The patient had a sudden cerebral infarction after surgery, and blood clots recurred after the thrombus was removed. The regret was that the patient was deaf.

This happened during my training: After a subtotal gastrectomy, the patient had a sudden cerebral infarction. He was immediately sent to the interventional operating room for thrombectomy, but soon suffered another cerebral infarction. At over 80 years old, he could not withstand such a torment, and the rescue was ultimately ineffective.

Looking back on the whole incident, there are actually many questions worthy of our deep thought: Why do patients suffer repeated cerebral infarctions?

This is closely related to the patient's own condition.

According to the surgeon, the patient's family did not discover the problem until they were packing up their belongings in the ward and preparing to go home. In the old lady's bedside table, she had not taken any of the preoperative medications prescribed by the doctor. All of these medications were intended to prevent blood clots and reduce various complications.

During the routine examination before the operation, it was found that the patient had old blood clots in the deep veins and thickened carotid artery intima. In addition, there might be a certain amount of blood loss during the operation, which indicated that there might be a risk of blood clots in the perioperative period. Therefore, during the preoperative visit, the anesthesiology department communicated with the attending physician and asked her to give the patient some drugs to prevent blood clots.

Considering that surgery also carries a risk of bleeding, the compromise is to stop taking medication one day before surgery. In addition, the medications taken are theoretically not likely to affect blood coagulation.

Since the anesthesiology department cannot visit the ward every day, the task of reminding patients to take their medications falls to the surgery department.

The surgeon was also very dedicated and specifically reminded the old lady to take her medicine on time.

However, what he didn't know was that the old lady was a very strong-willed and polite person. Facing the doctor's instructions, Hengha agreed. But due to her old age, she couldn't hear anything clearly.

Because I didn't dare to take anything else and was too embarrassed to ask the doctor, I simply didn't take it. It wasn't until the family members cleaned up the ward that they discovered that the medicine had not been touched.

We cannot blame anyone for this tragic ending. Should we blame the surgeon for not telling us? He did tell us. Should we blame the anesthesiologist for not doing a good job of preoperative visits? They did find problems. Should we blame the old lady? She herself could not hear clearly. Only by summarizing experience and lessons can we avoid the next tragedy.

The biggest problem in this matter is the problem of communication. Not only should we communicate well, but we should also execute well. This is a good way to communicate.

Finally, we will explain the cause of the incident from a professional perspective to raise everyone’s awareness of prevention.

The patients themselves have deep vein thrombosis and problems with the arterial intima, especially the carotid intima, which lays the foundation for the high incidence of cerebral thrombosis. Related studies have shown that there is a linear relationship between carotid artery plaques and the incidence of stroke.

Can a healthy person get deep vein thrombosis? No, if she does, it means that she must have a high risk factor for thrombosis.

Let me explain again why we should emphasize perioperative prevention. This is because surgical stress, bleeding or pain will affect the balance of the blood coagulation system in the body. Once the balance is broken, it will either cause bleeding or thrombosis. Once the thrombotic reaction is triggered, thrombosis may form wherever there is blood.

This patient had plaques in his carotid artery, which became a hotbed for thrombosis. As a result, due to various factors, thrombosis would form repeatedly.

Some people say, why don’t doctors provide timely anticoagulation treatment?

Which doctor would dare to give drugs rashly for such a major operation? Moreover, once the blood coagulation system becomes active, it is difficult to control.

After learning from the painful experience, doctors should communicate carefully and ensure that patients follow the instructions; patients should listen carefully to the doctor's instructions. A successful operation requires not only the efforts of medical staff, but also the cooperation of patients and their families.

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