoxun County get better treatment and how to further develop the construction of the Department of Neurology of the County People's Hospital is a question that I have been thinking about along the way. After entering Xinjiang, after a short period of adjustment, I quickly joined Zeng Weijun to check the patient's condition in the ward and enter the neurology department of the county people's hospital.
Since entering Xinjiang, it has been learned that Tuoxun County is an area with a high incidence of cerebrovascular diseases, and the county people's hospital has carried out intravenous thrombolysis green channel treatment under the guidance of the first two batches of experts from the Department of Neurology of the Affiliated Hospital to Xinjiang, and established an independent neurology department, and since January to May 2023, 28 patients have undergone intravenous thrombolysis. It has been effective for many patients with acute ischemic stroke within the time window**, but there are still deficiencies in the writing of stroke medical records and the quality control of links.
During this period, I organized many trainings for personnel in the department, formulated a green channel reward and punishment system, improved the quality of medical record writing for stroke patients, and optimized the treatment process of stroke patients. Some patients are not suitable for intravenous thrombolysis with alteplase** within the time window, and it is also an important work for me to further endovascular intervention** in these patients.
Zeng Weijun, an expert in neurology in Xinjiang, presided over the regular stroke meeting and formulated a reward and punishment system for stroke centers.
On October 12, 2023, a 72-year-old Uyghur aunt was admitted to the hospital with a 2-hour paralysis of her left limb. The patient is unable to move his left limb in bed and is drowsy. Although the onset is within the time window of intravenous thrombolysis, the patient has a history of intracranial hemorrhage, and macrovascular disease cannot be ruled out in combination with clinical symptoms and relevant neurological assessment. I actively communicated with the patient and family and decided to undergo endovascular intervention**. The whole cerebral angiography was quickly completed, and the contrast results showed that there was no obvious filling defect in the main blood vessels of the patient, and the responsible blood vessels were considered to be the occlusion of the right middle cerebral artery and the symptoms of hemiplegia. According to the patient's angiography, I led the interventional team of Tuoxun County People's Hospital to perform intracerebral arterial thrombolysis for the patient. The left limb function of the patient after the operation was significantly improved compared with that before the operation, and our medical staff gave us a thumbs up.
Patient** gives a thumbs up to the medical staff when he is discharged.
There is a long way to go to aid Xinjiang, and there is a long way to go. In the face of the people's thirst for high-end medical technology and the shortage of hospital talents, I feel that the responsibility on my shoulders is very heavy. Xinjiang has a vast area, and in the past, patients had no improvement in symptoms after intravenous thrombolysis, and needed to be referred to a higher-level hospital for endovascular intervention**, which took 2 hours to drive. When a blood vessel in the brain is blocked, 1.9 million brain cells die every minute. For patients with acute cerebral infarction, every minute saved in blood volume recanalization will become a guarantee for the patient's prognosis. If we can get this "**2 hours" and directly carry out endovascular intervention** locally, we can greatly reduce the disability and mortality rate of patients with acute severe ischemic stroke. I would love to break through this technical bottleneck so that these patients can get timely ** at their doorstep. To this end, I actively led local medical workers to carry out relevant Xi training, and together built a solid and strong diagnosis and treatment and intervention team.
Zeng Weijun checked the patient's condition in the ward.
On December 2, 2023, as the sound of an ambulance approached, an 83-year-old patient suffered from aphasia with a right limb movement disorder1After 5 hours of admission, the patient was drowsy, motor aphasia, unable to move the right limb, and had a history of coronary heart disease, hypertension, and diabetes. After evaluation and improvement of relevant examinations, the patient's symptoms did not improve significantly after alteplase intravenous thrombolysis**, and after communicating with the patient's family, he agreed to further endovascular intervention**, and the patient's left middle cerebral artery occlusion was confirmed after emergency angiography, and intracranial artery thrombectomy was performed. I taught what I had learned to the interventional team of the Department of Neurology of Tuoxun County People's Hospital without reservation, and led them to perform intracranial artery stent thrombectomy for the patient. After the operation, the patient's blood flow was immediately recanalized, and he was finally out of danger.
Preoperative contrast imaging versus post-thrombectomy.
Preoperative cranial CT versus follow-up cranial CT the day after surgery
This operation is the first successful percutaneous intracranial artery stent embolectomy since the establishment of Tuoxun County People's Hospital, marking a new step in the field of neurointervention, and also opening a new chapter in acute ischemic cerebral infarction in Tuoxun County Hospital.
During my six months in Xinjiang, I deeply felt that aiding Xinjiang had further enriched my feelings for my family and country and improved my political position. Although I am 3,000 kilometers away from my hometown, absent from the growth of my children and indebted to my parents, every time I see the sincere smiles and warm hugs of my brothers and sisters of all nationalities, my heart is more moved and missionary.
There is still a long way to go, and there is still a heavy burden on our shoulders. I will continue to carry forward the fine style of cadres and talents in medical aid to Xinjiang, truly solve the practical problems of the people, meet the health needs of the people in the border areas, and let the benevolence of southern Hunan take root in Tuoxun.