The scientific name of leech is leech. In the novel "How Steel Was Tempered", when the hero Paul Korchagin was hospitalized in the Soviet Union, the blood congestion in his wound did not heal for a long time. Soviet doctors used leeches to suck away the blood from his wound. The hero is saved. This treatment method of sucking blood with leeches was pioneered by the Egyptians in 1500 AD. Although this method seems primitive and ancient, the reporter learned from the Hunan Provincial Cancer Hospital today that the hospital successfully saved a patient with tongue cancer using tiny leeches. The patient's transplanted tissue flap was on the verge of necrosis after surgery, allowing the patient to avoid a second surgery. It is reported that it is the first time in China that leech in vivo therapy is used to desilt free skin flaps in patients with tongue cancer.

Free flap transplantation protects the quality of life of patients with tongue cancer

Mr. Chen, 50, came to Hunan Cancer Hospital for treatment in 2012 due to left tongue cancer. Professor Yu Jianjun, the director and chief physician of the Second Department of Head and Neck Surgery, performed a left hemiglossectomy and free flap repair with anastomosis of blood vessels. No radiotherapy or chemotherapy was performed after the operation, and the patient returned to his normal life. Since 2022, Mr. Chen found that another tumor had grown on the right side of his tongue, and chemotherapy was ineffective. Mr. Chen once again came to the Hunan Provincial Cancer Hospital to seek the next step of treatment.

“During the operation in 2012, half of the patient’s tongue had been removed. This time, because other conservative treatments were ineffective, the remaining right tongue body could only be removed. In order to ensure the patient’s quality of life, another operation was necessary. A free flap transplantation that anastomoses blood vessels is performed to repair the wound. "Yu Jianjun said that after tongue cancer patients have their tongue tumors removed, patients with medium and large defects can choose various soft tissue flaps to repair the wounds. Usually, a set of skin flaps with veins and arteries are removed from the patient's arms or legs and sutured and fixed to the defect. The arteries and veins are micro-anastomized with the arteries and veins in the neck, so that the transplanted tissue can once again receive blood supply. And live.

After determining the treatment plan , Yu Jianjun immediately organized a team to perform surgery on the patient, and the surgery was successful. After a week of follow-up observation of the skin flap, Mr. Chen can be discharged from the hospital if no special circumstances occur. But in the early morning of the fourth day after surgery, the nurse on duty suddenly discovered that the skin flap transplanted on Mr. Chen's tongue was in abnormal condition. "The nurse immediately informed me to check the situation after finding out. At that time, I saw that the skin flap was purple-black, which was an obvious sign that the venous return of the skin flap was blocked and local blood stasis formed." Yu Jianjun said that usually 3 days after skin flap transplantation is the dangerous period , Mr. Chen’s situation generally does not occur after 3 days, but Mr. Chen’s several rounds of chemotherapy before surgery may cause damage to the vascular endothelium, making him more prone to problems than ordinary people.

Yu Jianjun introduced that for this kind of skin flap congestion, the usual approach is to perform surgical exploration as soon as possible, but this time the situation appeared on the 4th day after the operation. The effect of surgical exploration is expected to be poor. If effective measures are not taken, If treated promptly, the transplanted tissue will inevitably cause necrosis due to local blood stasis. The consequence is that another major surgery and tissue transplantation must be performed, causing additional pain and financial burden to the patient.

The novels he read when he was a child brought him inspiration for treatment

At this time, the doctor had no better choice except drug treatment, and the patient and his family were also very anxious. , drug treatment is generally not effective. Yu Jianjun was in a hurry and thought of the novel "How Steel Was Tempered" that he had read when he was a child. He wrote about the plot of a Soviet doctor using leeches to apply serum to the hero's wound. Leech, also known as leech, is a traditional special medicinal aquatic animal in my country. Its dried products are processed and used in traditional Chinese medicine. It has the effects of treating stroke, high blood pressure, clearing blood stasis, amenorrhea, bruises, etc. Live hungry leeches can be used to suck blood. The therapy can eliminate congestion and instantly increase local blood flow.

"It would be nice if there were leeches..." Yu Jianjun muttered to himself beside Mr. Chen's bedside, which attracted the attention of the patient's family members. "There must be some in our countryside! I'll ask my friends to catch a few in the fields," said Mr. Chen's family.

Yu Jianjun quickly stopped. Wild leeches have a complex growth environment and may be attached to many germs and other microorganisms that are harmful to the human body. They are not suitable for clinical treatment. Mr. Chen's family members thought again and again and remembered that there was a leech farm in their hometown that specialized in breeding medicinal leeches. Therefore, with the contact of Mr. Chen’s family, several leeches were finally purchased from a leech farm in his hometown. At noon that day, after the doctor evaluated and cleaned the leeches, he began to use leech in vivo therapy on Mr. Chen’s bruised skin flap. .

"On the one hand we It uses the blood-sucking function of leeches to suck out local venous blood. Once the leech starts sucking blood, its mouthparts will attach to it and will not fall off naturally until it is full, so no manual intervention is needed," Yu Jianjun said. In terms of aspect, this therapy uses hirudin with anticoagulant function released by leeches during the blood sucking process to remove accumulated blood in the tissue and increase tissue perfusion. Compared with manual acupuncture bloodletting, living leech blood sucking can eliminate congestion and immediate Increase local blood flow.

A few hours later, most of the congestion in Mr. Chen’s skin flap was removed by leeches, and the local color became noticeably lighter. It showed that the local congestion was significantly improved, and the doctor did the same thing again the next day. The color of the transplanted skin flap basically returned to red. Mr. Chen was spared the pain of another surgery. Currently, Mr. Chen is recovering well after the operation and has resumed eating and speech functions. Get ready to start the next step of treatment.

Living leech therapy requires professionals, and citizens should not blindly imitate it

Yu Jianjun recalled that "living leech therapy" was a memory left behind by reading novels when he was a child. This was achieved after becoming a doctor myself. "Our Head and Neck Surgery Department has been carrying out microsurgery since 2003, and we often encounter situations like Mr. Chen's. However, because surgical exploration is not always effective, some patients can only undergo skin flap surgery again. This situation is currently domestic There is no way for the outside world to completely avoid it. At that time, I thought, it would be great if I could use leeches to suck out the congestion." He said frankly that although Mr. Chen's successful application of leech therapy was a replicable clinical experience, there was still a chance. Such as leech breeding conditions, usage scenarios, etc. Yu Jianjun also called on relevant departments to formulate complete access standards and specifications to further manage them. If leeches are used in a safe context, they will certainly be an effective option for the management of tissue valvular and venous crises after microsurgery. Due to the high incidence of oral cancer, Hunan Province has always been at the forefront of the country in the number of free tissue repair defects after oral cancer surgery. If this method is effective in a large number of people, it can be promoted in the industry and ultimately benefit patients.

Yu Jianjun reminded that living leech therapy must be completed by professional medical staff under very special circumstances. Directly using wild leech or rough cultured leech for blood-sucking treatment may cause bacteria or viruses to escape from the damaged skin. Entering the human body can lead to adverse consequences such as sepsis, meningitis, and sepsis. It can also cause non-stop bleeding, chronic blood loss, and lead to anemia. In your daily life, you should not blindly try leech therapy. It should only be used with the participation of professionals.