One day in early July, Chen Guoqiang, director of functional minimally invasive neurosurgery at Tsinghua University Yuquan Hospital, received a patient from Tianjin. The patient, surnamed Wang, is 73 years old. One day two years ago, Mr. Wang suddenly felt a severe pain on his left side of the face, as if he had been struck by electricity, and the pain started on his left side of the face and teeth. Since then, the pain appeared every day, and the frequency of attacks and the degree of pain kept increasing, and was diagnosed as “trigeminal nerve pain” by the hospital. Mr. Wang found a famous neurosurgeon, Chen Guoqiang, after asking around for medical help.
The patient was in respiratory arrest before the operation and ran with death for 4 hours
After the strict preoperative examination was completed, the patient was pushed into the operating room at 8:00 a.m. on July 4. Just as the anesthesiologist was preparing to administer anesthesia, an unexpected situation occurred: without any drug administration by the anesthesiologist, the patient, who was talking freely with the anesthesiologist, suddenly broke off his language and suffered respiratory arrest, and at the same time, the “EEG dual spectrum index monitoring”, which monitors the patient’s degree of consciousness, showed that the patient rapidly went into deep The “EEG dual spectrum index monitoring”, which monitors the patient’s level of consciousness, showed that the patient rapidly went into a deep coma!
In the case of the patient’s respiratory arrest, the brain ischemia for 4-5 minutes, the brain cells appear to be permanently dead, and even if saved, he is only a vegetable! This sudden change was unexpected by everyone and the situation was very critical.
Chen Guoqiang, who has rich clinical experience, immediately organized the medical staff on the scene to take emergency treatment measures, inserting ventilator, oxygen, opening fluid access, urinary catheterization and other treatment measures were carried out in an intense and orderly manner. The patient’s vital signs soon stabilized, but he was still unconscious.
Based on the patient’s clinical performance, Chen Guoqiang made a decisive diagnosis of “brainstem infarction”. While the patient was returned to the ward, Chen Guoqiang invited experts from neurology and cerebrovascular surgery to come for consultation. It was agreed that the patient’s condition was due to a problem in the vertebrobasilar system, an important vascular system supplying blood to the brainstem. However, the risk of embolization is also very high, which may lead to multiple bleeding.
It was a matter of time. After obtaining the consent of the patient’s son, Chen Guoqiang personally directed a rescue team consisting of neurologists and neurosurgeons to perform a rescue embolization on the patient.
With the injection of embolization drugs into the patient’s body little by little, the patient’s right upper limb started to move, and after a few minutes, the right leg started to move on its own, followed by the left upper limb. Half an hour later, the patient slowly opened his eyes and the ventilator parameters showed that the patient could breathe on his own. The medical staff and family members present immediately let out a whispered cheer: awake! Awake!
At 12:30, after four hours of emergency resuscitation, the patient finally came to his senses. His son shed hot tears of excitement.
Identifying the culprit of the sudden condition and helping the patient get rid of the disease completely
Mr. Wang, who was pulled back from the brink of death by Chen Guoqiang, was in pain after he came to his senses, but the severe pain in his face came again repeatedly, and he strongly requested another surgery to treat trigeminal neuralgia.
Although the microsurgery for trigeminal neuralgia is not a problem for the highly experienced Chen Guoqiang and other experts, and the safety and cure rate of the surgeries performed by them over the years have always remained at the forefront, the unexpected conditions that occur during the surgery greatly exceed the risks of the surgery and should not be attempted again under normal circumstances. However, the unexpected conditions that occurred during the procedure greatly exceeded the risks of the surgery and should not be attempted again under routine circumstances.
After a discussion among experts at Tsinghua University Yuquan Hospital, it was decided that the real “culprit” of the incident had to be identified before the patient could undergo surgery again. So, Chen decided to use “whole brain angiography” to find out where the knot was. A “whole brain angiogram” is a test in which a long catheter is punctured at the femoral artery at the root of the thigh, sent retrograde through the artery to the entrance of the artery supplying the brain, and contrast is pushed in to see if there are any lesions in the vessel.
