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  • 泰山之子丨董频:守卫咽喉要道,练就制胜“刀法”

    本期嘉宾:董频

    董频,山东省泰安市新泰人,现任上海市第一人民医院耳鼻喉科主任医师、教授、博士生导师,耳鼻喉科主任、学科带头人,教研室主任,市一临床医学院副院长。上海市耳鼻喉学会副主委,中国中西医结合学会耳鼻喉科分会常委、上海副主委。

    主要从事耳鼻咽喉 - 头颈肿瘤的临床及科研工作,具有熟练的手术技能及疑难病症诊断技巧,从事咽喉肿瘤的临床与基础研究、鼾症和嗓音疾病的诊断与治疗。承担科技部国家重点研发项目和国家自然基金、上海市科委等项目十余项,获上海市科技进步奖,省部级奖励 4 项。指导 41 名博士后及博士、硕士研究生。近 5 年来发表 80 余篇论文,其中 SCI 收录 35 篇、编写著作 16 本。

    "到上海 20 年了,还是一口泰安话。"

    初次在上海市第一人民医院耳鼻喉科见到董频医生,记者就感到了乡音的亲切。

    这位同时承担着国家重点研发项目和十余项上海市科委重点项目的泰安籍耳鼻咽喉 - 头颈肿瘤临床及科研专家,还是一名"刀客",已经主刀为上万患者进行了手术,帮他们重获健康。

    用他的话说,"做手术就像在完成一件艺术品,手术做得完美,特别有成就感。"

    本期《泰山之子》带您走近新泰老乡、上海市第一人民医院耳鼻喉科主任董频,感受耳鼻咽喉疾病救治过程中的生死时速。

    精益求精,练就制胜"刀法"

    为何选择从医,董频的答案与大部分医疗从业者相似。

    "听老师说医生这个职业永远需要,加上当时母亲的身体一直不好,自己毫不犹豫就报考了山东医学院。"董频说,自己的青年时代对未来职业没什么规划,大学毕业后便留校在齐鲁医院,分科的时候被分在耳鼻喉科,就这样,他开始了一生的行医之路。

    当时,山东医学院耳鼻喉科在全国都算得上响当当,董频的老师王天铎更是业界"泰斗"。

    自此,董频开始专攻咽喉疾病的治疗,功力突飞猛进,尤其是老师在艰苦的手术环境下,依然能凭有限的手术条件创造奇迹,这一点让他受益终身。

    "从老师的身上我学到的最多的是敬业精神,以及对学科探索的敬畏和执着,也正是这种精神,指引我一步步向前。"如今的董频,已经是耳鼻喉科响当当的"金手指",他善于运用现成的条件进行手术,对器械、环境、助手的要求并不苛刻,因为他有一双"敏感而神奇"的手,在困厄的手术中出奇制胜。

    "有时候,手就是很好的手术工具,比如有些病人颈部有大的肿块,很快能找到,但是颈部血管太多,用刀剪都不安全,干脆就用手来分离。刀是锐利的,手是钝的,最安全,而且可以感觉血管的搏动,灵敏度更高。外科医生要凭着悟性参透对器械的感觉,有些地方需要锐利,有些地方需要钝,要练就这些,所以就要付出更多的勤奋,不断练习。"

    董频的刀法在业界引起了广泛赞誉,他甚至不需要助手协助,一台手术下来清爽、干净。

    "医学领域有很多未知数,解决问题的办法都是根据病人的需要想出来的,医生治愈了病人,同时,也是病人成就了医生。"董频始终认为,面对所有的疾病治疗,都要心怀敬畏,容不得一丝丝马虎。

    同时,在追求学术研究的道路上,董频也进行着不懈的追求。上世纪九十年代,董频博士毕业,获得笹川医学奖学金,赴日本研修一年,在日本久留米大学学习头颈外科。

    他说,"在久留米大学有两大的收获,一个是喉功能保留术;另一个是多学科合作,在日本一台手术是一个多学科团队的合作,其中有负责切除肿瘤的医生,肿瘤切除后还有负责修复的整形科医生。"

