50 year old woman with severe hemorrhagic shock of splenic artery aneurysm burst burst-reshacker

The patients with CT angiography map of Zhenjiang 50 year old Ms. Chen severe shock Zhang Jijun hemorrhage 50 year old woman with splenic artery aneurysm burst burst, a few days ago experienced a desperate heart experience — hidden in the body of splenic artery aneurysm burst burst bleeding. Fortunately, after the hospital doctor in a timely and accurate diagnosis and prompt for surgery, "like a piece of tofu for fishbone, finally saved her life. 22, the reporter learned in Zhenjiang Fourth People’s Hospital, Ms. Chen is currently stable. The sudden outbreak of the disease, the hospital disclosed that this has never participated in any physical examination before Ms. Chen, there is a certain relationship. In the afternoon of October 14th, Ms. Chen was sent to the Fourth People’s Hospital of Zhenjiang for severe pain in the upper abdomen. CT examination revealed massive hemorrhage in the abdominal cavity, but the exact cause of bleeding was unknown. Hospital emergency room immediately with the Department of general surgery director Zhang Jijun contact, Zhang Jijun immediately let medical staff for patients with CT angiography examination. Soon, the examination showed rupture of splenic artery aneurysm. When the patient has brought severe shock, a very dangerous disease ", director Zhang Jijun has 30 years of clinical experience told reporters, when ruptured splenic artery aneurysm Chen sent bleeding emergencies like this, must be" calm judgment, fast processing". After diagnosing the cause, Zhang Jijun and his team immediately performed surgery. The whole operation lasted more than 2 hours, and the amount of bleeding was as high as 5000 ml, which was equal to the whole body’s blood. "This operation can be completed smoothly to the doctor, but also a test", Zhang Jijun introduced the first CT angiography for Ms. Chen, get timely and accurate diagnosis, which is the foundation; secondly, in the operation, if not timely, quickly find the splenic artery vascular occlusion, rapidly, it is difficult to think of the consequences. The patients with ruptured aneurysm after formation of retroperitoneal hematoma after huge around abdominal vessel and pancreas, "spleen artery accurately found in huge hematoma, like finding a fishbone in a piece of tofu, have many years of clinical experience and touch feeling, a fear is difficult to find," Zhang Jijun said. And it is because of the accurate diagnosis and rich clinical experience, the operation is successful, Ms. Chen lucky life. At present, Ms. Chen is in stable condition and is recovering from treatment. So, why does the patient have this sudden illness? "Patients had never had physical examination, interview, Zhang Jijun introduction, after understanding, Ms. Chen has never participated in the examination, and did not know that they have high blood pressure, do not know when the patients with splenic artery aneurysm. "Understanding down, she is a" three noes "hundred-percent patients", said Zhang Jijun, a rare clinical splenic artery aneurysm, but if there are increased abdominal pressure factors, trauma, high blood pressure, can be induced by aneurysm rupture. Faced with this dangerous patient, Zhang Jijun reminded, regular physical examination is necessary. Usually, abdominal ultrasonography can be used to detect splenic aneurysms in advance so as to deal with them in time. At the same time or the trauma society traffic injury trauma database Specialized Committee member Zhang Jijun also told reporters that the close relationship between pregnancy and splenic artery aneurysm, 95% "during pregnancy can rupture, and endanger life. Ling now

50岁女子脾动脉瘤突发爆裂大出血重度休克张继军介绍患者病情CT血管造影图镇江50岁的陈女士,几天前经历了一场心惊肉跳的殊死经历——隐藏在其体内的脾动脉瘤突发爆裂后大出血。万幸的是,送医后医生及时准确诊断并立即为其手术,“好比一块豆腐中找根鱼刺”,才终于挽回了她的生命。22日,记者在镇江市第四人民医院了解到,陈女士目前病情稳定。而之所以突发凶症,院方透露,这与陈女士此前从未参加过任何体检,有一定干系。10月14日下午,陈女士因上腹剧烈疼痛,被送往镇江市第四人民医院抢救。经CT检查,发现其腹腔内大面积出血,但具体出血原因不详。医院急诊室马上与院普外科主任张继军联系,张继军立即让医务人员为病人做CT血管造影检查。很快,检查显示为脾动脉瘤破裂。“病人送来的时候已经重度休克,病情非常凶险”,有着30多年临床经验的张继军主任告诉记者,陈女士送来的时候脾动脉瘤已破裂大出血,遇到这种紧急情况,必须要“冷静判断,快速处理”。在诊断出明确病因后,张继军和他的团队立即实施手术。整个手术进行了2个多小时,期间患者的出血量高达5000毫升,等于整个身体的血换了一遍。“此次手术能顺利完成对医生来说,也是一个考验”,张继军介绍,首先为陈女士做CT血管造影检查,得到及时准确的诊断,这是基础;其次,在手术中,如不能及时、快速找到脾动脉主干血管,迅速阻断,后果也很难想。患者动脉瘤破裂后,在腹腔大血管及胰腺周围形成巨大的后腹膜血肿,“要在巨大血肿中准确找到脾动脉血管,就如同在一块豆腐中寻找一根鱼刺一样,没有多年的临床经验和触摸手感,一时恐怕难以找到”,张继军说。而正因为有了准确的诊断和丰富的临床经验,手术得以成功,陈女士万幸保命。目前,陈女士病情稳定,正在恢复治疗中。那么,患者何以会突发此凶症? “患者此前从未体检过”,采访中,张继军介绍,经术后了解,陈女士从未参加过体检,并且也不知道自己有高血压,更不知何时患有脾动脉瘤。“了解下来,她是个不折不扣的‘三无’病人”,张继军说,脾动脉瘤临床少见,但如存在腹压增高因素、外伤、血压升高等情况,即可诱发瘤体破裂。面对这一凶险的患者,张继军提醒,定期体检很有必要。通常腹部超声检查,就可提前发现脾动脉瘤,以便及时处理。同时还是中华创伤学会交通伤及创伤数据库专业委员会委员的张继军还告诉记者,脾动脉瘤的发生与妊娠关系密切,“怀孕期间95%会发生破裂,危及母子生命。现在怀二胎的也比较多,因此在做围产期检查时,也应当做上腹部B超检查”,张继军提醒,再有,当发生不明原因腹痛及腹腔出血,应立即为患者做CT血管造影检查。链接:脾动脉瘤的病因一般认为与动脉壁结构异常和内分泌水平改变有关。主要病因包括脾动脉纤维肌性发育不良、多次妊娠、门静脉高压、急慢性胰腺炎等,其他少见病因包括医源性损伤、外伤、感染等。需特别指出的是:脾动脉瘤破裂死亡率达36%,而妊娠期更容易发生破裂,并且其死亡率可上升至高达70%。编辑:乔金玲相关的主题文章: