Chapter 861 I'll rescue you
Even if he is saved, he will have intellectual disability at the least. If it is a little more serious, various cardiovascular and cerebrovascular diseases will kill him.
It is conservative to say that he will live to two years old. It is incredible that he can survive the first week.
The conclusion of this doctor in the neonatal intensive care unit is actually the general understanding of the academic community.
Therefore, it won a lot of likes.
But even so, there was a message below.
"Why don't you ask Dr. Xu to give it a try? What if he has a solution?"
As soon as this was said, the comment area that was originally full of approval began to diverge.
"It is probably useless for Dr. Xu to come..."
"What if it works?"
"Your 'what if' does not meet the quality of a professional doctor. Giving patients and their families unnecessary hope is not kindness, but cruelty!"
"Dr. Xu has made outstanding achievements in the field of cerebrovascular diseases. No one knows how far he has studied cerebrovascular diseases. I really think we can give it a try!"
"..."
...
Half a day later, this rare Galen vein malformation was pushed to the front page of the medical forum help page.
Xu Qiu, who had just finished the operation, learned that the forum was open, and only then did he have the opportunity to log in and take a look.
He noticed the first post at the first time.
He clicked in and saw the general idea.
"It turned out to be Galen's vein malformation..."
This disease is very rare and belongs to congenital vascular disease.
The academic community has not yet clarified its pathogenesis, and there are only a few speculations without evidence, such as being related to genetics or being exposed to radiation during pregnancy...
The so-called Galen's vein is actually another name for the great cerebral vein. It is the largest cerebral vein that connects and flows into the straight sinus. It is also one of the most important components of the cerebral venous system, and it mainly drains the venous blood flow deep in the brain.
The impact on the patient of such a blood vessel problem can be imagined.
"Stage vascular embolization... This method is indeed a commonly used treatment technology..." Xu Qiu flipped through the comments below and nodded from time to time.
However, the efficacy of staged vascular embolization is not particularly good.
There are even fewer people who can master this technology.
In comparison, another technology has greater advantages.
Gamma knife!
This is a radiotherapy method. To put it simply, it uses gamma rays to stereotactically gather and destroy pre-selected target tissues.
The advantages of this technology are obvious - any position that is not suitable for surgical resection can be covered by the gamma knife.
The most common is deep brain tumors, which are often beyond the reach of scalpels, and the gamma knife is the best choice.
It can not only avoid craniotomy, but even does not require surgery, and the cost of treatment is very low.
For pregnant women, it is difficult to operate and cannot perform surgical correction on the fetus in the abdomen, so the gamma knife is undoubtedly a good choice.
As for the high radiation dose of the gamma knife and the possibility of fetal malformation, there is no need to discuss this.
Medicine pays attention to risks and benefits. Ordinary pregnant women should try to avoid CT machines, but for the "blessed little angel" who has no other way out, if they do not do the gamma knife, the fetus will almost certainly die; if they do the gamma knife, the probability of malformation... It is easy to judge which is more serious.
"However, it depends on the area where the arterial malformation is located..."
Xu Qiu turned back to the medical records uploaded by the patient.
Gamma knife has a more significant effect on deep lesions involving the thalamus and midbrain. As for other areas, the occlusion rate will be much lower.
After seeing the patient's ultrasound and CT film, Xu Qiu's eyes dimmed.
Although the imaging of the fetus in the abdomen was not particularly clear, he still identified several key points.
The area of the fetal cerebral vein was significantly thickened, showing tumor-like expansion, clear edges, and tortuous drainage veins around it.
The most serious expansion should be venous aneurysms and occipital sinuses.
If it was just like this, the gamma knife would be the most suitable choice.
However, the fetus also has significant dural blood supply!
In this case, the gamma knife is not applicable.
Only by performing a straight operation and blocking the dural blood supply can the problem of Galenic vein malformation be solved...
"This is the rhythm of having to do surgery." Xu Qiu frowned.
Considering all the circumstances, staged vascular occlusion is indeed the best way.
That is, within four to five months after birth, multiple vascular embolizations are performed to reduce the blood flow through the abnormal blood vessels and maximize the blood supply to the brain.
This technology itself is very difficult to operate and has great risks.
For Xu Qiu, staged embolization is not a surgery that can stop him. The difficulty of operation is just practicing for one or two weeks in a simulated operating room.
The reason why he does not advocate staged embolization is that it can only be performed after birth.
Even if staged embolization can be successful, even if the operation is very effective, even if the fetus is delivered smoothly, for this baby, its brain development, cardiovascular development, etc. have been finalized in the mother's body, and irreversible damage has already been caused.
In other words, he is no longer a normal person when he is born. No matter how magical the staged embolization is, it is impossible to change the irreversible brain damage and congenital cardiovascular lesions...
"No, in fact, any way of waiting for the fetus to be born before performing surgery is to make up for the loss."
Xu Qiu fell into deep thought.
As long as the fetus is born, the irreversible consequences have already occurred. Continuing the operation is only to save its life.
But for Xu Qiu, he not only wants to save a life, but also wants this life to live like a normal person.
However, it is almost impossible to do this.
Unless... Galenic vein malformation can be solved before the fetus is born and before the development of the brain is finalized.
Thinking of this, Xu Qiu hurriedly looked at the report of the pregnant woman.
At this time, she was exactly 31 weeks pregnant. The fetal brain development has begun, but it has not yet completed development. If intervention is carried out at this time, it is indeed possible to save the damage of venous malformation to intelligence and cardiovascular system.
Then the question is, how to operate on the fetus before it is delivered and in the mother's belly?
Ten minutes later, Xu Qiu finally came up with the answer.
…
Modu, a Class III maternal and child hospital.
In a VIP ward, Fang Jiajia was holding a mobile phone, and the screen showed the content of the reply to the medical forum.
She is the "blessing little angel" herself.
After posting the message, she ignored it and consulted the doctor again. The advice she got was still the same as before - terminate the pregnancy.
But she still had a glimmer of hope in her heart.
However, when she logged back into the forum and saw the countless doctors' messages below, her eyes gradually dimmed.
Like the doctors in this hospital, experts in other places also did not recommend continuing the pregnancy!
Seeing this, Fang Jiajia was completely desperate.
