Mr. Gong, 63, was diagnosed with esophageal cancer in May 2023, which was a bolt from the blue for him and his family, who had just retired and enjoyed their old age.
After chemotherapy combined with immunization**, the patient's condition was not effectively controlled. So radiotherapy was started, and according to the protocol, 25 radiotherapy sessions were required. However, the patient suddenly had massive hemoptysis during the 9th radiotherapy, with a volume of about 300ml. During his hospitalization in a hospital in Beijing, various hemostatic drugs were used, and even the continuous application of "posterior pituitary hormone", known as internal medicine hemostats, could not effectively stop bleeding. As a result, the patient underwent bronchial artery embolization**, bronchial artery embolization is considered to be the most effective vascular intervention method for hemoptysis, with an immediate hemostatic rate of 73-98%, but the patient was hemoptysis of about 500ml again after bronchial artery embolization, and he was unable to speak, eat and move normally, and his life was in danger.
With so many big hospitals and so many experts in Beijing, is my illness really hopeless? "Patients and their families are in a desperate situation. If hemoptysis is not effectively controlled, there will be a risk of hemorrhagic shock and even asphyxia, and the consequences will be unimaginable. When he was desperate, he was introduced to the bronchoscopic diagnosis and technology of Zhou Yunzhi's medical team of the Emergency General Hospital, which was leading in the country, and had made clear diagnoses and successfully carried out tens of thousands of difficult cases, and its clinical technical level was highly praised by the medical community and patients.
The patient's family came to the Emergency General Hospital with the last glimmer of hope and found Zhou Yunzhi, director of the Department of Respiratory and Critical Care Medicine, hoping to implement tracheoscopy as soon as possible to find out the cause of bleeding and carry out microscopic ** to effectively stop hemoptysis, but bronchoscopy is extremely risky and difficult, and major hospitals are discouraged.
The patient's family found Zhou Yunzhi in the outpatient clinic, and Zhou Yunzhi said to the family after learning more about the condition: "Send the patient to the emergency general hospital immediately, we will go all out to treat it!" ”
As soon as the ambulance arrived at the emergency general hospital, Zhou Yunzhi immediately went to the intensive care unit to conduct a comprehensive physical examination of the patient, and carefully examined the chest CT, and found that there was a cavitary lesion in the middle lobe of the right lung, which was considered to be the culprit of hemoptysis. Because the patient did not respond well to hemoptysis drugs** and bronchial artery embolization**, it was decided to perform bronchoscopic hemostasis**.
Before the operation, Zhou Yunzhi fully communicated with Cheng Qinghao, director of the Department of Anesthesiology, and made a plan for the treatment of intraoperative hemorrhage, such as preparing sufficient tracheoscopic hemostatic drugs before surgery, preparing balloons in advance to compress hemostasis, and preparing blood before surgery. During the operation, a large amount of bloody secretions could be seen in the tracheal lumen, and active bleeding in the medial segment of the right middle lobe could be seen after full suction and clearing, and the bleeding stopped after hemocoagulation enzyme microscopic spraying, but the patient had hemoptysis of about 100ml again after surgery, which means that the hemostatic effect of bronchoscopy was not good. Zhou's team faced unprecedented challenges.
The patient has intermittent hemoptysis, and all kinds of ** methods have poor results, but as long as there is 1% hope, we must do 100% of our efforts. "Everyone did not flinch in the face of difficult problems, and Zhou Yunzhi's mobilization ignited the confidence of the team.
After the brainstorming of the team, we formulated two plans: one is to perform bronchial arteriography again, trying to find the blood vessel of the right middle lobe lesion and then embolize. However, the patient has already undergone bronchial artery embolization in the hospital**, so it is more difficult and technically demanding, and if the target vessel is still not found, the patient's risk will be increased. The second is surgical lobectomy, but the patient's history of esophageal cancer, poor nutrition, high surgical difficulty, high intraoperative risk, and great trauma to the patient.
