Qianjiang Evening News·Hours News Correspondent Wang Rui Hu Xiaofeng
Yesterday afternoon, he walked out of the isolation ward of the first Affiliated Hospital of Zhejiang University School of Medicine, 36-year-old Chen Hua (pseudonym) took 42 days. After experiencing the face of the new coronavirus, he fought hard with ECMO, and finally got rid of the god of death. At this time, he still had the fear of surviving the disaster. Against the backdrop of the red coat, a smile flashed across his face. He turned around and waved goodbye to the medical staff who were together day and night, and life was just around the corner.
: An 80-year-old Chen Atai who was discharged from the isolation ward was also discharged from the hospital at almost the same time. Atai, who suffers from hypertension and diabetes, has a strong will to survive. Under the careful treatment and care of medical staff, he successfully took off the ECMO that he had supported for 12 days and embarked on his way back to Ningbo. In the ward, two elderly patients with COVID-19 who underwent lung transplantation have also successfully escaped from ECMO and are recovering.
, two critically ill patients with COVID-19, who have experienced illnesses and recovered and were discharged from the hospital. In the treatment of ECMO patients with extremely low offline chances, they can almost be regarded as "lucky ones" or even "miracle" . But behind the luck and miracle is the isolation intensive care unit in Zhijiang Hospital. In the past two months, they have been under the impact of the virus on patients again and again like storms every day. Medical staff use the unity, pragmatic and meticulous "Zheyi Spirit", regardless of gains and losses, regardless of the cost, and finally won the victory with their technology and strength.
Yesterday, the Party Secretary of Zhejiang University First Hospital Liang Tingbo encouraged everyone during the MDT consultation: protects the lives of patients, we have accumulated a lot of treatment experience, which can be said to be an international model, our Zhejiang University First diagnosis and treatment plan is effective! Worth promoting!
Today, we selected Chen Hua and Chen Atai’s treatment experience, paid tribute to the medical staff, and expressed our gratitude to everyone fighting on the front line!
This year's Spring Festival is definitely the most bizarre and tortuous thing in Chen Hua's 36 years of life experience.
He and his wife, who live in Xiaogan, Hubei, plan to travel abroad during the Spring Festival. Unexpectedly, they changed their return trip several times and landed in Hangzhou. All the crew, including Chen Hua and his wife, were quarantined and observed. I didn't expect that I was infected with the new coronavirus as if I had won the prize, and my life was in danger.
DAY1: How could I get infected?
Chen Hua is still puzzled. How did he get hit? According to the doctor's speculation, he is from Hubei and is likely to have encountered the virus when he set out in Wuhan. This is why doctors later discovered that the virus in the first generation of patients has stronger virulence and more severe attacks on the lungs and other organs.
If time can go back to January 19, he will definitely choose to give up this trip. That day, he and his wife drove from Xiaogan to Wuhan Airport , and took a plane to Malaysia and Singapore for free. "Before leaving, I knew a little about the epidemic, but I didn't think it was serious at the time, so I still traveled as planned." After playing in Malaysia for 3 days and Singapore for a day and a half. Although I didn't have enough fun, the couple still returned according to the pre-determined itinerary and planned to go home for the Spring Festival.
But the epidemic development was beyond imagination. Wuhan was "closed". On January 24, they changed their flight to Hangzhou. Airport, flight, trip... Chen Hua, who has never worn a mask, couldn't think of any link that made him fall into the trap.
At that time, Hangzhou had already carried out a first-level response to the epidemic and was quarantined as soon as it was landed. Within two days, his wife developed symptoms and was sent to a hospital in a certain district for treatment. On January 27, he also started to have a low fever. "I tested the virus several times in a row and were all negative. I was lucky that I might be fine." Chen Hua said that on February 2, he had a high fever of 39℃ and was finally diagnosed.
"Cough, lack of strength, asthma, can only walk a few meters away, but can't walk." On February 3, due to the rapid progress of his condition, he was transferred from a designated hospital to the Zhijiang Campus of Zhejiang University First Hospital.
