市中心医院多学科接力救治重症静脉窦血栓患者
<div class="wx_rich_media_content" id="jsWxContainer"><section style='font-size: 16px;'><section style='justify-content: flex-start; display: flex; flex-flow: row; margin-bottom: 10px;'><section style='display: inline-block;width: 100%;vertical-align: top;align-self: flex-start;flex: 0 0 auto;border-style: dotted;border-width: 1px;border-color: rgb(95, 156, 239);padding: 26px 20px 20px;'><section style='text-align: justify;color: rgb(62, 62, 62);line-height: 2;'><p style='word-break: break-all;text-indent: 2em;text-wrap: wrap;'>近日，渭南市中心医院急诊科收治一外院转入脑血管患者，患者住院期间症状不稳定，伴癫痫发作、意识障碍。</p></section><section style='text-align: justify;'><p><br></p></section><section style='font-size: 15px;text-align: center;'><p><strong>术前影像</strong></p></section><section style='margin: 6px 0%;justify-content: flex-start;display: flex;flex-flow: row;'><section style='display: inline-block;vertical-align: middle;width: 33.33%;padding-right: 3px;padding-left: 3px;align-self: center;flex: 0 0 auto;'><section style='text-align: center;margin-right: 0%;margin-left: 0%;line-height: 0;'><section style='vertical-align: middle;display: inline-block;line-height: 0;'><span class="wxart_image" wx-style='display:inline-block;vertical-align: middle;width: 100%;'></span></section></section><section style='text-align: center;font-size: 14px;'><p><strong>静脉血栓影</strong></p></section></section><section style='display: inline-block;vertical-align: middle;width: 33.33%;padding-right: 3px;padding-left: 3px;align-self: center;flex: 0 0 auto;'><section style='text-align: center;margin-right: 0%;margin-left: 0%;line-height: 0;'><section style='vertical-align: middle;display: inline-block;line-height: 0;'><span class="wxart_image" wx-style='display:inline-block;vertical-align: middle;width: 100%;'></span></section></section><section style='text-align: center;font-size: 14px;'><p><strong>静脉性脑出血</strong></p></section></section><section style='display: inline-block;vertical-align: middle;width: 33.33%;padding-right: 3px;padding-left: 3px;align-self: center;flex: 0 0 auto;'><section style='text-align: center;margin-right: 0%;margin-left: 0%;line-height: 0;'><section style='vertical-align: middle;display: inline-block;line-height: 0;'><span class="wxart_image" wx-style='display:inline-block;vertical-align: middle;width: 100%;'></span></section></section><section style='text-align: center;font-size: 14px;'><p> <strong>静脉窦</strong></p><p><strong>广泛血栓</strong></p></section></section></section><section style='text-align: justify;'><p><br></p></section><section style='text-align: justify;color: rgb(62, 62, 62);line-height: 2;'><p style='word-break: break-all;text-indent: 2em;text-wrap: wrap;'>急诊科讨论后给予患者复查颅脑CT，患者脑出血非常见部位，与CT室积极讨论后不排除颅内静脉窦血栓形成。经神经内科医师会诊后，考虑患者颅内静脉窦血栓形成可转入神经内科治疗。<br></p></section><section style='text-align: justify;'><p><br></p></section><section style='text-align: center;font-size: 15px;'><p><strong>术中血栓及术后复查CE-MRV</strong></p></section><section style='margin: 6px 0%;justify-content: flex-start;display: flex;flex-flow: row;'><section style='display: inline-block;vertical-align: middle;width: 33.33%;padding-right: 3px;padding-left: 3px;align-self: center;flex: 0 0 auto;'><section style='text-align: center;margin-right: 0%;margin-left: 0%;line-height: 0;'><section style='vertical-align: middle;display: inline-block;line-height: 0;'><span class="wxart_image" wx-style='display:inline-block;vertical-align: middle;width: 100%;'></span></section></section><section style='text-align: center;font-size: 14px;'><p><strong>术中取出血栓</strong></p></section></section><section style='display: inline-block;vertical-align: middle;width: 33.33%;padding-right: 3px;padding-left: 3px;align-self: center;flex: 0 0 auto;'><section style='text-align: center;margin-right: 0%;margin-left: 0%;line-height: 0;'><section style='vertical-align: middle;display: inline-block;line-height: 0;'><span class="wxart_image" wx-style='display:inline-block;vertical-align: middle;width: 100%;'></span></section></section><section style='text-align: center;font-size: 14px;'><p><strong>复查MRV正位</strong></p></section></section><section style='display: inline-block;vertical-align: middle;width: 