走近北京地坛医院妇产科你的笑容 我最开心(走基层·蹲点调研)


走近北京地坛医院妇产科你的笑容 我最开心(走基层·蹲点调研)

2011年09月03日04:48  来源:人民日报  作者:姚雪青
刘敏(右一)与同事在给乙肝大三阳产妇做剖腹产手术。

  刘敏(右一)与同事在给乙肝大三阳产妇做剖腹产手术。

  本报记者 姚雪青摄

  蹲点感言

  在很多人看来,医生是一份社会地位高、体面又高薪的工作;其实其背后,却有着鲜为人知的艰辛与危险。特别是传染病医院的医生,还要承受身体、心理两方面的巨大压力:为艾滋病患者做手术时,医护人员就面临着职业暴露的风险。他们穿的一次性防护行头,往往需要好几百元,患者使用的床单、铺垫、器具也都是一次性的,连成本投入都比普通医院高……

  从这一意义上来看,刘敏和她的同事们有理由期待,国家给予传染病医院及医护人员更有力的扶持。

  这样的场景如此特殊帽子、口罩、透明防护眼罩、一次性防护服、特制厚手套、塑料脚套。手术台上,“全副武装”的医护人员正在为一名艾滋病患者进行宫颈癌切除手术。监测仪上,闪现着规律跳动的心电图……

  这样的场景如此平常无影灯下,消毒、铺单、开腹,主刀医生操着手术刀的手绝没有一丝颤抖,专注的眼神中看不出一点犹豫。护士熟练地将器械排放在托盘里,平稳地递过去……

  “这是一个高风险行业。职业风险难以完全避免”

  8月30日中午12时10分,北京地坛医院第三手术室。这已经是主刀医生、妇产科大夫刘敏今天的第三台手术了。“相比前两台剖腹产手术,这台手术难度较大、操作要求更细致,将持续3个小时左右,需要我们有很好的身体素质和心理素质。”刘敏说。

  自从走进医院大门,特别是得到允许进入手术室后,不断有医护人员提醒着同样“全副武装”的我:这里是传染病医院,一定要注意防护要站在离手术台较远一点的地方,不要乱摸乱碰,不要靠近器械和血液污染物等。

  尽管做好了思想准备,第一次呼吸手术室内的空气,看到血肉模糊的人体组织,并与艾滋病患者近距离接触,在内心深处我还是感到了一丝忐忑。转念一想,对于记者而言,采访仅此一回,而对于习惯了在刀光针影下工作的医护人员来说,成天与传染病患者打交道,职业暴露的风险是不是很大?

  “这确实是一个高风险行业,工作中发生职业暴露的意外难以完全避免。”刘敏和她的同事们介绍说,今年4月,地坛医院急诊科的一位大夫在给艾滋病感染患者做气管镜时,不慎被患者剧烈咳嗽喷出的血痰溅入眼睛内;此前不久,一位外科大夫在手术过程中被手术刀扎伤了手。此后一个多月的时间里,这两位医生一边服药治疗,一边忍受着药物的副作用继续上班。所幸的是,经过检查,两人都没有被感染。

  “通过"四免一关怀"政策,艾滋病孕妇及其所生婴儿的抗病毒药物由国家免费提供,还能得到一定的补贴,非常人性化。而传染病医护人员面临着较高的职业风险,也希望国家能尽快出台政策,落实针对传染病医院及医护人员的补贴、补助,甚至保险等。”刘敏建议。

  “乙肝妈妈生下健康宝宝让我最开心”

  3个小时前的同一间手术室里,伴随着一声响亮的啼哭声,刘敏和她的同事们迎来了当天早上的第一个新生儿。

  “恭喜啊,是个漂亮的姑娘!”护士一手抱着刚剪完脐带的婴儿进行简单清理,一边安慰手术台上虚弱的产妇。这位患有乙肝大三阳的新妈妈躺在手术台上,侧头打量着宝宝,满脸幸福的笑容,泪珠在眼眶中打转……

  在相邻的几间手术室里,乙肝大三阳产妇的另外几台剖腹产手术正在陆续进行。“这样的手术,平均一年1000多例吧。”我站在走廊上,不时看到有护士进进出出,将新生儿们抱去进行清洁和护理。

  “我国是乙肝高感染率国家。以前,确实没有更好的办法,绝大多数乙肝母亲都没法逃脱把病毒传给婴儿的命运,有些就遗憾地放弃生小孩;现在,随着医疗技术的发展,通过母婴阻断等干预、预防手段,乙肝病毒携带者也能拥有健康的孩子。”刘敏说,“但也有些患者并不了解情况,年纪不小了才到处看病、考虑这个问题。对乙肝病毒携带者来说,趁年轻且病情较为稳定时尽早科学地要孩子,是更好的选择。”