DAY4: At the age of 36, I entered the ICU
Chen Hua never thought that he would enter the ICU at a young age.
"In the first few days in the ordinary ward, people felt a little uncomfortable. Suddenly one day the doctor told me that I was going to enter the ICU." Chen Hua did not feel much trouble in his heart, so he took out his mobile phone and sent a message to his wife, who was also diagnosed,: "I am going to enter the ICU."Later the doctor told him that at that time, his lungs had many lesions, his oxygenation index continued to decline, and his condition was progressing rapidly. The treatment team needed to intervene in advance with rich experience.
There is a doctor's metaphor that, at first, the hypoxic patient of new coronary pneumonia was like a person walking on a cliff, the road was always flat, and when he walked forward, he could not see the cliff, and the doctor might not see it either. When the doctor reacted, one of his feet had fallen. Fortunately, the team of Zhejiang University First Hospital that Chen Hua met had already seen the end of the disaster and "stopped the cliff" in time.
virus did not give up the crazy attack because of Chen Hua's young and strong body. From the CT film, the lungs of the first day, the third day, and the fifth day were like cartoons, and the CT film was watched. Almost white, the virus kept attacking the lungs. The lungs, which were originally as loose as a balloon, were as if they were deflated, causing extremely critical adult respiratory distress.
DAY6: Intubation, ECMO, the ultimate treatment was all
and entered the ICU. Because of the difficulty of breathing and the person had no strength, Chen Hua and his wife's daily "phone call" was interrupted.
for two days of high-flow oxygen therapy, Chen Hua did not improve, and the oxygenation index was lower than 100. This means that oxygen inhalation is ineffective, his lungs have failed, and Chen Hua developed respiratory distress syndrome.
"He is so young, he must try his best to save him! "Professor Liang Tingbo, Party Secretary of Hospital, consulted with the expert team, and Chen Hua became the "focus figure". On February 8, tracheal intubation treatment.
" Pay attention to details and not let a detail slip through the cracks of the fingers. "So, there were many more eyes around Chen Hua, like embroidery, staring at vital signs, various instruments, and staring at the slightest change.
" Basically, from that day on, people were broken, and there was a memory in the middle that had no impression. "Chen Hua said that since various subsequent treatments require anesthesia and sedation, he was almost in a coma and could not remember what happened at all.
However, the critical care team remembered it clearly.
" After intubation, it was stable for several days, but there were still twists and turns. We are tenacious, and the virus is tenacious. "The next day after intubation, bilirubin increased, and Chen Hua immediately received artificial liver treatment.
wave after one wave was not settled. On February 10, Chen Hua suddenly had pneumothorax . In layman's terms, the principle of the ventilator was to pump air into the lungs, and his lungs progressed into a hard plastic bag due to the virus attack. After the positive pressure was pumped, the lungs broke.
"This is the first huge risk he faces. If acute lung function deteriorates, he may not last for a few days. " For the entire treatment team, this is also the first time that everyone feels "not good" in the process of treating Chen Hua. At that time, facing this virus that humans have never encountered, the country's treatment plan for the new coronavirus was updated one by one. These experts who have experienced SARS and H7N9 know that this time is a harder and harder to crack. Previous experience may not be a hit. Experts from Zhejiang University First Hospital are very clear that they must rely on evidence-based medicine. There is a saying that the attack on human body by
virus is Three weeks determine life and death. In theory, patients have survived in the fight against the virus. The virus retreats, but the mess left behind has almost come to an end. It is not easy to clear the virus and save the patient.
Every time the disease is discussed, experts are verbally fighting back and forth. Everyone has a copy of Chen Hua's basic physical data. Experts from the surveillance room, infectious diseases department, respiratory department, laboratory department, radiology department, and pharmacy department come up with the optimal opinions based on their own majors. "Eliminate the virus as soon as possible! "Is hormones useful? "For this life of "nothing, you're gone" that holds even a little hope, and the team has a tacit understanding.
