A puncture is performed at the radial artery of the right hand, where a slender catheter is inserted. The catheter is like an earthworm, constantly meandering along the blood vessels under the careful manipulation of the doctor. From the wrist, this catheter will reach the heart... Recently, the reporter came to the cardiac catheterization room of Yuebei People's Hospital to witness a routine PCI operation (percutaneous coronary interventional surgery).
In the cardiac catheterization room, the reporter met the famous "iron man" doctor of the cardiology department in northern Guangdong - Tang Liangqiu, director of the Department of Internal Medicine and Cardiovascular Medicine of Shaoguan Yuebei People's Hospital, and chief physician.
Delicate "hand kung fu"
Unblock the "lifeline"
In the heart catheterization room, a large transparent window separates the two rooms, inside the window is the interventional treatment room, the doctor is fully immersed in the heart stent operation; outside the window is the technician operation room and the nurse operation room, Tang Liangqiu stared at the display screen, introduced the surgical process to the reporter, and communicated the progress of the operation with the doctor through the walkie-talkie.
When the catheter reaches the coronary sinus, the doctor then sends the catheter into the coronary artery through delicate operation. Next, contrast agents are injected, and with the help of DSA (Digital Subtractive Angiography System), the coronary artery morphology is revealed.
In the display outside the operating room, the reporter saw that with the help of contrast agents, the blood rushed from each contraction and relaxation of the heart. The heart is like a powerful pump, and each beat makes the blood quickly fill the blood vessels and then quickly withdraw.
"Normal blood vessels are a relatively clear line, and if there is narrowness, there will be less development." Tang Liangqiu pointed to the screen, and a thick and clear blood vessel suddenly became only a quarter of the original thickness, looking very blurry, "This is narrowness."
Tang Liangqiu introduced that the maximum degree of coronary artery stenosis is more than 50%, which means that its blood supply to the heart is only 50% or even less than normal, and it can be diagnosed as coronary heart disease.
"This patient has become more than 80 percent stenosis." Tang Liangqiu said that this is a more serious stenosis, so it is necessary to implant a stent after balloon expansion to prop open the narrow blood vessels to quickly open the narrow blood vessels.
"Now we have to bring the balloon in and expand it in the narrow." Tang Liangqiu introduced that the doctor in the interventional treatment room is holding the catheter, through delicate rotation, the balloon is slowly introduced, and the strength and angle of each tiny operation determine its direction. The balloon is then expanded and molded in a narrow area. Finally, the stent is pushed along the guide wire to the stenosis-causing or occlusive site to achieve the effect of supporting the blood vessel.
Pass! At the moment when the blood vessels are propped up, the blood is like a rushing river, surging with torrents. With the help of stents, the "two sides" of the blood vessels are "widened" and the "lifeline" can be unblocked. The small and blurry blood vessels that were originally on the screen became thick and clear, which also meant that the PCI operation was very successful.
By 11 a.m., this was the eighth PCI operation performed in the cardiac catheterization room, after Tang Liangqiu had already done three. "If you are fast, the interventional surgery can be done in about twenty minutes, usually thirty or forty minutes." Tang Liangqiu revealed that it is more common to do more than twenty units a day, and at most 35 units have been done in a day.
In recent years, the team led by Tang Liangqiu has completed more than 2,000 cases of coronary heart disease PCI and more than 4,000 cases of contrast surgery every year, including more than 600 cases of emergency PCI, and has completed more than 20,000 cases of coronary heart disease diagnosis and treatment surgery.
And time to fight for speed
Fight for your life with death
"Emergency surgery is a life-threatening attempt with death." Tang Liangqiu said.
Nearly one-third of the annual coronary heart disease PCI surgery volume of Guangdong North People's Hospital is an emergency department. That means 365 days a year, every day of the year, always on standby, ready to go to the operating room.
Emergency surgery pays attention to a "fast". After receiving the emergency call, the chest pain center treatment green channel is activated with one button. Tang Liangqiu and other interventional team members rushed to the cardiac catheterization room as soon as possible to prepare for surgery.
The patient's condition changes at any time and cannot be delayed for half a second. Even many patients have lost consciousness and should not be called. Medical staff performed on-site rescue, performed CPR, and followed the flat car all the way to the operating table. At the same time, first aid measures such as ECG monitoring and defibrillators are activated at the same time.
