[introduction] Drug methamphetamine has a strong stimulating effect on the human central nervous system, and strong toxicity. Methamphetamin
[introduction] Drug methamphetamine has a strong stimulating effect on the human central nervous system, and strong toxicity. Methamphetamine dependence is very strong, smoking will produce strong physiological excitement, consume a lot of people's physical strength and reduced immune function, serious damage to the brain tissue of heart, and even lead to death. Can also cause mental disorders, showing a paranoid, aggressive, illusion, resulting in violent behavior.
For patients with multiple detoxification invalid, surgical treatment may be the last way of rebirth. The following is an example of Tangdu Hospital of The Fourth Military Medical University professor Wang Xuelian surgeon completed minimally invasive surgery, for reference.
The first course of hospitalization for patients with detoxification
With Sohn, 30 years old, male, the main cause of repeated methamphetamine after limb tic 8 years "in 2012-05-21 hospital.
Course Description: patients in 8 years ago and its curious friends temptation began taking drugs for smoking, "ice", the amount of about 0.lg/ times, 1 times / day. Taking twitching limbs, with brief unconsciousness, lasting for a few minutes after remission. 5 years ago, self treatment, during the use of substitutes, no obvious symptoms of withdrawal, after six months can not control and relapse. 1 years ago, self rehabilitation, continued after January relapse. 2 weeks ago to stop drug use so far, there is no physical symptoms, for surgical treatment, then to the hospital, through the urine and naloxone test, "opioid drug dependence" diagnosis of hospital income.
Primary diagnosis: opioid drug dependence.
Diagnosis: 1, repeated methamphetamine 8 years of history. 2, after taking the drug seizures. 3, repeated detoxification repeatedly.
Diagnosis and treatment plan: after entering the Department to improve blood routine, liver and kidney function, electrolyte, coagulation series, ECG and chest X-ray examination. Selective stereotactic surgery.
Patient physician Wang Xuelian recorded before operation
The patient did not appeal to fatigue, palpitation and other discomfort, spirit, sleep, food has no obvious abnormal size nake. Vital signs stable, no fever. Check with roughly.
Wang Xuelian: chief physician rounds opioid dependence patients, no obvious contraindications to routine examination before surgery under general anesthesia, recently stereotactic multi-target radiofrequency ablation, to preoperative preparation. Ordered to perform.
Surgery chief physician Wang Xuelian and the anesthesiologist preoperative checking record
With the spirit, rest, no discomfort, check with. By positive preoperative preparation, the examination has been improved. After preoperative discussion, stereotactic stereotactic radiofrequency ablation of multiple targets in the brain. The anesthesiologist seen accidents and complications in patients with family members to explain the possibility of anesthesia.
Wang Xuelian was seen patients, medical accidents and complications and explain to patients and their families during and after surgery may occur, patients' families understand that. Patients and their families agreed to surgical treatment, has been signed on the consent of the surgery and anesthesia consent. Operation orders have been under the supervision of the doctor's orders.
Drug treatment patients on the day of surgery record: Wang Xuelian chief physician Date: 2012-05-28
Patients in anesthesia today with stereotactic multi-target radiofrequency ablation. After the success of general anesthesia, conventional line painting, disinfection, local scalp infiltration anesthesia, the head of the smooth positioning device. MRI3.0 the anatomy of the head of the target location, clear intracranial structure. After the positioning of the operation room, supine position. Conventional disinfection, shop sheet. Local anesthesia, bilateral frontal midline l2cm from the top of the eyebrows 3.5cm longitudinal incision of scalp 4 cm, mastoid retractor scalp, skull drilling, bone margin bone wax coating. Stellate incision of dura mater, electric cortex, complete hemostasis.
Placed stereotactic positioning device, according to the operation target to determine the preoperative localization of bilateral nucleus accumbens and anterior limb of the internal capsule, the RF electrode implantation therapy. After the treatment is completed, remove the electrode. After hydrogen peroxide and / or saline solution were repeatedly washed, it was confirmed that there was no active bleeding. Suture the galea scalp and bandaged. Less bleeding during operation, stable vital signs.
Wang Xuelian, director of physician instructions: postoperative prevention of infection, hemostasis, nerve nutrition, nutritional support, anti epilepsy and symptomatic support treatment, strict observation of changes in condition. Ordered to perform.
Recovery of patients after detoxification
The first day after operation, the patients with clear consciousness. The spirit of poor, a small amount of liquid, the catheter has been pulled, normal urine, no headache, nausea and vomiting discomfort. Check the physical signs of life, limb movement, no obvious abnormalities, temperature 37.5 degrees, considered for the postoperative, central response. No obvious symptoms such as incontinence. The head dressing was dry, without abnormal exudation.
Chief physician Wang Xuelian rounds after instructions: Patients with stable disease, stop electrocardiogram and continue to give oxygen, anti-inflammatory and hemostasis, rehydration and symptomatic supportive treatment. Dense state. Ordered to perform.
Second days after surgery, patients with stable vital signs, the spirit, can be a small amount of liquid, no headache, nausea and vomiting discomfort. Check with the basic. Changes in the wound healed well without exudation. Maximum body temperature 38.
Chief physician Wang Xuelian rounds after instructions: postoperative fever, blood routine examination to exclude infection, treatment with more than. Closely observe the change of condition.
Third days after operation, the patients with clear consciousness, spirit, night eating Xiuke, normal urine, no obvious discomfort v.. The vital signs were stable, and the movement of limbs was not obvious. Body temperature returned to normal. Head dressing without effusion.
Chief physician Wang Xuelian rounds after instructions: Patients with stable disease, and continue to give anti-inflammatory, hemostatic, rehydration and symptomatic supportive treatment. Dense state.
Records of discharged patients
The general condition of the patient, eating Xiuke instrument, urine normal. Check body: vital signs stable, no fever. Double pupil, such as large circle, diameter 3mm, light reflection sensitive. The muscle tension of limbs was normal and the physiological reflex was normal. Today, a I / stitches, wound healing.
Chief physician Wang Xuelian rounds after instructions: Patients with stable disease, postoperative recovery is good, can be discharged from the hospital and inform the discharge orders.
After the discharge of patients with a return visit records: Sohn has no desire to discharge when discharged, after discharge in the family's care, physical and mental recovery is very good. In a number of phone calls, sun and his family said the results of the surgery is very satisfactory, so long time, Sohn did not take drugs, basically returned to normal.
[interpretation] surgical operation in Tangdu Hospital detoxification is based on modern physiology orientation technology and cellular localization based on ablation, through the analysis of electrical signals in the brain cells, and complemented by NMR, spiral CT and other advanced imaging diagnostic technique, so as to determine the best surgical targets cause addiction -- "neural reward in the central nucleus accumbens. And then use radio frequency heating microelectrode to destroy the addictive cells in the brains of drug addicts. After days of hospitalization, the patients usually need only about 2 hours.