Changjiang Daily Wuhan Client March 16 (Reporter Liu Xuan Correspondent Liu Wang) “Fortunately, there is no delay at home. If you come later, the doctor will not be able to return to the sky.” Looking at the recovering old uncle Ma, Wuhan City Zhong Ruolei, director of the Department of Vascular Surgery at the Sixth Hospital (Affiliated Hospital of Jianghan University), was very emotional. Just the day before Mr. Ma was admitted to the hospital, 52-year-old Mr. Li stayed at home for three days because of the same chest and back pain, and lost his life on the way to the hospital.
The old man had back pain and went to the doctor in time to save his life
73-year-old old man Ma lives in Houhu Community. On the morning of March 11, he suddenly felt severe back pain. Thinking it was out of breath, the old man didn’t care too much and sat on the sofa to rest for a while. Not only did the pain not relieve, but it became more and more severe. The body seemed to be split in half with a knife, and the pain was like being torn apart. His family rushed him to the nearest city No. 6 hospital.
The doctor carefully asked about the medical history and highly suspected that Mr. Ma had aortic dissection. After aortic CTA and dual-source CT quick scans, the doctor’s inference was confirmed: thoracic aortic dissection, the blood vessel was torn about 15 cm, and the tear was very close to the left subclavian artery. Aortic dissection is very dangerous and must be operated on immediately, otherwise, once the dissection ruptures, it can be fatal in an instant.
Director Zhong Ruolei (pictured right) and Dr. Sun Guoyang are operating on Uncle Ma. Photo by Correspondent Liu Wang
After obtaining the consent of the family, Mr. Ma was immediately pushed into the operating room. The tricky thing is that the left subclavian artery is the main channel for blood supply to the brain and upper extremities. Directly inserting the stent to seal the breach will block this “main artery”, causing cerebral ischemia or even cerebral infarction, so it must be preserved. . Zhong Ruolei, director of the Department of Vascular Surgery, led the team to use the “extracorporeal fenestration” endoluminal isolation of the covered stent to precisely open the “window” on the aortic stent. The released fenestration stent perfectly preserved the left subclavian artery, covering and sealing the dissection rupture, and Mr. Ma turned the corner. On the second day after the operation, Uncle Ma was able to get out of bed and walk.
Compared to Mr. Ma, Mr. Li, 52, is not so lucky. On March 8, Mr. Li developed back tear-like pain. He endured it at home for 3 days. When he couldn’t hold it any longer, he decided to go to the hospital. As a result, his aortic dissection ruptured halfway, and he died before reaching the hospital.
80% of patients with aortic dissection suffer from high blood pressure
The aorta is the “main artery” that supplies blood to the heart. It is thick and thick. Blood vessels are composed of inner, middle and outer layers, which are normally closely attached together. If the intima is affected by some factors for a long time, such as high blood pressure and atherosclerosis, it will become brittle and eventually “torn” by the flowing blood. After the intima is ruptured, a large amount of blood is poured between the intima and the adventitia, forming a bulging bag, which is aortic dissection. Zhong Ruolei introduced that if the blood pressure keeps rising, just like a tire blowing out if you keep inflating the tire, the tumor will burst, and the patient will die immediately due to sudden massive blood loss.
According to clinical statistics, about 80% of patients with aortic dissection suffer from high blood pressure, and most of them have neglected blood pressure control, resulting in high blood pressure all year round. “Foreign patients with aortic dissection are generally in their 50s and 60s. In my country, patients with aortic dissection are generally 10-15 years younger than those in Europe and the United States. In recent years, there has been a clear trend of younger people.” Zhong Ruolei explained that this is because young people People generally lack awareness of physical examination. They don’t know they have high blood pressure, or they know they have high blood pressure, but they don’t take it seriously, and it’s caused by the lack of standardized medication. Although aortic dissection is menacing, as long as blood pressure is well controlled, most aortic dissections can be prevented.
He reminded that once there is sudden severe chest or back tear-like pain, especially when lifting heavy objects, playing basketball, yawning, coughing, defecation, etc. Carry it, go to the hospital immediately, especially for patients with a history of hypertension. At this time, not only acute myocardial infarction should be considered, but also the possibility of aortic dissection should be ruled out.
[Editor: Yu Lina]