屯門醫院公布病人死因報告

屯門醫院今日公布去年11月一名患有急性心肌梗塞病人的死因報告，本院再次表示對事件感到十分難過。



去年十一月二十三日早上因暈倒而導致頭部受傷，該名患有長期心臟病的男子送往屯門醫院急症室，醫生為其安排腦部電腦掃描和心電圖檢查，根據心電圖結果，診斷為急性心臟病，遂安排至內科病房留醫。調查委員會經深入調查後認為，病人入院當日，由於頭部顱內滲血情況並不明顯，如醫生單靠檢視電腦掃描膠片，實難以察覺其滲血現象。故此，委員會建議多項改善措施，包括建議醫生在一些高危個案中，除了檢視傳統掃描膠片外，並與電腦數碼影像作對照，以加強準確性。


根據病歷紀錄，病人因患有心臟病，正服用阿士匹靈和其他治療心臟病的藥物；防止血管閉塞，基於病人即時有生命危險，醫生遂處方阿士匹靈和其他通血管藥物。


病人於兩日後情況轉壞，陷入昏迷，需以儀器協助呼吸。醫生為其進行第二次腦部電腦掃描，發現顱內有明顯出血。經腦外科醫生評估後認為病人並不適合接受手術。內科醫生遂繼續使用藥物治療病人的顱內出血和急性心肌梗塞情況，惟病人情況並無好轉，延至十一月二十七日凌晨離世。


醫生其後覆視病人的首次腦掃描的數碼影像時，發現病人顱內右前方，在入院當日已有輕微滲血。一般而言，顱內出血病人並不適宜使用通血管藥物。


調查報告指出，當日病人入院後，急症室醫生已立刻安排電腦掃描，基於情況危急，故醫生在檢視病人腦掃描膠片後，即時作出診斷，並將他轉送內科病房。其後內科和心臟科醫生亦分別檢視病人的電腦掃描膠片。


調查委員會成員曾覆核病人入院當日的電腦掃描膠片，均認為影像未能清楚顯示病人顱內右前方出現滲血，所以單靠檢視電腦掃描膠片的影像，應難以察覺滲血現象


委員會作出以下建議：


1.在處理高危個案時，除了檢視傳統掃描膠片的影像，亦輔以檢視電腦數碼影像，以加強準確性。


2.在處理高危個案時，主診醫生應考慮及早徵詢當值放射科醫生對電腦腦掃描結果的意見。


3.如果病人頭部曾經受傷，醫生應及早和病人及家屬講解使用通血管藥物的潛在風險。


院方接納委員會報告並正跟進有關建議。本院對事件感到十分難過，已向家屬解釋報告的詳細內容，並再次致以最深切慰問。

越來越喜歡這裡了，每天一定有新的分享，感恩喔!! 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