頌學碎骨入腦4厘米 日後或出現腦癇後遺症

[img=448,298]http://l.yimg.com/fe/p/news/mingpao/20100902/167tgjc02jo17c-i0.jpg[/img]
市民為梁頌學打氣的鮮花、心意卡及禮物，放滿屯門醫院大樓一角。梁太昨透過醫院發表公開信，多謝港人的關心和禮物，她鼓勵大家回復正常生活，不要再傷心流淚。


[img=448,299]http://l.yimg.com/fe/p/news/mingpao/20100902/167tgjd00eptq8-i0.jpg[/img]
梁頌學主診醫生方道生（左）說，頌學頭骨內仍有約4至5粒碎骨，深入逾4厘米，暫不會冒險動手術取出。右為負責控制感染的新界西醫院聯網病理學部部門主管郭德麟。


(明報)2010年9月2日 星期四 05:10

【明報專訊】[b]在菲律賓挾持人質事件中腦部受傷的梁頌學（Jason），在屯門醫院    接受腦部手術後雖未脫離危險期，但顱內壓已降至正常，最令主診醫生方道生關注的是，有4至5粒碎骨埋在腦內逾4厘米深，方醫生初步決定暫不取出。不過，有專家指出，如碎片遺留，日後或出現腦癇後遺症[/b]（見另稿）。

方道生又透露，菲律賓醫生急救時替梁頌學「塞了」大量止血藥物，或會增加血管阻塞，他的雙手亦因在當地接受靜脈注射，導致軟組織受細菌感染。醫管局    表示，有需要時，可調動其他醫院專家和資源，替頌學治療。

食物及衛生局長周一嶽    昨在探訪梁頌學後表示，頌學昨天已經退燒，腦腫情况亦有改善，但相信他的康復之路會是「艱辛漫長」。



[b]未脫危險期 暫不取出碎骨
[/b]
身兼新界西醫院聯網腦神經外科部門主管的方道生說，現時最關注是頌學頭顱內遺下的4至5粒骨碎，在腦內逾4厘米深，取出會有一定風險，幸而暫沒發現碎骨影響主要血管，亦沒有出現細菌感染如膿瘡等，暫時決定不會冒險取出碎骨，以免破壞更多腦部組織及動靜脈血管。

方道生表示，替梁頌學動手術時發現，菲律賓的醫生替他急救時，塞了大量的網狀止血物，可能增加靜脈血管阻塞；頌學的腦部腫脹，除他本身傷勢引致之外，亦可能與菲律賓醫生截了腦部兩條靜脈血管有關。不過，他強調，雖然發展結果未必對Jason最有利，但當時外科醫生未能預計，因此「不覺得決定是錯」。

他說，兩條靜脈被截後，梁頌學腦部前三分之一部分沒有血液流通，但幸運的是，磁力共振顯示，頌學的腦部已生出一些旁支血液管道通血，相信已紓緩閉塞。

方道生表示，上周四進行的手術為梁頌學移除前額，兩日後的電腦掃描顯示，其顱內壓已回復正常水平，腦內空間沒之前般擠迫，相信已較前舒服許多，「這方面有少少定心丸」。方道生估計，兩三日後，頌學將須開氣管口呼吸，以免因長期使用喉管，影響聲帶，但不會預測其康復進度。


[b]手臂受感染 料因在菲受靜脈注射
[/b]
新界西醫院聯網病理學部部門主管郭德麟表示，梁頌學回港後，由他負責控制感染，發現頌學雙手手臂有大面積軟組織受細菌感染，相信是在馬尼拉    的醫院接受靜脈注射有關。早前化驗顯示，頌學肺部帶有抗藥性惡菌，導致初期肝炎和發燒，但治療後情况受控，現時進展「令人滿意」。郭德麟說，雖然頌學腦內骨碎未見有感染，但不能排除有菌，因此需要長期注射強力抗生素。


[b]或與國際專家會商研治療法[/b]

另外，本港醫療界十分關注梁頌學傷勢，中文大學腦外科潘偉生教授昨聯絡方道生，建議可透過視像電話，與國際知名頭部創傷專家，如劍橋    大學Peter Hutchinson、澳洲    墨爾本    Rosenfeld、美國    Bullock以及內地專家研究解決辦法。

醫管局表示，屯門醫院是全港五個創傷中心之一，去年接收宗600宗嚴重創傷個案，現派出腦外科、內科、外科、骨科、麻醉科、微生物科專家為梁頌學會診，有需要時，可調派其他醫院專家和其他資源應付。


轉自:[url]http://hk.news.yahoo.com/article/100901/4/k03u.html[/url]

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