一颗“痘”2张病危通知书+5天抢救+3万医疗费!再也不敢手欠了

2017-09-20 郦晓君 澎湃新闻

脸上长“痘子”,忍不住挤一下,生活中很多人都有这样的习惯。但有人挤“痘”却差点危及生命,医生连下了两张病危通知书。

据报道:脸上长“痘子”,忍不住挤一下,生活中很多人都有这样的习惯。但有人挤“痘”却差点危及生命,医生连下了两张病危通知书。

“患者姓张(化名),50岁,家住嘉兴,中等身材,从事体力劳动,半个多月前急诊转到我们医院,来的时候情况很凶险,整张脸基本上都是肿的,尤其是眼睑部、嘴巴,张口受限,已经不能自主呼吸,高热,有39.5℃。”浙大一院口腔科副主任汪国华主任医师说。

进一步检查后,张先生的主管医生、浙大一院口腔科主任刘建华主任医师发现,张先生的左侧口角肿胀、光亮,有个直径约1.5厘米的组织发黑,且有少量脓血性液体流出,便追问病史。

张先生患糖尿病多年,平时血糖控制得还可以。入院前几天,发现自己左侧上嘴唇长了颗“痘子”,开始他没在意。两天后,“痘子”逐渐长大,约米粒大小,有点痛,他觉得难受,就用手挤了一下,挤出一些白白的东西。

半小时后,张先生就发现自己挤过的“痘子”肿了,但因为身体没有其他不适感,也就没放心上。第二天下午,张先生发现整张嘴都肿了,且越肿越大,还出现头痛,浑身难受等症状,家人慌了神,立即送往当地医院就诊。

“开始,当地医生也没查出具体的病因,只是对症处理,给他挂盐水。”汪医师说,然而,张先生的病情进展得远比大家预料的要快,并出现了高热、呼吸困难等症状,血糖也高上去了。

当晚8:19,张先生被转到浙大一院。经检查,被诊断为上唇疖肿并发左侧颌面部多间隙感染,一种若不及时处理会危及生命的口腔疾病。

两次下病危通知书,抢救5天才脱离生命危险

尽快切开排脓是治疗间隙感染的主要方式,但由于张先生患有糖尿病,治疗难度大大增加。

“他在好几天没吃东西的情况下,随机空腹血糖竟然也达到了15.3(正常人在7.1以内),血酮体很高,有2个‘+’。临床上,一个‘+’就算严重,有发生酮症酸中毒(内科急症,有致命的危险)的风险。”汪国华医师说,“我们先后给他下了两张病危通知书。”

考虑到张先生病情的危重性、复杂性,刘建华主任及其团队请来了ICU、五官科、内分泌科等多学科专家联合会诊。确定治疗方案后,张先生接受了切开排脓手术,刘主任在张先生的左上颌部切开一个小口子,切除了一块约8厘米大小的坏死组织,并伸入引流条直到脓腔,让脓液流出来,术中流出脓液约100毫升。

随后几天,每天约50-100毫升脓液被引流出来。5天后,病情终于得到了控制,各项生命体征趋于平稳,脱离了生命危险。一个星期前顺利出院,然而,由于张先生的脓肿面积较大,颜面部有所受损,日后还需要做颌面部整形手术。

面部“危险三角区”的“痘子”千万不要挤

9月19日,张先生到医院复查,聊起那颗“痘子”,仍心有余悸、后悔不已,他怎么也没想到自己只是随手挤了一下,竟酿成这么严重的后果,治疗花了3万多块钱不说,还险些丢了性命。

汪国华医师说,长在张先生上嘴唇的那颗“痘子”,临床上称之为“疖”,和青春痘长得很像,主要表现为局部红、肿、痛的小结节,以后逐渐肿大,呈锥形隆起。数日后,结节中央因组织坏死而变软,出现黄白色小脓栓,是毛囊和皮脂腺感染造成的一种疾病;青春痘是皮肤角化过度造成栓塞、皮脂排泄障碍所致的毛囊皮脂腺慢性炎症。

不过,无论是疖还是痘,汪医师都不建议随便乱挤,尤其是长在面部“三角区”位置的。“人体口腔颌面部的血管非常丰富,构成深、浅两个静脉网,互相吻合,但没有静脉瓣(一种类似于阀门的组织),以至于血液既可以向心回流,也可离心反流。因此,当面部尤其是两侧口角至鼻根部(医学上称之为“危险三角区”)发生感染(如,疖、痈等)后,若随意搔抓、挤压、挑破、热敷及意外损伤等,都可导致炎症迅速扩散,严重者危及生命。”

