Surgeons treat diseases, anesthesiologists save lives. Anesthesia not only protects patients from pain during surgery, but more importantly, ensures the patient’s vital signs remain stable throughout the entire surgery. This is a “technical job.” Recently, a patient with severe pulmonary hypertension was successfully treated under the escort of the anesthesia department of our hospital.
70-year-old Grandpa Zhu suffered from intermittent abdominal pain for several months. He was hospitalized in several large tertiary hospitals in the city. He was finally diagnosed with adenocarcinoma of the transverse colon. However, due to the patient's older age, reduced physiological functions and poor body compensatory ability , combined with severe pulmonary hypertension, diabetes , coronary heart disease and other diseases, surgical anesthesia was extremely risky, and he could not tolerate surgical treatment and was refused, so he came to our hospital for treatment.
Considering that the patient's huge intestinal tumor has caused intestinal obstruction, he cannot eat normally, and his quality of life is very poor. In addition, he has many underlying diseases, the tumor has metastasized to the lungs, and his lung function is also very poor. At the same time, the preoperative cardiac ultrasound examination showed that the patient's pulmonary artery pressure was 99 mmHg (mean pulmonary artery pressure at sea level and resting state ≥ 25 mmHg, and ≥ 30 mmHg during exercise can be diagnosed as pulmonary hypertension . Pulmonary hypertension is divided into mild and moderate , severe, 2540mmHg is mild; 4155mmHg is moderate; greater than 55mmHg is severe), all of the above have brought huge challenges to anesthesia. Director Zhong Jianghe said: "In the perioperative period, the lack of any consideration of the patient's condition may put his life in danger."
In order to achieve refined management of anesthesia, Director Zhong Hejiang organized the anesthesiology team to carry out active Preoperative discussion, based on the patient's condition, careful consideration of every link from preoperative assessment, anesthesia plan formulation, anesthesia induction, maintenance to recovery, and a multidisciplinary joint consultation to determine the surgical plan, and decided to completely solve the problem of intestinal tract for Grandpa Zhu. The fundamental problem is blocking .
Everything was ready, Grandpa Zhu was pushed into the operating room, taking huge risks, everyone came on stage, and the anesthesia team's "breakthrough" was from beginning to end. Director Zhong Hejiang led the anesthesia team to conduct invasive arterial and venous puncture pressure measurement and ultrasound-guided block for the patient. After preparing all the drugs and items, the real anesthesia came one after another. Between the anesthesia team and the digestive disease team With full cooperation, the patient's indicators were stable and the operation was successfully completed. In order to avoid complications , Grandpa Zhu was transferred to the intensive care unit after the catheter was pulled out.
"Try your best to help me heal, and I will fully cooperate with you. I want to live!" Before the operation, Grandpa Zhu looked at Director Zhong Hejiang and said with hope. Careful before the operation, diligent during the operation and diligent after the operation, the expert team of the Digestive Disease Center of the Anesthesiology Department of our hospital has lived up to the trust of the old man. Now Grandpa Zhu is also recovering smoothly. From the beginning, he had the mentality that an accident might happen at any time. You have to slowly become more confident.
"Anesthesia allows surgical operations to be carried out safely and smoothly, and patients recover better and more comfortably. Improving professional capabilities is a gradual process, but a serious and responsible attitude must be maintained from the beginning to the end. It needs to be persisted from the moment you step on the job until you retire and leave the job. time." Director Zhong Hejiang said. As the "protagonist behind the scenes", anesthesiologists are often racing against time. Almost all operations are inseparable from the participation of anesthesiologists. They see all directions, listen to all directions, and are on call 24 hours a day. Therefore, they must have rapid response and processing capabilities. Speed, as one of the main forces in ensuring that patients survive the perioperative period safely, the anesthesiology department of our hospital will continue to use solid knowledge, superb technology, and warm care to escort every operation.
Popular science Little knowledge: Pulmonary hypertension (PH) refers to the increase in pulmonary vascular resistance and pulmonary artery pressure caused by changes in the structure or function of the pulmonary blood vessels caused by a variety of heterologous diseases (causes) and different pathogenesis. The clinical and pathophysiological syndromes then develop into right heart failure or even death.The clinical symptoms of pulmonary hypertension lack specificity and are mainly related to symptoms of progressive right ventricular insufficiency, which are often induced after exertion and manifest as fatigue, dyspnea, chest tightness, chest pain and syncope. Some patients may also present with dry cough. and exercise-induced nausea and vomiting. Severe pulmonary artery dilation can cause pulmonary artery rupture or dissection.
Correspondent | Chen Tingrong
Editor |