  据地坛医院病案统计室的统计,自1992年4月医院开展母婴阻断工作到2010年8月31日,共计10357例相关病例,其中乙肝8783例(成功率97%以上)、HIV(艾滋病病毒)42例(截至2009年底可确认36例,成功率100%)。

  “地坛医院妇产科,有90%的产妇是传染病患者。你要问我最开心的事情,就是病人被救活、生下健康的宝宝,圆做妈妈的梦。”从事妇产科医生已经25年、今年49岁的刘敏轻轻地对我说。

  “真希望有更多新生力量补充到我们的队伍里来”

  27岁的王女士认定刘敏是她这辈子的大恩人。一周前,王女士刚生下个大胖儿子。她患有乙肝,被地坛医院收治。一年半以前,她住在医院待产,因为突发并发症,加上宫缩引起剧烈疼痛,几乎昏厥。后来,还因为出现血栓,又被转去ICU。“要不是刘医生抢救得当,我可能连命也保不住了。”

  回想起这一段经历,正在手术室外做术前准备的刘敏说:“当时接到值班医生打来电话,已经过了半夜12点,来不及多想,立即从西四环的家里开车赶到东北五环外的医院。”

  由于随时都会有紧急情况发生,且大多数普通医院不具备收治条件,来自全国各地的传染病产妇们往往会选择地坛医院这样的专业医疗机构,所以“妇产科医生们的手机,从来都是24小时开着,随叫随到,节假日也不例外。”刘敏说。

  王女士说,晚上还看到刘医生来查房,第二天一早还是她;又要出门诊、做手术,有时候忙得午饭都吃不上……“家里人肯定会担心的吧?”

  “家人已经习惯啦。真希望有更多新生力量补充到我们的队伍里来,传染病医院的妇产科医生还是太缺了。”听了我的转述,刘敏从容地回答完,又仔细地将手洗了洗,向手术室方向走去。






艾滋病不治会早死,早治才康复 艾滋病不治会早死,早治才康复 艾滋病不治会早死,早治才康复 艾滋病不治会早死,早治才康复

 
图示∶2011年5月正式出版的《中国特色医疗金鉴》登载的刘君主任及其机构事迹 
 
 

慢性艾滋病早期中医药治疗保障生命论证

红津液饮料面世 或将能预防艾滋病

更多来源∶新浪商业登载
http://vic.sina.com.cn/news/27/2010/1231/26801.html


TOM新闻登载

http://post-social.news.tom.com/s/63000AD83310.html

中国青年网 健康频道

http://news.youth.cn/jk/201012/t20101231_1447239.htm

 环球时报-环球网

http://news.163.com/10/1231/15/6P8B7PTU00014JB6.html


 环球网

http://china.huanqiu.com/hot/2010-12/1390550.html

 

 

Approached Beijing Ditan Hospital, I am most happy you smile (the months of research to go grass roots)
At 04:48 on September 3, 2011 Source: People's Daily Author: Yao Xueqing
Liu Min (right) with colleagues in the maternal HBeAg to hepatitis B Caesarean section.

The reporter Yao Xueqing photo

Months of reflections

In the eyes of many doctors is a high social status, dignity and well-paid work; actually behind, but it has known the hardships and danger. Especially the infectious diseases hospital doctors, but also bear the physical, psychological aspects of pressure: an operation for AIDS patients, health care workers are faced with the risk of occupational exposure. They wear disposable protective outfit, often require several hundred dollars, patients with bed sheets, bedding, appliances are also one-time, even the high cost of inputs than the general hospital ... ...

From this sense, Liu Min and her colleagues reason to expect that national infectious diseases hospital and medical staff to give stronger support.

This scene so special hats, masks, transparent protective goggles, disposable protective clothing, special thick gloves and plastic booties. The operating table, "heavily armed" in health care for AIDS patients is to be a cancer surgery. Monitor on, flash a regular beating of the ECG ... ...

This scene so common under the shadowless lamp, disinfection, draping, laparotomy, the surgeon's scalpel, speaking absolutely no trace of trembling hands, of eyes seen no hesitation. Nurses skillfully equipment emissions in the tray, smooth hand it over ... ...

"This is a high risk sector. Occupational risk is difficult to completely avoid"

At 12:10 on August 30, Beijing Ditan Hospital, the third operating room. This was the surgeon, obstetrics and gynecology doctor Liu Min's third surgery today. "Compared to the previous two cesarean sections, this surgery more difficult, more detailed operational requirements, will last three hours or so, we need to have good physical and mental qualities." Min said.