All the expert groups and medical staff in the ICU, have an APP installed on the mobile phone, which can update the patient's data in the surveillance room in real time . "So, I always look at my phone during those days, even if I wake up in the middle of sleep, the first thing I do is to look at his indicators. ”
DAY12: The ultimate treatment plan, ECMO support for 13 days
pneumothorax did not improve, and the treatment was in trouble.After the expert team discussed, Chen Hua used ECMO, which is the strongest method of extracorporeal life support. It can temporarily replace the patient's cardiopulmonary function and gain time for cardiopulmonary rehabilitation for patients. The expert group took into account various factors in this decision.
If you continue to use the ventilator, the rupture of his lungs will become larger and larger, which will inevitably cause greater danger. If the ventilator is stopped in order to protect the lungs, the pressure in the lungs will drop, and he will soon be unable to breathe. Like many critically ill patients in Wuhan who have not received timely treatment, the body will not get oxygen and the organs of the body will fail. At that time, could partially replace lung function by using ECMO, reduce the burden on Chen Hua's own lung pressure, exchange time and space, and give the lungs time and space to heal themselves.
Soon, the ventilator + ECMO began to operate, and Chen Hua's condition was temporarily under control. However, the question of whether the doctor can get rid of it successfully after taking ECMO has taken great pains to the doctor. At that time, the proportion of patients who successfully rescued ECMO experience in China was only 20 to 40%, and almost no patients with COVID-19 were able to take off alive after using ECMO.
DAY16: Challenge! "Sober ECMO"
allows critically ill patients to survive and make them live better. Chen Hua, 36, is the youngest critically ill patient in the ICU. For his recovery, medical staff have devoted a lot.
"During the treatment process, you must ensure that your brain function is good." The team experts innovatively applied "Sound ECMO", "Patients take ECMO without consciousness. After a cycle, their lungs may be cured, but other organs and muscles atrophy and deteriorate due to 'dormancy'." Compared with patients with deep sedation, sober ECMO must be "man-to-person". You should know that once a patient is awake, he may experience problems such as irritability and movement, even if he accidentally touches the pipeline, it may cause the patient to die immediately and accidentally. Doctor chooses to do this, which means carrying all risks and pressures on his shoulders.
Although it is an ECMO in a waking state, Chen Hua has stared at him all night long. Few people know how long and fast it is to go from the dark night to a ray of sky light to the overly brightness outside the ward window of Zhijiang Campus.
The scene of human-machine connection, Chen Hua felt that he was bound in a cocoon by the instrument tube. The scene was magical like a science fiction film, but it was also abnormal. Seeing the bright red blood flowing from the thumb-thick tube drawn out from the neck into the buzzing machine circulating, it was quite shocking.
Despite this, the doctor and nurse helped him get up with the machine every day, and pedaled the recovery bicycle on his feet. On the first day, Chen Hua couldn't stand steadily and couldn't pedal. On the second day, for one minute, and later, as the bicycle time increased, the doctors smiled happily: There is hope!
supports lung function on one hand, fights inflammation and infection on the other hand, keeps racing against viruses and tug of war with death. How far has
refined treatment reached? ECMO's flow regulation, complication prevention, sputum-sucking and consolidating treatment, all of them are put on.
exhausted all the ways to get the patient back. In order to restore the patient's gastrointestinal function as soon as possible, Chief Physician Fang Qiang, the head of the isolation ICU, delivered the porridge to the ward and fed it to Chen Hua bite by bit. Later, Chen Hua recalled that the porridge was comparable to the delicacies of mountains and seas.
The battle was held until the 17th, and good news from the laboratory department came: Chen Hua's virus turned negative!
htmlOn December 18, Zhejiang University First Hospital took the lead in releasing the "COVID-19 Zhejiang Diagnosis and Treatment Experience (Lite Version)". This Zhejiang version of the plan, which has attracted much attention from domestic experts, has accumulated a large amount of precious clinical diagnosis and treatment experience and condensed the efforts of hundreds of experts.
DAY24: ECMO has been removed! Return from the brink of death!