There are often both risks and benefits, and the decision to restart bronchial artery embolization is made after full communication with the patient's family**. The embolization proceeded as planned, and the family waited anxiously outside the operating room. Zhou Yunzhi led Chief Physician Luo Lingfei, Attending Physician Zhang Peng and other team members, with superb medical skills and rich experience, finally found the culprit of the bleeding artery and successfully embolized, after embolization, the patient stopped all hemostatic drugs and did not have hemoptysis. Repeat tracheoscopy does not have any bloody discharge from the medial segment of the right middle lobe, which means that the bleeding has completely stopped. When Zhou Yunzhi led the medical team to the ward for rounds, the patient's excitement was overflowing, and he gave a thumbs up and praised the superb skills of Zhou Yunzhi's team.
Mr. Gong, who was originally destined for death, created a miracle of life under the treatment of Zhou Yunzhi's team. Zhou's team is like a lighthouse, bringing hope to patients and regaining their confidence in life.
It is understood that respiratory interventional diagnosis and treatment technology is a difficult technology, which is a great test of surgical experience, operation technology, treatment system, postoperative care, etc. Since 2004, the Department of Respiratory and Critical Care Medicine of the Emergency General Hospital has carried out bronchoscopic interventional diagnosis and treatment technology, and now Zhou Yunzhi leads the team to carry out more than 3,000 cases of various interventional surgeries under bronchoscopy every year, with skilled operation technology and rich surgical experience, which has brought good news to tens of thousands of patients with dyspnea and improved the quality of life. Its technical level is in the forefront of Beijing and even the country.
Department Profile. After years of unremitting efforts and innovative development, the department has become an independent clinical department with respiratory outpatient clinic (general, specialist), respiratory ward, bronchoscopy room, internal medicine thoracoscopy room, pulmonary function room, intensive care unit, CT room, catheterization laboratory, central laboratory and other functions.
The department has set up lung cancer outpatient clinics, minimally invasive lung cancer outpatient clinics, pulmonary nodule outpatient clinics, airway stenosis, airway fistula outpatient clinics, chronic obstructive pulmonary disease (COPD) outpatient clinics, bronchial asthma outpatient clinics, ** reaction outpatient clinics, interstitial lung disease specialized outpatient clinics and other specialized outpatient clinics. The department is equipped with all kinds of advanced instruments and equipment, and routinely carries out the diagnosis and treatment of various respiratory diseases, among which the interventional diagnosis and treatment technology is at the leading level in the country. In 2014, it took the lead in opening a "green channel" for airway obstruction in Beijing, which was effective within half an hour of hospitalization and saved the lives of countless patients with acute and critical airway stenosis. In 2017, it was approved as a rigid endoscopy training base of the Chinese Association of Endoscopists, training nearly 1,000 doctors across the country.
Department Featured Technologies:
1. Transairway technology: carry out first-class bronchoscopic diagnosis and treatment, including: rigid scope, argon knife, carbon dioxide freezing, balloon dilation, laser, low-temperature plasma radiofrequency, microwave, airway stent placement and removal, radioactive seed implantation, local drug injection, photodynamic **, sealing of various fistulas, etc., to comprehensively solve the problem of airway obstruction and airway fistula of patients. Diagnosis and ablation of pulmonary nodules by electromagnetic navigation bronchoscopy** to solve the problem of pulmonary nodules in patients. At the same time, patients with end-stage chronic obstructive pulmonary disease (COPD) were treated with bronchoscopic one-way valve lung volume reduction and bronchial thermoplasty for refractory asthma to improve the quality of life of patients.
2.Percutaneous puncture techniques: needle biopsy and solid tumor ablation of all parts of the body, including argon-helium knife, microwave, radiofrequency, laser, radioactive particle implantation, interstitial photodynamic and other technologies.