Since the door into the hospital, in particular, has been allowed to enter the operating room, we have been reminded of the same staff, "heavily armed" I: infectious disease hospital here, be sure to pay attention to protection to stand farther away from the operating table somewhere Do not fumble tinker, not near the equipment and blood contaminants.

While doing the mental preparation for the first time the operating room breathing the air, see the bloody tissue and close contact with AIDS patients, in my heart I still feel a trace of apprehension. Then I thought, for the reporter, the interview, the only one back, and accustomed to the work in the shadow of the needle Daoguang for healthcare professionals, all day dealing with infectious diseases, occupational exposure to risk is not great?

"This is indeed a high-risk industry, occupational exposure occurred at work is difficult to completely avoid the accident." Liu Min and her colleagues said that in April this year, Ditan Hospital, a doctor in the emergency department to do the bronchoscopy in patients with HIV infection When patients with severe cough spray accidentally gets into the eyes of the bloody sputum; this long ago, a surgeon a scalpel during surgery, was stabbed in the hand. After over a month, two doctors side medication, while enduring the side effects continue to work. Fortunately, after checking, they are not infected.

"Through the" Four Frees and One Care "policy, pregnant women and their babies born to HIV antiviral drugs available free of charge by the state, but also a certain subsidies, very human, while infectious diseases facing higher health care occupational risks, also wants the state to the policy as soon as possible, the implementation of infectious disease hospitals and health care for subsidies, grants, and even insurance. "Min recommendations.

"Hepatitis B mother gave birth to a healthy baby so I am most happy."

3 hours before the same operating room, accompanied by loud wails, Liu Min and her colleagues first morning ushered in a newborn.

"Congratulations, ah, is a pretty girl!" Nurse hand holding the baby just a simple hair cut the umbilical cord clean up, while a weak maternal comfort on the operating table. The new mother with hepatitis B HBeAg on the operating table, side head looked at the baby, happy smile on his face, tears in eyes and round and round ... ...

Several adjacent operating room, the other maternal hepatitis B HBeAg several Caesarean section is carried out in succession. "This kind of surgery, the average year over 1000 cases of it." I stood in the corridor, and out from time to time to see a nurse, will hold their newborns to carry out cleaning and care.

"China is a high prevalence of hepatitis B countries. Before there is really no better way, the mother could hardly escape the vast majority of the hepatitis B virus to the baby's fate, some would regret giving up a baby; Now, with medical technology development, through interventions such as PMTCT, means of prevention, hepatitis B virus carriers can have a healthy child. "Min said," but some patients do not understand the situation, not very young doctor was everywhere, consider this issue . of hepatitis B virus carriers, the still young and relatively stable condition when to have children as soon as scientific, is the better choice. "

According to statistics altar room of the hospital medical record statistics, from April 1992 to carry out the hospital PMTCT work to August 31, 2010, a total of 10,357 cases related cases, including 8783 cases of hepatitis B (the success rate of more than 97%), HIV (AIDS virus) and 42 (the end of 2009 can be confirmed in 36 cases, the success rate of 100%).

"Ditan Hospital, is 90 per cent of maternal infectious diseases. You ask me the most happy thing is that the patient was saved, gave birth to a healthy baby, round mother's dream." Obstetrics and gynecology doctors have 25 years, Liu Min, 49, said to me gently.

"I hope to add more new forces come into our ranks."

Identified 27-year-old Ms. Wang Min was her great benefactor in this life. A week ago, Ms. Wang has just gave birth to a big fat son. She suffers from hepatitis B, was admitted to the hospital to the altar. Year and a half ago, she lived in the hospital to be produced, because unexpected complications, coupled with severe pain caused by uterine contractions, almost fainting. Later, also because of the emergence thrombosis, was transferred to ICU. "If Dr. Liu save properly, I might even life also retain his job."

Recall an experience, being done outside the operating room before surgery to prepare Liu Min, said: "It was the doctor on duty received a phone call, has been the midnight, time to think, immediately drove home from the West Fourth Ring rushed to Northeast rings outside the hospital. "

As always, there will be an emergency, and most general hospitals do not have the condition treated, maternal infectious diseases from around the country who often choose to altar professional medical organizations such as hospitals, and the "doctors of obstetrics and gynecology phone, always open 24 hours, on-call, holidays are no exception. "Min said.

Ms. Wang said, the evening also saw Dr. Liu to the rounds the next morning or she; but also a clinic, surgery, and sometimes are too busy to eat lunch ... "the family will certainly be worried, right?"

"Family members have become accustomed to friends. Really hope that more new force added to our ranks, the infectious diseases hospital obstetrician or so missing." Listened to my account, Min calmly answering, and carefully will hand a wash, go in the direction to the operating room.

 
 
 
 
 

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