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超过60%的脑出血发生在这个区域。_高鹰生殖中心

来源: 新华社
01:39:50

一加5g手机曝光超过60%的脑出血发生在这个区域。

西游·降魔篇

    下载APP 阅读本文更深度报道 大咖小传成惠林,医学博士,主任医师,博士生导师,现任东南大学附属中大医院神经外科主任。江苏省医学会神经外科分会委员,兼神经脊柱学组组长,中国医师协会神经外科分会脊柱脊髓学组副主任委员,中华医学会神经外科分会脊柱脊髓学组委员,中国研究型医院学会脊髓脊柱专业委员会副主任委员。从事神经外科临床及教学工作30余年,在颅脑和脊柱肿瘤、颈腰椎病、神经损伤与康复、脑血管病手术治疗方面有较深入研究。获国家自然基金、省部级课题多项,发表SCI论文10余篇,国家统计源期刊论文60余篇。获中华医学二等奖、江苏医学科技奖、军队科技进步奖等多项奖励。参编专著5部。获发明专利3项。大咖有约脑出血,起病急、病情凶险,致残率和致死率都非常高。这个原本被认为是老年人“专利”的疾病,现在也已经呈现出年轻化的趋势,三四十岁甚至更年轻发生脑出血,已并不少见。专家表示,脑出血的抢救方法与出血的部位、出血量都有密切关系,而传统取出脑部血肿需要开颅,现在内镜微创技术用于脑出血抢救,巴掌大的手术破口变成钻个直径3厘米左右的孔,创伤小了,患者更加受益。通讯员崔玉艳扬子晚报/扬眼记者杨彦摄影/摄像戎毅晔典型病例38岁的赵先生是个餐馆老板,忙起来没日没夜的,烟龄14年,酒龄也有14年,长期高血压也没有重视。今年年前,赵先生一天中午喝了点白酒,两个小时后,突然出现了言语不清情况,右侧手脚活动也不灵光了,家人意识到情况不对,拨打120后将赵先生送到了东南大学附属中大医院,此时,赵先生已经呈浅昏迷状态,头颅CT显示,左侧基底节脑出血。在明确病情后,该院神经外科苗伟、顾斌主治医师为赵先生进行了微创手术,取出了赵先生脑部的血肿。手术在赵先生颅骨上开了个直径3厘米左右的小孔,然后通过特制内镜鞘置入神经内镜,在内镜视野下抵近观察血肿,进而安全有效地将脑部血肿清除。相比开颅手术动辄四五个小时,这台微创手术仅仅进行了一个小时左右,患者恢复也比较快,出院时已经可以简单说话了,并且能站立及缓步行走。大咖解读60%以上脑出血,都在基底节脑出血的概念,大家已经都不陌生,它占全部卒中的20%-30%,发生的原因主要与脑血管的病变有关。现代人高血脂、高血糖、高血压等情况越来越多,血管老化变硬,再遇上血压波动,就很容易发生危险。脑出血的危险程度,与发生部位有很大关系,发生在脑干部位的出血最为凶险,在所有脑卒中中病死率最高,预后也比较差。而绝大多数的脑出血,其实发生在脑部一个叫“基底节”的部位。“大约60%以上的脑出血都会发生在基底节,这是由脑部的解剖结构决定的。”成惠林教授介绍,大部分血管在体内的状态是弯弯曲曲的,血流就比较平缓,而在基底节正巧有大血管分枝成几个小血管,还呈90度的“急拐”,是血管状态最薄弱的位置,因此也成了脑出血的重灾区。做个CT,明确血管是“堵”还是“破”脑出血和脑梗都属于卒中,发病时两者的症状是比较类似的,患者都有可能出现神志不清、说不出话、口舌歪斜、一侧肢体偏瘫等症状,多数患者也会留有不同程度的运动障碍、认知障碍、言语吞咽障碍等后遗症,但两者的病因正好相反。