內容目錄
Text/Yangcheng Evening News All-Media Reporter Zhang Hua
Correspondent Wang Shuhui
“During the Spring Festival, 4 cases of aortic dissection were received in February.” Guangdong Province No. Zhong Zhimin, director of the Provincial Cardiovascular Surgery Department of the Second People’s Hospital, said, “This situation is a bit unexpected, and it may be related to the extremely cold weather during the Spring Festival this year. Fortunately, timely surgery has saved all risks and these patients have been discharged smoothly.” 80% of aortic dissection is related to hypertension, so hypertension must be prevented.
4 cases of aortic dissection, with an average age in their early 40s
The aorta is the largest blood vessel in the human body through which blood is transported to the whole body. The wall of the aorta is made up of three layers of tissue, called the intima, media, and adventitia, that fit together. Due to various pathological factors, the intima of the arterial wall is torn and aortic dissection occurs. After the occurrence of aortic dissection, the arterial wall itself will become thin and brittle, and the periphery of the blood is only wrapped by a thin layer of adventitia, as if buried “Bombs” in the blood vessels. If the outer membrane cannot withstand the blood pressure in the body, the outer membrane will “explode”, causing massive bleeding, and the fatality rate is almost 100%.
During the Spring Festival, Ms. Liu, a 34-year-old migrant worker in Guangdong, suffered from severe chest pain. She was transferred from Taishan to the Second Provincial Hospital in the early morning of the first day of the new year. At 5:00 in the morning, the hospital opened a green channel for her, giving priority to conducting total aortic CTA, cardiac color ultrasound and other examinations for Ms. Liu, and finally diagnosed her as “acute type A aortic dissection”. The condition is very dangerous and requires emergency surgery. .
At this time, the patient’s condition was not very good, the body temperature of the lower extremities decreased due to ischemia, and the consciousness was not very clear. Zhong Zhimin, director of cardiovascular surgery, led the team to perform emergency aortic sinus shaping and total aortic arch artificial vascular replacement surgery for Ms. Liu, and successfully rescued her from the brink of death.
Such young patients are actually rare in clinical practice. Zhong Zhimin said that when he came to the hospital, the patient’s blood pressure was measured as high as 180mmHg, and the patient had never used antihypertensive drugs. In addition, the sudden cooling and cold weather at that time might have accelerated the occurrence and development of the disease. According to statistics, during the month of February, the Second Provincial Hospital admitted 4 patients with aortic dissection. The average age is only 40 years old. Obviously, the disease has a younger trend.
Tear pain in the chest and back needs to be careful
On February 18, the second provincial doctor admitted another patient. patients with arterial dissection. Mr. Wang, 52, who lives in Guangzhou, suffered from tearing pain in his chest and back. He endured it for 4 hours and then went to the emergency department of the Second Provincial Hospital for medical treatment. The emergency department performed a thoracic and abdominal CTA examination for Mr. Wang. The examination showed that his aortic dissection involved a wide range, and the torn part was very close to the opening of the coronary artery, which would “burst blood vessels” at any time.
It only took 3 hours from admission to the operating room. Subsequently, the team of chief physician Zhong Zhimin completed aortic sinus angioplasty + ascending aorta, total aortic arch artificial vessel replacement + descending aortic stent implantation for Mr. Wang. After the operation, Mr. Wang carried out follow-up rehabilitation treatment under the guidance of cardiovascular surgery, respiratory medicine, and rehabilitation medicine. At present, Mr. Wang has basically recovered and was transferred to the general ward for continued treatment.
Zhong Zhimin said that the occurrence of aortic dissection is difficult to predict, but once it occurs, severe chest and back pain will occur, and emergency medical attention should be sought at this time. Moreover, nearly 80% of aortic dissections are caused by high blood pressure. People who do not take regular medication to control blood pressure have a higher risk of aortic dissection. Long-term poor eating habits, smoking, and alcoholism can also lead to atherosclerosis. To further induce the occurrence of hypertension, a large proportion of patients with aortic dissection are obese patients.
In addition, patients with Marfan syndrome have congenital absence of elastic fibers in the middle aortic wall, and the quality of blood vessels is lower than that of normal subjects, which increases the risk of aortic dissection.
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