    这些收获,让他至今受益,也正是这些学习成果,让他在如今的手术过程中更加追求完美,甚至是在手术缝合的处理上,也会力求带给患者一个"美的记忆"。

    救治过程经历无数次生死时速

    2000 年,世纪之交。董频接受了上海市第一人民医院的邀请,来到上海扎根。

    董频的手术已经做了上万例,从这些实战经历中,董频的临床手术水平站到了上海以及全国本专业的最高水平,获得了同行和患者的赞誉。

    "经验都是积累后的水到渠成,做咽喉手术,首先是解剖熟练,其次是判断的准确性,要知道哪里有血管,先把血管稍微分开,再下刀,做到胆大心细。"了解董频的人都知道,他是个幽默感很强的人,在手术中的状态也是快乐的,手术的速度也相当快,同样的手术别人做三个小时,可能他一个小时就收工了。

    董频的科室经常收治"老大难"病人,这已是司空见惯。常有二级医院把复杂病人送来给他医治,比如有病人高龄,肝癌术后、肝硬化、肝功能差,同时又是喉癌和下咽癌,有手术指征的,董频一定会收治。"做手术就像在完成一件艺术品,手术做得完美,自己也开心,特别有成就感。"董频说。

    多年"刀客"生涯,董频经历了无数次生死时速。

    "有一次是急诊送过来的,病人颈部全是疤痕,做过放化疗,呼吸困难,一躺下就没有呼吸了,颈部找不到气管。当时只有我和一个博士生在,博士生着急拔腿就要去喊人,我一把拽住他,来不及了,救人要紧。当时不能按照常规操作,就在喉结下方正中间两公分处,找了一把手术刀一刀切下,病人转眼有了呼吸,血压本来下降到 40,切开后立马上升到 80,病人得救了。"面对风险,董频除了经验,更多的是担当。

    呼吸都停止了的病人,这个时候如果医生不敢担当,稍有疑虑,病人生命危在旦夕。

    "咽喉是人体的要道,出现问题可能要命,我们是和死神在赛跑。"董频明白,作为主刀医生的他是没有退路的,在生死关头只有奋勇向前,抢夺时机,遏住生命的咽喉,才能赢得整场交锋。

    推动上海和泰安优势医疗互补

    董频是一名"刀客",如今还担任着国家重点研发项目的研发首席科学家。

    如今,他承担着"咽喉专用手术机器人"的研发任务,董频告诉记者,"医疗器械的国产化、小型化和专业化是我们未来医学发展和临床医疗的方向。"

    《支撑喉镜管腔内自进化、口腔种植专用手术机器人研发及评价改进研究》是科技部的重点研发项目,它按照全链条布局、一体化实施的思路,旨在解决制约我国机器人技术及应用的关键问题,推进我国机器人技术抢占国际制高点,为形成机器人技术 - 示范应用 - 产业化发展的良性循环奠定基础而设立的。本课题由董频牵头,联合上海交通大学机动学院、上海第九人民医院、北京大学第一医院共同实施完成。

    然而,对于"咽喉专用手术机器人",董频更是凭借其专业技术知识展开探索,目前该项目获得国拨科研经费的支持,正在快速推进中。

    另一方面,董频作为泰安走出来的专家,常年关心家乡医疗事业的发展,回新泰老家进行了多次学术演讲,并且每年都举办会议或活动,组织肿瘤外科讨论会,就两地双方优势互补进行交流,让家乡共享先进的医学经验,让家乡的优秀医学人才获得更高端的学习进修机会,目前也已经在耳鼻喉专业等多个学科上开辟协作项目,促进两地的医疗领域交流和发展。

    与此同时,董频还致力于为家乡病患解决病痛,通过远程会诊、回泰就诊等多个渠道,为家乡的病人提供诊疗建议,亲自回泰进行手术治疗等。

    目前,擅长多种类型的喉部分、喉次全切除发音重建术、根治性或选择性颈淋巴清扫术、全喉切除术、下咽癌切除喉功能重建术等技术的董频已经获得过中华医学、上海市科技进步奖等多项省部级奖励,指导 41 名博士后及博士、硕士研究生,为推动泰安和上海两地的医学优势学科互补,培养家乡的医学人才,付出着努力。

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