上海市第一人民医院多科室联合为罕见心脏海绵状血管瘤患者实施手术

2017-02-15 陈静 中新网

因咳嗽去医院就诊,却发现心脏左后侧竟又长了半个“心脏”。近日,上海市第一人民医院接诊了一位奇特的患者,经检查和专家会诊,确诊其所患为极其罕见的心脏海绵状血管瘤。医院心外科、胸外科等多科室专家团队运用人工体外循环技术,使患者心脏停跳40分钟,成功为患者摘除了这枚“不定时炸弹”,目前患者已康复出院。



因咳嗽去医院就诊,却发现心脏左后侧竟又长了半个“心脏”。近日,上海市第一人民医院接诊了一位奇特的患者,经检查和专家会诊,确诊其所患为极其罕见的心脏海绵状血管瘤。医院心外科、胸外科等多科室专家团队运用人工体外循环技术,使患者心脏停跳40分钟,成功为患者摘除了这枚“不定时炸弹”,目前患者已康复出院。

53岁的许阿姨(化名)因为咳嗽多日不止,到附近医院就诊检查。结果却意外地发现胸腔里长了个肿块,而且个头不小,已经有5厘米大,几乎是小半个心脏的体积了,这把许阿姨吓了一跳。

忐忑的许阿姨随即来到上海市第一人民医院求助,进一步检查发现,这个肿块紧贴心脏左后侧,性质不明,医生当即建议手术摘除。

入院后第四天,许阿姨被送入手术室,主刀医生从侧面开胸,呈现在医疗人员眼前的是一枚与心脏紧密粘连的肿瘤。据参与手术的市一医院心外科主任袁忠祥介绍,许阿姨的肿瘤长在心脏冠状动脉上,与心肌紧紧粘连,血供丰富,出血风险大,手术风险非常高,稍有不慎,就会伤及心脏,甚至有性命之虞。然而如果不及时为患者手术,血管瘤一旦破裂,后果不堪设想,由我院心外科、胸外科等多科室组成的专家团队顶着巨大压力,决定立刻为许阿姨实施手术。

由于要在心脏上动刀,只有暂时让心脏“休息”一下才能进行手术,这时就需要“人工心脏”接替人体心脏的工作。手术团队为许阿姨建立了低温体外循环——原本流经心脏的血液完全经插管流入人工心肺机,随着4摄氏度的冷心停搏液注入,患者的心脏随之停止跳动。时间宝贵,医疗团队立刻着手剥除。由于粘连紧密,主刀专家如同在心尖上雕花一样细细剥离,所幸血管瘤边缘尚清楚,在心脏停搏状态下仅用了四十多分钟,即顺利从许阿姨的心脏上剥下一个鸭蛋大小的海绵状血管瘤,术中仅有少量出血。术后,许阿姨恢复得很好,不到一周即顺利出院。

据了解,生长在心脏上的海绵状血管瘤非常罕见,多数是先天性血管畸形所致。由于长在心脏上,一旦破裂出血,就会造成心包填塞,导致心脏骤停猝死,就如同埋在心脏上的一枚不定时炸弹。即使血管瘤不破裂,随着肿瘤体积的不断增大也会压迫心脏,影响血供,最终影响心脏功能,导致心衰。专家提醒,海绵状血管瘤有一定的复发几率,而且难以预防,因此手术切除后仍需定期随访复查,一旦再发就能早发现、早诊治,降低风险。

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    2017-02-17 syscxl
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  6. [GetPortalCommentsPageByObjectIdResponse(id=1914906, encodeId=5054191490604, content=<a href='/topic/show?id=e823249e392' target=_blank style='color:#2F92EE;'>#人民医院#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=24973, encryptionId=e823249e392, topicName=人民医院)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8143398, createdName=lily1616, createdTime=Sun Nov 26 14:38:00 CST 2017, time=2017-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1348255, encodeId=04e6134825558, content=<a href='/topic/show?id=1eaf89e26d3' target=_blank style='color:#2F92EE;'>#血管瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89726, encryptionId=1eaf89e26d3, topicName=血管瘤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fc8528, createdName=clmlylxy, createdTime=Fri Feb 17 01:38:00 CST 2017, time=2017-02-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1443935, encodeId=99c11443935fb, content=<a href='/topic/show?id=e7601992ea4' target=_blank style='color:#2F92EE;'>#上海市#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19927, encryptionId=e7601992ea4, topicName=上海市)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83erZjNAt5tmhEibeth6ic6albyTSZPiaJWo65S17HKWhSicCsY9SmjRJgPut2nqfvkiblrkZtv1T8vPSCAQ/132, createdBy=ad4d5130176, createdName=ms3046638856685384, createdTime=Fri Feb 17 01:38:00 CST 2017, time=2017-02-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1467182, encodeId=9906146e18233, content=<a href='/topic/show?id=ef32e9539e8' target=_blank style='color:#2F92EE;'>#罕见#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79539, encryptionId=ef32e9539e8, topicName=罕见)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=29f36868190, createdName=syscxl, createdTime=Fri Feb 17 01:38:00 CST 2017, time=2017-02-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1551036, encodeId=99b61551036a1, content=<a href='/topic/show?id=04886565ee9' target=_blank style='color:#2F92EE;'>#海绵状血管瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65657, encryptionId=04886565ee9, topicName=海绵状血管瘤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a0ba14160863, createdName=lvliquan, createdTime=Fri Feb 17 01:38:00 CST 2017, time=2017-02-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1591762, encodeId=39aa1591e625f, content=<a href='/topic/show?id=3047656523d' target=_blank style='color:#2F92EE;'>#海绵状#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65652, encryptionId=3047656523d, topicName=海绵状)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=223518012442, createdName=cooco, createdTime=Fri Feb 17 01:38:00 CST 2017, time=2017-02-17, status=1, ipAttribution=)]
    2017-02-17 cooco