通俗地说,脑梗的问题在“堵”,血栓将血管给堵住了,脑部供血不足,缺血缺氧引发脑细胞死亡;而脑出血的问题在于“破”,血管破了,血液在脑部形成血肿,压迫到神经,甚至因为血肿导致颅内压增高,使得脑部组织产生位移而引发脑疝,使得患者生命垂危。无论是脑梗还是脑出血,时间就是生命,脑出血的患者情况还会更危急。早一分钟抢救,无论是挽救患者生命还是术后康复都意义重大。但由于两者症状相似,所以一旦患者被送到急诊,需要立即做CT检查明确病情,才能对症抢救。巴掌大vs3厘米,微创手术患者康复更快通常来说,如果出血的位置不是特别危险,根据患者的情况,20毫升甚至30毫升内的脑出血有保守治疗的可能,病情更重的就需要急诊手术治疗了。以往手术治疗都做开颅手术,取出部分皮瓣和骨瓣,将脑组织暴露然后清除血肿,患者脑部的破口差不多巴掌大小,手术得做上三四个小时。“长时间以来,取出脑部血肿别无他法,手术也没有更精进的可能,在内镜技术发展起来之后,微创取血肿才得以实现。”成惠林教授介绍,以往的开颅血肿清除术,要看清血肿与出血点情况,避免不了要牵拉脆弱的脑组织,创伤比较大。一旦血肿位置比较深,清除效率与效果都不是特别理想。而内窥镜的微创手术直接建立起了外部到血肿处的通道,无需牵拉脑部组织,减少了对脑部神经系统的医源性损害,对深部结构的暴露、观察也更好,通过内窥镜可以直接看到出血点然后进行电凝止血,干净利落。同时由于切口小了很多,麻醉时间、手术时间都大幅缩短,住院时间也从原来的20多天降到了10来天左右,不仅术中对神经损伤减小了,患者还能更快进入康复阶段。提醒高血压患者切勿剧烈运动近年来,包括脑出血和脑梗在内的脑卒中发病率和致残率逐年增高,那如何快速识别及预防呢?专家提醒,如果突然出现神志不清、肢体无力、面部肢体麻木、口舌歪斜、说不出话、严重眩晕、视物重影等症状,一定要高度警惕脑血管意外。一旦发现,要立即拨打120送医。预防脑卒中要改掉抽烟、酗酒、熬夜等不良习惯。生活起居要有规律,不可过度劳累。保持适度锻炼;多食蔬菜、水果、豆制品;保持情绪稳定,心情舒畅;定期复查。积极接受治疗控制好血压、血糖,能够有效预防卒中发生。高血压导致的脑出血是卒中中重要的一类。眼下早春时节是脑出血的高发季节,这与换季气温不稳定导致的血压波动有关。高血压患者应当经常测量血压,如果过高需要在医生指导下及时处理。同时高血压患者也不建议剧烈活动,慢走、小跑步、打太极拳都是比较合适的。此外,情绪上的大起大落也会影响到血压的稳定,所以有高血压的患者,也要尽量避免情绪波动,以免发生意外。下期预告何侠,主任医师,肿瘤学博士。江苏省肿瘤医院放疗科主任,南京医科大学肿瘤放射治疗教研室主任。江苏省临床重点专科肿瘤放射治疗科学科带头人,江苏省放射治疗中心主任,江苏省放射治疗质控中心主任。担任江苏省肿瘤防治联盟放射治疗专委会主任委员;南京医学会放射肿瘤治疗学分会主任委员;江苏医学会放射肿瘤治疗学分会前任主任委员和候任主任委员;江苏省医师协会肿瘤放疗医师分会前任主任委员;江苏省抗癌协会理事,江苏省抗癌协会肿瘤放射治疗专业委员会主任委员等职。对各种恶性肿瘤特别是头颈肿瘤的放疗技术,尤其对鼻咽癌的精确放疗、化疗及预后有深入研究。主编、主译放射治疗专业论著、教材6部。主持及参与国自然及省厅级科研项目多项,发表SCI及相关专业学术论文80余篇,其中SCI论文40余篇。申请国家专利50余项,研究成果获省科技进步奖及卫生厅新技术引进奖多项。

