Qilu One Point Reporter Xu Liang Correspondent Zhang Xiaoran Houjin
The treatment of lower limb arteriosclerosis obliterans is not too complicated in itself, but if the patient is over 90 years old and has underlying diseases such as heart disease, high blood pressure , then the difficulty and risk of the operation will be greatly increased, and the requirements for the doctor's technical level will be greatly increased.
Recently, the Department of Vascular Surgery of Dezhou Municipal Hospital has risen to the challenge and climbed to the peak of technology. It has joined hands with the Department of Critical Care Medicine, Department of Surgical Anesthesia, Department of Cardiology, Department of Imaging, Department of Neurology and other disciplines to perform minimally invasive surgery. , two elderly people over 90 years old suffering from lower limb arteriosclerosis obliterans were saved from danger.
Multi-dimensional linkage 92-year-old man successfully underwent surgery
html On June 1, 92-year-old Ms. Li found that her left foot was somewhat weak and she felt slightly numb. Because he suffered from high blood pressure, high blood sugar, and was hospitalized for cerebral infarction, his family members rushed him to the Neurology Department of Dezhou Municipal Hospital at 5 pm on the 2nd. However, the brain CT scan after admission showed that Ms. Li had no new ischemic lesions, so the problem most likely occurred in the blood vessels of the lower limbs.Sure enough, color ultrasound showed that Ms. Li had an acute blockage in the femoral artery in her left lower limb, resulting in muscle ischemia, nerve damage, and symptoms of coldness, weakness and pain in the lower legs. The blood vessels must be opened immediately, otherwise it will cause damage to the lower limbs. Amputated due to ischemia.
For Qi Hongjun, director of vascular surgery with many years of medical experience, it is not difficult to operate on patients with lower limb arteriosclerosis and occlusion. But Ms. Li is 92 years old this year and also suffers from coronary heart disease and hypertension. To ensure safety, doctors from the surgical anesthesia department and critical care medicine department also participated in the formulation of the surgical plan.
"The patient's cardiopulmonary function and physical condition are too poor to tolerate open surgery under general anesthesia. Minimally invasive surgery under local anesthesia can improve safety." Chen Shihui, deputy director of vascular surgery, explained that according to the traditional surgical method , which requires incision of the blood vessel to remove the thrombus, which is a large trauma. However, minimally invasive surgery uses a mechanical thrombus removal system to aspirate the thrombus. It only needs to insert a catheter into an incision the size of a "keyhole". It provides local anesthesia, fast recovery, and is more suitable for physical conditions. poor elderly patients.
Precise minimally invasive escort for vascular health of elderly patients
html On June 4, with the joint efforts of vascular surgeons Qi Hongjun, Chen Shihui, Shang Aijun and the cardiology and ICU teams, after one and a half hours of precise operation and tacit cooperation, the surgical team was Ms. Li sucked out the thrombus in the blood vessel and placed a stent to completely open the blocked blood vessel. After the operation, Ms. Li regained feeling in her calves and became rosy. She was transferred to the ICU for monitoring. After a few days, she returned to the general ward and has now recovered and been discharged.In fact, just three hours before Ms. Li was admitted to the hospital, the Department of Vascular Surgery of Dezhou Municipal Hospital had just completed a mechanical thrombectomy operation for lower extremity arterial thrombosis. The subject of the operation was Ms. Fang, who also suffered from arteriosclerosis obliterans of the lower limbs and was also 92 years old.
When she was admitted to hospital on May 29, Ms. Fang's heart rate was already as high as 130 beats/minute. At this time, her left leg had been in pain for more than ten days. The skin of her left foot was as pale as paper, accompanied by coldness and numbness. "It's normal for your legs and feet to be uncomfortable as you get older. You can get better by soaking your feet and massaging them. If you really can't take some painkillers." With this idea in mind, Ms. Fang "treated" herself at home, but her condition did not improve until I came to the hospital because it was unbearable. Unexpectedly, I was admitted to the ICU due to leg pain.
"The heart of the elderly has atrial fibrillation , which is one of the high-risk factors for blood vessel blockage." Chen Shihui said that the atrial beating frequency is fast and irregular, blood stasis forms thrombus, and after falling off, it flows to all parts of the body with the blood, resulting in cerebral embolism , limb arterial embolism.
Two days later, Ms. Fang’s vital signs were stable. Under the guidance of Qi Hongjun, Chen Shihui performed minimally invasive interventional surgery on Ms. Fang.During the operation, "mechanical catheter suction" was performed to effectively remove the thrombus, and then further "balloon expansion molding and stent placement" were performed. Immediate postoperative angiography showed that the occluded artery was completely unobstructed, and the patient's lower limbs quickly experienced numbness and pain. be relieved. Subsequently, the patient was transferred to the ICU for continued observation. After his physical signs stabilized, he was transferred to the cardiology department for follow-up treatment.
Experts remind: If your legs are painful or cold, seek medical advice early and don’t be careless.
"Arteriosclerosis obliterans of the lower limbs is a very common disease, especially in patients with cardiovascular and cerebrovascular diseases, and is more common in middle-aged and elderly people." Chen Shihui explained, The formation of atherosclerotic plaques in the lower limbs causes stenosis and occlusion of the arteries of the lower limbs, leading to chronic ischemia and pain in the limbs. If not treated in time, complete occlusion of the arteries of the lower limbs will lead to tissue necrosis and eventually amputation.
Smoking, diabetes , hyperlipidemia, hypertension, etc. are the main causes of arteriosclerosis obliterans in the lower limbs. "This type of patients has no obvious symptoms in the early stage, but only feels cold, numbness, pain, and cramps in their lower limbs, and then develops intermittent claudication and resting pain. Many elderly people think that leg pain is normal as they get older. phenomenon, thus delaying treatment. "Chen Shihui said that every year, the department has patients with nerve and muscle necrosis and amputation due to delayed medical treatment. Therefore, if high-risk groups have the above symptoms, they should go to regular medical institutions in time to avoid missed diagnosis and Misdiagnosis.
Since April this year, the Department of Vascular Surgery of Dezhou Municipal Hospital has continued to reach the peak of technology and performed operations on more than ten elderly people over 80 years old suffering from arteriosclerosis obliterans of the lower limbs, two of whom were over 90 years old. These operations can be completed with high quality, relying on the multidisciplinary diagnosis and treatment model of Dezhou Municipal Hospital. There is a tacit cooperation between departments, doctors’ diagnosis is accurate, and the surgical plan is meticulous. In the next step, the Vascular Surgery Department of Dezhou Municipal Hospital will further strengthen the discipline construction, improve the level of diagnosis and treatment, and provide patients with more high-quality, safe and accurate diagnosis and treatment services.
