Source: Xinwang-Commercial News Editor: Goode 2022-02-24 16:07:22
Xinwang February 24th News (Chief reporter Cong Li Correspondent Xie Xiaozhen) Bones can be seen everywhere, but they cannot only appear in the trachea. You must know that a small bone can cause big problems. No, Mr. Zhang (pseudonym), who was bedridden for a long time due to cerebrovascular disease, almost died because he accidentally inhaled a bone. Finally, it was successfully removed with the help of a bronchoscope in the Department of Respiratory and Critical Care Medicine of Qingdao Municipal Hospital, and the condition was relieved.
During Lantern Festival, it was suspected that his teeth were “blocked”
71-year-old Mr. Zhang was bedridden for a long time due to inconvenience of movement due to sequelae of cerebral hemorrhage. In early February this year, he suffered from repeated suffocation, coughing, and sputum. The family did not pay attention to it at first, but later found that the teeth fell out. It is considered that the old man accidentally brought his teeth into the digestive tract after eating the Lantern Festival. In the following days, the symptoms of wheezing and coughing of the old man gradually worsened, and he could not lie down, and his family became more and more nervous and afraid. Seeing a doctor at a local hospital, the doctor considered “foreign body in the trachea and possible loss of teeth”, so he was urgently transferred to Qingdao Municipal Hospital. The receiving physician urgently contacted the imaging department to complete the CT scan of the lungs, indicating “high-density shadow in the right main bronchus, consider foreign body”.
The patient was admitted to the hospital after emergency consultation with the doctor on duty in the Department of Respiratory and Critical Care Medicine. Liu Xuedong, vice president and director of the Department of Respiratory and Critical Care Medicine, led the respiratory team to discuss the patient’s condition, considering that a large foreign body blocked the right main airway orifice, wheezing was related to one-lung ventilation, and the foreign body existed in the airway for a long time. Surroundings are accompanied by granulation tissue hyperplasia. Due to the smooth surface of the teeth and the sharp roots of the teeth, there may be risks of slippage, airway penetration, massive bleeding and infection during bronchoscopy; coupled with the patient’s disturbance of consciousness and the inability to communicate normally, it increases the difficulty of bronchoscopy for foreign body removal and requires anesthesia. Department of medicine, thoracic surgery and other professional escort.
The operation is difficult, but urgent. After explaining to the patient’s family the necessity of bronchoscopy and a series of risks that may occur during the operation, the family agreed to the surgical plan and accepted the possible adverse consequences.
Gentle but fast, the troublesome bones were pulled out
The operation was performed by Han Xiudi, deputy director of the Second Department of Respiratory and Critical Care Medicine, and Dr. Wang Yi in the bronchoscope. Preoperative ECG monitoring indicated that the oxygen saturation was only 83%. With the skillful cooperation of the anesthesia and nursing team, the bronchoscope quickly entered the patient’s airway through the mouth, and the microscope clearly showed that there was a bony foreign body at the opening of the right main airway that nearly completely blocked the airway, covered with granulation and pustules.
In this case, the operation under the microscope must be gentle, the periphery of the foreign body is sharp, and there is a risk of cutting the airway and bleeding. Dr. Wang Yi carefully used the foreign body forceps to slowly clamp the surface of the foreign body, moved it gently, and repeatedly confirmed that there was no damage or bleeding, and then quickly took it out together with the bronchoscope. The foreign object that was taken out turned out to be a 2*2cm bone, not a tooth. After the bone was removed, the patient’s finger pulse oxygen saturation rapidly increased to more than 95%. After re-entering the mirror, the lumen has recovered and there is no obvious bleeding. After the operation, the patient continued to be given anti-infection and other symptomatic treatment, and the symptoms of wheezing and cough were significantly relieved.
Deputy President Liu Xuedong reminded: bronchial foreign bodies are common clinical emergencies, and the incidence is mostly in children and the elderly, often caused by eating, speaking, laughing, etc. Foreign bodies can remain in the laryngopharyngeal cavity, throat cavity, In the trachea and bronchi, it can cause hoarseness, dyspnea, coughing, and repeated pulmonary infections.
For a long time, let life breathe freely
This foreign body removal is only one of the “eighteen martial arts” of bronchoscopy. Bronchoscopy is a common diagnosis and treatment technique in respiratory and critical care medicine. It can be used not only for routine diagnosis and examination, but also for the diagnosis and treatment of some intractable diseases, such as chronic unexplained cough, wheezing, atelectasis, and pulmonary nodules. , lung mass, unexplained pleural effusion, hemoptysis, diffuse lung lesions, hilar or lymph node enlargement, lung cancer, etc.; the technology can also treat diseases such as endobronchial tuberculosis, endobronchial tumors, bronchial stones, silicosis Whole lung lavage, etc.
The Respiratory Department of Qingdao Municipal Hospital has carried out bronchoscopy technology since the 1990s. The Department of Respiratory and Critical Care Medicine of this department has completed nearly 1,000 cases of bronchoscopy and diagnosis and treatment every year, dedicated to the treatment of respiratory diseases and critically ill patients. Accurate diagnosis and standardized treatment meet the needs of patients for comfortable and painless medical services, so that more patients can enjoy high-level diagnosis and treatment services.
[Source: Xinwang-Business News Editor: Goode]