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tai wei chuang shou shu jin jin jin xing le yi ge xiao shi zuo you, huan zhe hui fu ye bi jiao kuai, chu yuan shi yi jing ke yi jian dan shuo hua le, bing qie neng zhan li ji huan bu xing zou. da ka jie du 60 yi shang nao chu xue, dou zai ji di jie nao chu xue de gai nian, da jia yi jing dou bu mo sheng, ta zhan quan bu cu zhong de 20 30, fa sheng de yuan yin zhu yao yu nao xue guan de bing bian you guan. xian dai ren gao xue zhi gao xue tang gao xue ya deng qing kuang yue lai yue duo, xue guan lao hua bian ying, zai yu shang xue ya bo dong, jiu hen rong yi fa sheng wei xian. nao chu xue de wei xian cheng du, yu fa sheng bu wei you hen da guan xi, fa sheng zai nao gan bu wei de chu xue zui wei xiong xian, zai suo you nao cu zhong zhong bing si lv zui gao, yu hou ye bi jiao cha. er jue da duo shu de nao chu xue, qi shi fa sheng zai nao bu yi ge jiao" ji di jie" de bu wei." da yue 60 yi shang de nao chu xue dou hui fa sheng zai ji di jie, zhe shi you nao bu de jie pou jie gou jue ding de." cheng hui lin jiao shou jie shao, da bu fen xue guan zai ti nei de zhuang tai shi wan wan qu qu de, xue liu jiu bi jiao ping huan, er zai ji di jie zheng qiao you da xue guan fen zhi cheng ji ge xiao xue guan, hai cheng 90 du de" ji guai", shi xue guan zhuang tai zui bo ruo de wei zhi, yin ci ye cheng le nao chu xue de zhong zai qu. zuo ge CT, ming que xue guan shi" du" hai shi" po" nao chu xue he nao geng dou shu yu cu zhong, fa bing shi liang zhe de zheng zhuang shi bi jiao lei si de, huan zhe dou you ke neng chu xian shen zhi bu qing shuo bu chu hua kou she wai xie yi ce zhi ti pian tan deng zheng zhuang, duo shu huan zhe ye hui liu you bu tong cheng du de yun dong zhang ai ren zhi zhang ai yan yu tun yan zhang ai deng hou yi zheng, dan liang zhe de bing yin zheng hao xiang fan. tong su di shuo, nao geng de wen ti zai" du", xue shuan jiang xue guan gei du zhu le, nao bu gong xue bu zu, que xue que yang yin fa nao xi bao si wang er nao chu xue de wen ti zai yu" po", xue guan po le, xue ye zai nao bu xing cheng xue zhong, ya po dao shen jing, shen zhi yin wei xue zhong dao zhi lu nei ya zeng gao, shi de nao bu zu zhi chan sheng wei yi er yin fa nao shan, shi de huan zhe sheng ming chui wei. wu lun shi nao geng hai shi nao chu xue, shi jian jiu shi sheng ming, nao chu xue de huan zhe qing kuang hai hui geng wei ji. zao yi fen zhong qiang jiu, wu lun shi wan jiu huan zhe sheng ming hai shi shu hou kang fu dou yi yi zhong da. dan you yu liang zhe zheng zhuang xiang si, suo yi yi dan huan zhe bei song dao ji zhen, xu yao li ji zuo CT jian cha ming que bing qing, cai neng dui zheng qiang jiu. ba zhang da vs3 li mi, wei chuang shou shu huan zhe kang fu geng kuai tong chang lai shuo, ru guo chu xue de wei zhi bu shi te bie wei xian, gen ju huan zhe de qing kuang, 20 hao sheng shen zhi 30 hao sheng nei de nao chu xue you bao shou zhi liao de ke neng, bing qing geng zhong de jiu xu yao ji zhen shou shu zhi liao le. yi wang shou shu zhi liao dou zuo kai lu shou shu, qu chu bu fen pi ban he gu ban, jiang nao zu zhi bao lu ran hou qing chu xue zhong, huan zhe nao bu de po kou cha bu duo ba zhang da xiao, shou shu de zuo shang san si ge xiao shi." zhang shi jian yi lai, qu chu nao bu xue zhong bie wu ta fa, shou shu ye mei you geng jing jin de ke neng, zai nei jing ji shu fa zhan qi lai zhi hou, wei chuang qu xue zhong cai de yi shi xian." cheng hui lin jiao shou jie shao, yi wang de kai lu xue zhong qing chu shu, yao kan qing xue zhong yu chu xue dian qing kuang, bi mian bu liao yao qian la cui ruo de nao zu zhi, chuang shang bi jiao da. yi dan xue zhong wei zhi bi jiao shen, qing chu xiao lv