如果发现面部长了“痘子”,汪医师的建议是——

1.初起时,可用热毛巾热敷局部,涂碘伏或金霉素软膏,以促使疖肿吸收。

2.当疖肿快熟了(也就是摸着疖子不那么硬了),就可以涂鱼石脂软膏,这样可以使疖子尽早溃破。

3.如果疖子已经成熟,并在表面出现黄白色小脓点时,可请医生用消过毒的手术尖刀或注射器针头轻轻挑开脓点排脓。

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    2017-09-22 lfyang
  2. [GetPortalCommentsPageByObjectIdResponse(id=1471287, encodeId=3d4c14e1287db, content=<a href='/topic/show?id=ac13558e9cb' target=_blank style='color:#2F92EE;'>#抢救#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55879, encryptionId=ac13558e9cb, topicName=抢救)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=be1a7117101, createdName=lfyang, createdTime=Fri Sep 22 08:34:00 CST 2017, time=2017-09-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=246182, encodeId=def224618283, content=学习一下谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzaiabIFicf63hKvVMjL6aJlx4yX4UcXmzX9DyibCRcicq0QtCRWMaQKh8MYjE1D3EKUBopgiaGWYuqbeR/0, createdBy=0c2b1999806, createdName=三生有幸9135, createdTime=Thu Sep 21 06:12:17 CST 2017, time=2017-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=246110, encodeId=04a22461105a, content=好吓人啊.以后再也不敢挤了, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/17/d5be787205d0c34875ae55a61f49c17d.jpg, createdBy=2a762072202, createdName=路人甲115, createdTime=Wed Sep 20 22:26:53 CST 2017, time=2017-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=246095, encodeId=9a3d246095ef, content=学习了谢谢作者分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xJXLtMtt5B40XXuPjn9xn1rBhrM6fHLkX1hI86ZoWoPJkgDkZuJNKkBfBHOcRd1fAdezg7JlHNOokohdAp3WkI/0, createdBy=32c81964262, createdName=1e145228m78(暂无匿称), createdTime=Wed Sep 20 21:22:16 CST 2017, time=2017-09-20, status=1, ipAttribution=)]
    2017-09-21 三生有幸9135

    学习一下谢谢分享

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1471287, encodeId=3d4c14e1287db, content=<a href='/topic/show?id=ac13558e9cb' target=_blank style='color:#2F92EE;'>#抢救#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55879, encryptionId=ac13558e9cb, topicName=抢救)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=be1a7117101, createdName=lfyang, createdTime=Fri Sep 22 08:34:00 CST 2017, time=2017-09-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=246182, encodeId=def224618283, content=学习一下谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzaiabIFicf63hKvVMjL6aJlx4yX4UcXmzX9DyibCRcicq0QtCRWMaQKh8MYjE1D3EKUBopgiaGWYuqbeR/0, createdBy=0c2b1999806, createdName=三生有幸9135, createdTime=Thu Sep 21 06:12:17 CST 2017, time=2017-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=246110, encodeId=04a22461105a, content=好吓人啊.以后再也不敢挤了, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/17/d5be787205d0c34875ae55a61f49c17d.jpg, createdBy=2a762072202, createdName=路人甲115, createdTime=Wed Sep 20 22:26:53 CST 2017, time=2017-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=246095, encodeId=9a3d246095ef, content=学习了谢谢作者分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xJXLtMtt5B40XXuPjn9xn1rBhrM6fHLkX1hI86ZoWoPJkgDkZuJNKkBfBHOcRd1fAdezg7JlHNOokohdAp3WkI/0, createdBy=32c81964262, createdName=1e145228m78(暂无匿称), createdTime=Wed Sep 20 21:22:16 CST 2017, time=2017-09-20, status=1, ipAttribution=)]
    2017-09-20 路人甲115

    好吓人啊.以后再也不敢挤了

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1471287, encodeId=3d4c14e1287db, content=<a href='/topic/show?id=ac13558e9cb' target=_blank style='color:#2F92EE;'>#抢救#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55879, encryptionId=ac13558e9cb, topicName=抢救)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=be1a7117101, createdName=lfyang, createdTime=Fri Sep 22 08:34:00 CST 2017, time=2017-09-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=246182, encodeId=def224618283, content=学习一下谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzaiabIFicf63hKvVMjL6aJlx4yX4UcXmzX9DyibCRcicq0QtCRWMaQKh8MYjE1D3EKUBopgiaGWYuqbeR/0, createdBy=0c2b1999806, createdName=三生有幸9135, createdTime=Thu Sep 21 06:12:17 CST 2017, time=2017-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=246110, encodeId=04a22461105a, content=好吓人啊.以后再也不敢挤了, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/17/d5be787205d0c34875ae55a61f49c17d.jpg, createdBy=2a762072202, createdName=路人甲115, createdTime=Wed Sep 20 22:26:53 CST 2017, time=2017-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=246095, encodeId=9a3d246095ef, content=学习了谢谢作者分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xJXLtMtt5B40XXuPjn9xn1rBhrM6fHLkX1hI86ZoWoPJkgDkZuJNKkBfBHOcRd1fAdezg7JlHNOokohdAp3WkI/0, createdBy=32c81964262, createdName=1e145228m78(暂无匿称), createdTime=Wed Sep 20 21:22:16 CST 2017, time=2017-09-20, status=1, ipAttribution=)]
    2017-09-20 1e145228m78(暂无匿称)

    学习了谢谢作者分享!

    0