33.33%;padding-right: 3px;padding-left: 3px;align-self: center;flex: 0 0 auto;'><section style='text-align: center;margin-right: 0%;margin-left: 0%;line-height: 0;'><section style='vertical-align: middle;display: inline-block;line-height: 0;'><span class="wxart_image" wx-style='display:inline-block;vertical-align: middle;width: 100%;'></span></section></section><section style='text-align: center;font-size: 14px;'><p><strong>复查MRV侧位</strong></p></section></section></section><section style='text-align: justify;'><p><br></p></section><section style='text-align: justify;color: rgb(62, 62, 62);line-height: 2;'><p style='word-break: break-all;text-indent: 2em;text-wrap: wrap;'>患者转入神经内科后，行腰穿及核磁共振检查，考虑患者颅内静脉窦广泛血栓形成，病情危重。患者有行颅内静脉窦造影及取栓指征，与患者家属商议后，第一时间脑血管造影，明确颅内静脉窦血栓，并给与颅内静脉窦取栓，5小时后患者静脉窦再通，成功回病房进一步抗凝药物治疗。<br></p></section><section style='text-align: justify;'><p><br></p></section><section style='text-align: center;font-size: 15px;'><p><strong>出院前复查CT及患者情况</strong></p></section><section style='margin: 6px 0%;justify-content: flex-start;display: flex;flex-flow: row;'><section style='display: inline-block;vertical-align: middle;width: 33.33%;padding-right: 3px;padding-left: 3px;align-self: center;flex: 0 0 auto;'><section style='text-align: center;margin-right: 0%;margin-left: 0%;line-height: 0;'><section style='vertical-align: middle;display: inline-block;line-height: 0;'><span class="wxart_image" wx-style='display:inline-block;vertical-align: middle;width: 100%;'></span></section></section><section style='text-align: center;font-size: 14px;'><p><strong>血栓影消失</strong></p></section></section><section style='display: inline-block;vertical-align: middle;width: 33.33%;padding-right: 3px;padding-left: 3px;align-self: center;flex: 0 0 auto;'><section style='text-align: center;margin-right: 0%;margin-left: 0%;line-height: 0;'><section style='vertical-align: middle;display: inline-block;line-height: 0;'><span class="wxart_image" wx-style='display:inline-block;vertical-align: middle;width: 100%;'></span></section></section><section style='text-align: center;font-size: 14px;'><p><strong>血肿吸收</strong></p></section></section><section style='display: inline-block;vertical-align: middle;width: 33.33%;padding-right: 3px;padding-left: 3px;align-self: center;flex: 0 0 auto;'><section style='text-align: center;margin-right: 0%;margin-left: 0%;line-height: 0;'><section style='vertical-align: middle;display: inline-block;line-height: 0;'><span class="wxart_image" wx-style='display:inline-block;vertical-align: middle;width: 100%;'></span></section></section><section style='text-align: center;font-size: 14px;'><p> <strong>患者完全康复</strong></p></section></section></section><section style='text-align: justify;'><p><br></p></section><section style='text-align: justify;color: rgb(62, 62, 62);line-height: 2;'><p style='word-break: break-all;text-indent: 2em;text-wrap: wrap;'>经过积极治疗，患者症状明显缓解。术后患者进行病因学检查，与风湿免疫科讨论后，考虑患者为狼疮性脑炎。经风湿免疫科抗炎、免疫抑制治疗，患者康复后出院。</p></section><section style='text-align: justify;'><p><br></p></section><section style='text-align: justify;color: rgb(62, 62, 62);line-height: 2;'><p style='word-break: break-all;text-indent: 2em;text-wrap: wrap;'>颅内静脉窦血栓是一种少见病，发病率为13.2/100万。患者临床表现复杂，早期诊断困难，误诊率高达73%。重症静脉窦血栓若未得到及时救治可能造成非常差的预后效果。CT&MR室开展CE-MRV磁共振黑血成像技术，对静脉窦血栓诊断提供了保障。神经内科成功开展的静脉窦取栓术、静脉窦支架置入术，在颅内静脉窦诊断、治疗领域优势明显。</p></section></section></section></section><section data-style='margin-right: 8px; margin-left: 8px; outline: 0px; color: rgb(34, 34, 34); letter-spacing: 0.544px; caret-color: rgb(34, 34, 34); font-family: -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; text-align: center; visibility: visible;' class="js_darkmode__5" style='-webkit-tap-highlight-color: transparent; margin-right: 8px; margin-left: 8px; outline: 0px; letter-spacing: 0.544px; text-align: center; color: rgb(34, 34, 34); caret-color: rgb(34, 34, 34); font-family: -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; visibility: visible;'></section><p style='display: none;'><mp-style-type data-value="3"></mp-style-type></p></div><p></p> 中心医院技术好的 医院是救死扶伤的地方 确保患者生命安全 技术力量杠杠的 中心医院给力 脑出血康复不容易 现在的中老年人大多基础病比较多。需要综合治疗。 癫痫发作、意识障碍 住院期间症状不稳定
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