yu xiao guo dou bu shi te bie li xiang. er nei kui jing de wei chuang shou shu zhi jie jian li qi le wai bu dao xue zhong chu de tong dao, wu xu qian la nao bu zu zhi, jian shao le dui nao bu shen jing xi tong de yi yuan xing sun hai, dui shen bu jie gou de bao lu guan cha ye geng hao, tong guo nei kui jing ke yi zhi jie kan dao chu xue dian ran hou jin xing dian ning zhi xue, gan jing li luo. tong shi you yu qie kou xiao le hen duo, ma zui shi jian shou shu shi jian dou da fu suo duan, zhu yuan shi jian ye cong yuan lai de 20 duo tian jiang dao le 10 lai tian zuo you, bu jin shu zhong dui shen jing sun shang jian xiao le, huan zhe hai neng geng kuai jin ru kang fu jie duan. ti xing gao xue ya huan zhe qie wu ju lie yun dong jin nian lai, bao kuo nao chu xue he nao geng zai nei de nao cu zhong fa bing lv he zhi can lv zhu nian zeng gao, na ru he kuai su shi bie ji yu fang ne? zhuan jia ti xing, ru guo tu ran chu xian shen zhi bu qing zhi ti wu li mian bu zhi ti ma mu kou she wai xie shuo bu chu hua yan zhong xuan yun shi wu chong ying deng zheng zhuang, yi ding yao gao du jing ti nao xue guan yi wai. yi dan fa xian, yao li ji bo da 120 song yi. yu fang nao cu zhong yao gai diao chou yan xu jiu ao ye deng bu liang xi guan. sheng huo qi ju yao you gui lv, bu ke guo du lao lei. bao chi shi du duan lian duo shi shu cai shui guo dou zhi pin bao chi qing xu wen ding, xin qing shu chang ding qi fu zha. ji ji jie shou zhi liao kong zhi hao xue ya xue tang, neng gou you xiao yu fang cu zhong fa sheng. gao xue ya dao zhi de nao chu xue shi cu zhong zhong zhong yao de yi lei. yan xia zao chun shi jie shi nao chu xue de gao fa ji jie, zhe yu huan ji qi wen bu wen ding dao zhi de xue ya bo dong you guan. gao xue ya huan zhe ying dang jing chang ce liang xue ya, ru guo guo gao xu yao zai yi sheng zhi dao xia ji shi chu li. tong shi gao xue ya huan zhe ye bu jian yi ju lie huo dong, man zou xiao pao bu da tai ji quan dou shi bi jiao he shi de. ci wai, qing xu shang de da qi da luo ye hui ying xiang dao xue ya de wen ding, suo yi you gao xue ya de huan zhe, ye yao jin liang bi mian qing xu bo dong, yi mian fa sheng yi wai. xia qi yu gao he xia, zhu ren yi shi, zhong liu xue bo shi. jiang su sheng zhong liu yi yuan fang liao ke zhu ren, nan jing yi ke da xue zhong liu fang she zhi liao jiao yan shi zhu ren. jiang su sheng lin chuang zhong dian zhuan ke zhong liu fang she zhi liao ke xue ke dai tou ren, jiang su sheng fang she zhi liao zhong xin zhu ren, jiang su sheng fang she zhi liao zhi kong zhong xin zhu ren. dan ren jiang su sheng zhong liu fang zhi lian meng fang she zhi liao zhuan wei hui zhu ren wei yuan nan jing yi xue hui fang she zhong liu zhi liao xue fen hui zhu ren wei yuan jiang su yi xue hui fang she zhong liu zhi liao xue fen hui qian ren zhu ren wei yuan he hou ren zhu ren wei yuan jiang su sheng yi shi xie hui zhong liu fang liao yi shi fen hui qian ren zhu ren wei yuan jiang su sheng kang ai xie hui li shi, jiang su sheng kang ai xie hui zhong liu fang she zhi liao zhuan ye wei yuan hui zhu ren wei yuan deng zhi. dui ge zhong e xing zhong liu te bie shi tou jing zhong liu de fang liao ji shu, you qi dui bi yan ai de jing que fang liao hua liao ji yu hou you shen ru yan jiu. zhu bian zhu yi fang she zhi liao zhuan ye lun zhu jiao cai 6 bu. zhu chi ji can yu guo zi ran ji sheng ting ji ke yan xiang mu duo xiang, fa biao SCI ji xiang guan zhuan ye xue shu lun wen 80 yu pian, qi zhong SCI lun wen 40 yu pian. shen qing guo jia zhuan li 50 yu xiang, yan jiu cheng guo huo sheng ke ji jin bu jiang ji wei sheng ting xin ji shu yin jin jiang duo xiang.

    

    

    

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