The results of the examination were surprising: the patient’s internal carotid artery bifurcation was narrowed bilaterally, the right vertebral artery was completely occluded and the blood flow disappeared, and the beginning segment of the left vertebral artery was narrowed and only 20% of the space had blood flow through it. This means that the patient’s blood supply to the brain is not even half of what it is in a normal person, and a decrease in blood flow in any of the only remaining vessels would immediately endanger the patient’s life. The emergency situation during the surgery was caused by the patient’s nervousness, which led to vasospasm after the blood pressure was raised, causing a sudden spasm of the narrow vertebral artery itself and interrupting the blood flow to the brainstem.
After identifying the “culprit”, Chen decided to perform “vertebral artery stenting”, which is to open the most severely stenosed vertebral artery with an arterial stent fed through the femoral artery to ensure that the vertebral artery supplying blood to the brainstem is usually in danger of reoccurring during surgery. On July 12, Mr. Wang underwent the surgery and everything was normal after the operation.
The patient’s family was deeply touched by the high sense of responsibility and excellent medical skills of the doctors at Tsinghua University Yuquan Hospital, and they said that they would perform the surgery for “trigeminal neuralgia” even at great risk in order to get rid of the patient’s pain as soon as possible.
After detailed monitoring and examination, Chen Guoqiang decided to perform “trigeminal neuralgia” surgery on the patient, and on July 19, the patient was brought into the operating room again, and Chen Guoqiang was in charge of the surgery again.
On July 27, the patient boarded the train to go home.
Cultivation, accumulation, innovation, the six key words contribute to the high medical skills
Chen Guoqiang’s professional knowledge is solid and comprehensive, and he has a very high reputation in the neurosurgery system. At present, the treatment of facial muscle spasm and trigeminal neuralgia by microvascular decompression carried out under his leadership is in the leading position in China, both in terms of quality and quantity of surgery. He has been called the “chief nemesis of facial spasm and trigeminal neuralgia” by the industry and patients.
Chen Guoqiang’s excellent medical skills are not a one-time or two-time accident. Practice, accumulation and innovation are the six keys to his success. Chen Guoqiang studied under the famous neurosurgeon Professor Zuo Huanyuan, and has been working in the front line of clinical practice since he joined the hospital in 1986. “In 2003, he took the initiative to apply to be one of the first to enter the front line of the SARS outbreak and completed his task under extremely difficult conditions.
In 2004, Chen Guoqiang came to Tsinghua University Yuquan Hospital as a talented person introduced by Tsinghua University, and set up the Department of Functional Neurosurgery from scratch. In less than 3 years, the Department of Functional Neurosurgery became a strong department with 56 beds and more than 1,000 surgeries per year, and in a short time, it ranked among the top in Beijing and the country, and 90% of the surgeries were done by Chen Guoqiang himself. Since then, Chen has independently performed more than 4,500 neurosurgical procedures without a single fatal case. Currently, the department treats patients from all over the country and a large number of overseas Chinese patients from the United States, Canada, Australia, Japan and other countries.
Innovation, on the other hand, is the two words that Chen respects most and works hard for. Over the years, he has invented a multi-functional stereotactic surgery system for neurosurgery and has helped nearly 50 hospitals nationwide to carry out stereotactic surgery, obtained two national invention patents and three utility model patents, presided over a scientific research fund for returnees from the Ministry of Personnel and a medical science fund from Tsinghua Yu Yuan, in addition to participating in the National Natural Science Fund, Beijing Major Research Fund, Beijing Natural Science Fund, etc. In addition, he has also participated in many other scientific research projects, including the National Natural Science Foundation of China, Beijing Major Research Fund, Beijing Natural Research Fund, etc.
Chen Guoqiang has accumulated in practical medical treatment, published more than 30 papers in professional journals at home and abroad, participated in writing three professional books, and shared his creation and discovery with others.