Speed of life and death. 3.Transvascular interventional technology: bronchial arterial perfusion chemotherapy, embolization and endovascular stent technology have been carried out, which have been applied to patients with lung cancer and hemoptysis**, and have achieved very good results.
4.Transthoracic interventional techniques: Thoracoscopic pleural biopsy in internal medicine, bullolar volume reduction in internal medicine, ablation of malignant pleural diseases and photodynamic ** have been carried out.
5.Others: In the diagnosis and treatment of pneumoconiosis, the Department of Occupational Diseases jointly carried out large-volume whole-lung lavage at the same time. For patients with COPD, bronchial asthma, lung cancer and pulmonary nodules, establish health records, regular follow-up, and formulate re-examination and ** plans.
Discipline Leader.
Yunzhi Zhou, Director of the Department of Respiratory and Critical Care Medicine, Chief Physician, Professor, and Master Supervisor of the Emergency General Hospital.
Academic positions: Chairman of the Interventional Diagnosis and Treatment Translational Medicine Branch of the Beijing Society of Integrative Medicine, Vice Chairman of the Infectious Oncology Special Committee of the Chinese Anti-Cancer Association, Vice Chairman of the Respiratory Endoscopy and Interventional Branch of the Beijing Medical Association, Member of the Standing Committee of the Tumor Photodynamics Special Committee of the Chinese Anti-Cancer Association, Member of the Standing Committee of the Coal System Branch of the Chinese Preventive Medicine Association, Member of the Tumor Respiratory Disease Special Committee of the Chinese Anti-Cancer Association, Member of the Respiratory Committee of the Chinese Medical Association, Member of the National Technical Committee for Diagnosis and Identification of Occupational Diseases, Clinical Drugs** Member of the editorial board of the magazine.
Technical expertise: Since 2004, Zhou Yunzhi has carried out respiratory interventional diagnosis and treatment technology in China earlier, especially good at transbronchoscopic interventional diagnosis and treatment technology; Diagnostic techniques include ordinary bronchoscopic biopsy, brush examination, alveolar lavage, endoscopic ultrasound needle aspiration biopsy, navigation bronchoscopic biopsy and cryopulmonary biopsy, etc., ** technologies include rigid bronchoscopy, argon knife, laser, low-temperature plasma radiofrequency, carbon dioxide freezing, balloon dilation, drug injection, bronchoscopic radiotherapy seed implantation, photodynamic ** and endotracheal stent insertion and removal, airway fistula closure and other technologies** various benign and malignant airway diseases.
Since 2004, Zhou Yunzhi has completed more than 10,000 cases of various microscopic diagnosis and treatment operations, and is in a leading position among domestic and foreign counterparts, and has been praised for the diagnosis and treatment of patients with various airway diseases from all over the country. At the same time, he teaches about 100 doctors from all over the country every year, and has been recognized and praised by peers; At the same time, internal medicine thoracoscopy is used to diagnose and treat pleural diseases, such as thoracoscopic photodynamic **, internal medicine thoracoscopic bullous volume reduction, transbronchoscopic one-way valve lung volume reduction, bronchial thermoplasty, etc. He has rich experience in respiratory intervention**, and has rich experience in combining local ** (transvascular intervention, transairway intervention, percutaneous intervention and ablation of lung cancer) with systemic **.
In addition, Zhou Yunzhi has rich experience in the diagnosis and treatment of chronic obstructive pulmonary disease, bronchial asthma, chest infectious diseases, interstitial diseases, thoracic tumors and respiratory critical diseases. I have participated in the compilation of more than 10 monographs and published more than 40 articles. As the main researcher, he has undertaken a number of projects, and won 3 third prizes and 3 second prizes of the Science and Technology Progress Award of the Coal Industry Association.
*: Department of Respiratory and Critical Care Medicine.
Review: Zhou Yunzhi.
Producer: Peng Xuezheng.
Editor: Mo Peng.