"What are you doing? I just got out of the danger period." On February 26, Chen Hua sent a message to his wife who had not been in contact for nearly 20 days. He successfully removed the ECMO on this day, and his virus nucleic acid has turned negative for a week.
The wife simply replied with 5 words: "I understand, happy!" After experiencing this thrilling epidemic, the wife who had recovered at that time was waiting for her to recover.
"You can breathe, and I feel much more relaxed." Chen Hua thought to himself, at least half of the time has been successful.1
After strict monitoring and scientific treatment, Chen Hua finally passed this level successfully, just like the flowers in early spring, life bloomed again!
On that day, all the expert teams, including Secretary Liang Tingbo, changed their previous serious expression and finally smiled.
But what he didn't know was that the experts who were always following him looked at each other and smiled. They knew that there were reefs under the calm waves.
DAY36: Meeting the discharge standard, I am glad that I was treating
in Zhejiang First 1, Chen Hua's condition is getting better and better day by day.
"Human life is so fragile and precious. You must take good care of yourself." This is the most direct feeling that Chen Hua felt after experiencing life and death.
He was originally 77 kilograms, but because of this unprecedented serious illness, he lost only more than 60 kilograms. Therefore, he was very active every time, standing still, taking independent golden roosters, taking deep breaths, and exercising balance ability... Looking back on the past period, Chen Hua was like a toddler, under the professional guidance of a doctor, his life returned to normal.
"I am really glad that I am in Zhejiang and received treatment in Zhejiang First." Chen Hua said thank you for more than a dozen times, "I am reborn today with the care of the medical staff of Zhejiang University First Hospital."
He has experienced the superb skills of Zhejiang University First Hospital's First Hospital; he has witnessed the busy figure of the treatment team in the middle of the night; he has listened to the call from the medical staff in his ears, "Although they are all wearing protective clothing, now I can tell who it is as long as I listen to their voices."
Chen Hua wants to go back to his hometown in Hubei the most at the moment, although that is the core area of the epidemic. He knew that Zhejiang University First Hospital sent more than 150 medical teams to Hubei, and the cherry blossoms in Wuhan are in full bloom, and spring is here!
Another old man, Chen Atai (pseudonym), who is similar to Chen Hua, is a critically ill patient with the new crown that is currently verified by the oldest ECMO in the country to recover offline. She has now embarked on her way back to her hometown in Ningbo.
"After I was discharged from the hospital, I would definitely live to 100 years old!" Chen Atai joked with the medical staff with heartfelt pleasure, "So many doctors and nurses are surrounding me, I am a blessed person. I'm sorry for not living for a hundred years. You're so hard to save me."
35 days in the isolation ward of Zhijiang Hospital, Chen Atai said that when I recall it, it's as long as half of my life. "Being able to go out alive is the greatest gratitude to Zhejiang University First Hospital."
Time back to the Spring Festival. As a close contact of a confirmed patient with new coronary pneumonia, Chen Atai did not have any discomfort symptoms, but on February 2, the local hospital in Ningbo showed a positive nucleic acid test, and lung CT showed an infection of both lungs. He was immediately isolated and treated in the local hospital in Ningbo.
htmlOn February 9, due to the worsening of the condition, Chen Atai was transferred from the local hospital in Ningbo to the Zhijiang Campus of Zhejiang University First Hospital. The day after the transfer, he entered the ICU as a critically ill patient.As an elderly patient with COVID-19 and accompanied by underlying diseases such as hypertension, Chen Atai's condition progressed rapidly, and then developed respiratory failure and severe acute respiratory distress syndrome . He was intubated on February 14 and was treated with awake ECMO on February 25.
After the treatment of an experienced ECMO team, Chen Atai was in a stable condition and recovered by stepping on a bicycle in bed.
March 7, the day before Women's Day, 80-year-old Chen Atai went offline. After offline, all oxygen and circulation were stable. Many nucleic acid tests were negative, and the lung imaging lesions improved, meeting the discharge standards.
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