"In an urgent situation like this, you have to open the blocked coronary vein immediately, and you have to fight with time." The interventional team raced against the clock with endotracheal intubation and balloon-assisted breathing. Skilled puncture, angiography, balloon dilation, opening of occluded blood vessels, every operation is a thousand hammers. After the timely rescue of the intervention team, the coronary stent was successfully inserted, the patient's normal undulating heart rate was seen on the ECG monitor, and the fight with the god of death was declared victorious.
From rescue to the end of the operation, over the years, the interventional team led by Tang Liangqiu has set one "northern Guangdong speed" in emergency surgery.
"Several times I need emergency surgery when I am eating in the New Year, and it is common to be called for surgery in the middle of the night." Tang Liangqiu said that when he slept until he was halfway through sleep and was called to the emergency department, once or twice a week, "I actually want to sleep well." ”
"Some surgeries are difficult to do, and they take three or four hours." Tang Liangqiu introduced that some patients have chronic complete occlusive lesions, and some cannot go the right way, and they should do reverse bilateral.
Among them, an operation in 2019 is still fresh in his memory. An elderly patient had failed surgery in the hospital a month ago, and coronary perforation and pericardial effusion tamponade made the blockage of heart vessels very serious and relatively rare in clinical practice. The catheter was in place, the guide wire passed smoothly through the stenosis of the cyclotron branch to the far section, and everything went as smoothly as expected. Balloon dilation of the stenosis of the cyclotropic branch, smooth implantation of stents.
Next, the right coronary artery needs to be opened. It is difficult for the positive guide wire to pass through the occlusion segment, and once the guide wire cannot pass, it means that the operation fails. Time is lost minute by minute, half an hour, an hour... The guide wire was still not moving, and Tang Liangqiu on the operating table was already sweating.
He decided to take a different approach, using complex reverse interventional therapy for CTO lesions. After several hours of unremitting efforts, the guide wire finally reached the distal end of the occlusive vessel, and finally successfully implanted the stent and opened the occlusive vessel. At that moment, the hanging hearts of the people present finally let go.
"Interventional surgery requires a high degree of mental concentration, and the more difficult it is, the more stable it is." Tang Liangqiu said that as soon as the operation is completed, the feeling of hard work and fatigue will come up, but the operation will always be a hundred times more energetic.
"Every time I came back from rescue, I was very relieved. At this time, I can best appreciate the honor of being a doctor. Tang Liangqiu said with a smile.
Dr. Iron Man has an excellent reputation
Mentors poured in
In 1997, after Tang Liangqiu finished his training in Peking University Hospital, he returned to Yuebei Hospital to carry out interventional treatment for coronary heart disease. Over the years, he has worked quietly in front-line clinical positions. The mobile phone is turned on all day, on standby 24 hours a day, ready to carry out acute myocardial infarction stents, so dedicated that he is called "iron man" doctor by medical staff.
Over the years, Tang Liangqiu has received numerous pennants, letters of thanks and letters of commendation from patients and their families. He has an excellent reputation in northern Guangdong and is deeply trusted and praised by patients and their families.
Despite many reputations, Tang Liangqiu is still fighting in the front line. Due to the excessive amount of surgery, its long-term exposure to direct X-ray radiation has caused white blood cells to remain at a low level, and the skin of the hands has also suffered from radiation dermatitis. He never retreated, always leading the way. "Solving the pain of patients is my greatest joy." Tang Liangqiu often put this sentence on his lips.
As the leader of the internal medicine teaching and research team of Guangdong North People's Hospital, he has a solid clinical basic knowledge and rich clinical teaching experience, and at the same time teaches what he has learned to selflessly cultivate the younger generation.
Since serving as a master tutor at Shantou University School of Medicine, he has led graduate students and trained doctors every year, and is good at teaching according to his aptitude. In clinical teaching, Tang Liangqiu started from the pathogenesis and mechanism of common diseases and multiple diseases in cardiovascular medicine, and then analyzed the occurrence and development of diseases in combination with the clinical symptoms and signs of typical patients, and finally shared his clinical diagnosis and treatment experience with students. Its explanations are easy to understand and are deeply loved and affirmed by the students.
"We are now a national training base, and the doctors in the county have come here for further training, and many talents who can independently perform interventional surgery have been trained." Tang Liangqiu introduced that he will select doctors to study with the class on the spot, from observation to assistant to formal surgery, and it will take more than a year to study.
With the updating and iteration of medical knowledge, he maintains his learning, keeps up with the frontiers of medical development, actively participates in academic conferences and lectures, reads the latest guidelines and medical journals, often introduces the latest medical advances with interns in bedside teaching, and encourages students not to be satisfied with textbook knowledge, but to explore further. In recent years, he has published more than 30 papers in national medical journals, presided over 1 scientific and technological research project in Guangdong Province, won 2 first prizes and 3 second prizes of the Municipal Science and Technology Progress Award.
Embrace cutting-edge technology
Lead the development of the discipline
An excellent discipline leader and a united team can ensure the good development of the department. Yuebei People's Hospital is located in guangdong province and the surrounding areas of cardiology disease diagnosis and treatment center, discipline ability and construction level in northern Guangdong region in a leading position, shouldering the responsibility of escorting the cardiovascular health of the surrounding cities and counties and regions.
Tang Liangqiu, as the director of the Department of Cardiology and the leader of the discipline of the Department of Cardiology of North Guangdong People's Hospital, under his leadership, the interventional treatment technology and system of the Department of Cardiology of North Guangdong People's Hospital, from scratch, from weak to strong, have built interventional treatment of cardiovascular diseases into the technical advantages and characteristics of the department itself, ranking among the best in the prefecture-level and municipal hospitals at the same level in the province. The Department of Cardiology of North Guangdong People's Hospital has also made progress in medical technology capabilities and business in the past 10 years.
A set of data tells a lot of progress. The wards have developed from 1 to 5; the number of discharged patients has grown from less than 1,000 to more than 10,000; the annual number of interventional surgeries has developed from less than 100 to more than 5,000 interventional surgeries per year; from PCI surgery that can only complete simple lesions at the beginning to surgery that can now complete difficult and complex lesions, and the success rate of surgery is more than 99%.
At the same time, he led the team to build a "chest pain center" to escort the health of the people of Shaoguan. Tang Liangqiu led the department to take the lead in carrying out coronary interventional surgery, pacemaker implantation, radiofrequency ablation, congenital heart disease intervention and other cardiac interventional surgeries in the region, with a success rate of more than 99%. As medical director, he led the team to successfully pass the provincial and national standard version of the "Chest Pain Center" certification in 2018, and the provincial and municipal examinations highly recognized the operation of the "Chest Pain Center" of North Guangdong People's Hospital, and was rated as the "Chest Pain Center" demonstration base in Guangdong Province.
In recent years, the number, difficulty and success rate of surgeries completed by the department have ranked among the top hospitals of the same level in the province. Strong and excellent technical strength, but also recognized by the province and the country, was rated as the Chinese Medical Doctor Association cardiovascular disease interventional diagnosis and treatment training and the Ministry of Health cardiovascular disease interventional diagnosis and treatment grass-roots training base. In addition, interventional physicians have been trained in hospitals in surrounding cities and counties and helped guide the establishment of "chest pain centers" to carry out interventional treatment.
At present, the Department of Cardiology of North Guangdong People's Hospital is now a key clinical specialty in Guangdong Province, a specialty of "Eleventh Five-Year Plan" medicine in Guangdong Province, and a professional department of national drug clinical trials, and has won the honorary titles of Municipal Advanced Department, National May 1st Pioneer Post, National Towel Civilization Post, provincial and municipal Youth Civilization Number and so on. In the past three years, it has successfully declared more than 30 scientific research projects and 3 provincial-level projects. The department has won 1 third prize of provincial science and technology progress, 5 municipal science and technology progress awards (two of which have won the first prize of municipal science and technology progress), and published more than 60 papers in the past three years, including 3 SCI articles and 50 papers in core journals.
[Southern Daily, Southern + Reporter] Ye Zhiqiang
[Correspondent] Wang Yannan, Lu Yanping
【Author】 Ye Zhiqiang
【Source】 Southern Press Media Group South + client