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              健康扶貧之援疆醫生曾建平
              韓冬野  2019-01-04

              飛機平安著陸,視覺上經歷了蔚藍、純白到土黃的變化,那不是讓人恐懼的霧霾,而是來自世界第二大流動沙漠——塔克拉瑪干的黃沙。這里是新疆和田,這里有一群首都好兒女,他們一批批,用13年的時間在這片西北邊疆駐扎、幫扶。

              現任和田地區人民醫院外一科副主任的曾建平,是北京市委組織部和北京清華長庚醫院選派的第九批第二期援疆干部。駐疆剛半年,他便已習慣了和田的風沙。

              在曾建平入疆后,北京清華長庚醫院黨委書記周月紅帶隊入疆探望,關心他的生活和工作狀態。與家書的內容很像,援疆隊員們基本上都是“報喜不報憂”,但是,假如你注意到宿舍書桌上煙灰缸里堆滿的煙頭,你就能切實地感受到他們最大的困難是——寂寞。而讓人欣喜的是,曾建平已經迎著和田的風沙,把援疆的日子“咂出了味兒”。

              科室里的“一家親”

              援疆醫生只有扎根在科室,才能汲取到自身價值實現的愉快。而獲得信任和好感的最好方式就是做點實實在在的事兒。

              和田地區人民醫院副院長苗欣榮說,3月份曾建平醫生抵達和田,4月份外一科的三、四級手術就突然多了起來,他眼看著醫療水平的提升,心里特別欣慰。擔任了外一科副主任一職的曾建平與科室主任卡米力一起,把重心放在了質量控制上,如科室三級查房、病例規范書寫、多科聯合會診等臨床核心制度的嚴格執行,這為科室的醫療質量提升打好了基礎。之后他受任和田地區人民醫院住院醫師規范化培訓外科基地專家督導檢查組組長,組織多名援疆專家對醫院的8個臨床外科進行督導。

              不僅是醫療,曾建平對護理的指導和要求同樣嚴格。護士長寧芳榮說,曾建平很注重醫護的配合,指導護士做好術前護理,術后及時執行醫囑預防并發癥,加速患者的康復。醫院里開展了護理“六升兩降”專項活動,在曾建平的帶領下,外一科獲得了第一的好成績。“曾主任在各方面都起到了表率作用,增加了團隊的凝聚力,我們的心都在往一處想,勁兒往一處使。”

              走進和田地區人民醫院外一科,7名肝膽醫生中,6名是維族同胞,他們都尊敬地稱曾建平為“師傅”,而醫院的護士長則形容曾建平“很帥氣”。業余時間,曾建平會和他們一起找個廣闊的地方唱歌跳舞,這位曾經有點內斂的外科醫生也在融合中發生著改變。

              亮出“殺蟲”技  助力健康扶貧

              新疆以農牧為主,高發“包蟲病”,這是一種人畜共患寄生蟲病。在和田地區,肝包蟲病和結石是肝膽領域接診最多的兩大病種。

              庫爾班是曾建平接診的一位維族患者,剛剛27歲,卻因為肝包蟲病先后在和田縣和烏魯木齊市接受過兩次手術。今年6月他再次出現上腹脹痛的癥狀,到和田地區人民醫院就診,經診斷后確認肝包蟲病再次復發了。師承中國工程院院士、北京清華長庚醫院執行院長董家鴻,曾建平曾配合董院士完成了多例終末期肝包蟲病患者的手術,采用國際領先水平的體外肝切除、自體余肝移植的首創術式,在肝包蟲病的手術治療方面積累了豐富的經驗。面對庫爾班的病情,曾建平帶領著和田外一科醫師,進行了“肝包蟲全囊摘除術”,根治了庫爾班的肝包蟲病。康復后的庫爾班,恢復了活力,重歸警務崗位。

              只身援疆,曾建平也有犯難的時候。他在和田曾接診過一例巨大肝包蟲病患者,病變的位置非常特殊,不僅同時累及肝678段,而且與下腔靜脈、右肝靜脈和肝中靜脈等多條重要血管關系密切。“一人援疆,全院幫”是北京清華長庚醫院素有的傳統,接到曾建平的申請后,北京清華長庚醫院領導高度重視,雙方的信息技術人員迅速聯系,在遠程醫療系統上實現了病歷資料、音視頻的實時對接。董家鴻院士親自主持會診工作,結合曾建平傳輸的影像資料,肝膽胰中心團隊通過計算機輔助手術規劃系統為患者的肝臟建立了3D模型,為手術方案提供了精確的參考,最終手術順利實施。以曾建平為橋梁,目前北京清華長庚醫院已與和田市地區人民醫院對接,進一步落實遠程醫療。

              “包蟲病是和田地區因病致貧的大病,醫療扶貧的根本不僅是技術上的幫扶,而且要改變地區人民對疾病的認識。”曾建平說。他借助下鄉義診和結對子的機會,也會向患者多做一些疾病科普。

              重新認識“醫生擔當”

              因為飲食和環境的差異,感冒和腹瀉是援疆隊員們的常見病,即使有意加強了運動鍛煉,曾建平也沒有幸免。援疆隊伍中的醫生顯得尤為寶貴,他們不僅要為當地的患者服務,更肩負著為隊友們保駕護航的責任。

              今年5月,與曾建平同批的援疆干部、北京天壇醫院主任醫師姜除寒出現腹痛癥狀,曾建平初步判斷是胰腺炎,但因為疼痛還不強烈,也可能是常見的腸胃炎,姜醫師決定再觀察看看。凌晨4點多,曾建平臥室的電話響了,姜醫師腹痛難忍。曾建平連忙聯系指揮部派車,陪同姜醫師緊急入院,抽血、超聲等檢查結果一一反饋后,證實了曾建平的判斷——胰腺炎,同時合并有Ⅰ型呼吸衰竭。曾建平立即采取一系列治療措施,控制病情進一步惡化。北京援疆專家病倒的消息驚動了整個指揮部。當天晚上召開的專題會上“繼續在當地治療還是轉運”成為一個艱難的選擇題。大家紛紛將目光轉到了主管醫生曾建平的身上,從凌晨4點到晚上8點,他已經忙碌了一整天,醫療條件、專家病情、援疆身份、疾病不可控性等因素,一直在曾建平的腦海中不停地翻轉著。最終,曾建平憑借豐富的胰腺炎診療經驗,結合患者的實際情況,建議繼續在當地進行治療,如48小時后病情出現變化,再考慮轉運烏魯木齊。同時,曾建平和醫療小組制定了轉運北京等多套預案。第二日下午,北京特派的專家抵達了和田,第一時間趕赴醫院參與會診,在詳細的問診和查看病例后,高度肯定了曾建平的治療方案。最終,姜醫師在病情穩定后返回北京,并順利康復。

              當醫生要具有擔當精神,曾建平說:“這是體驗很深的一次。”“我是醫生”是曾建平在新疆學會的第一句維語,而他的實際行動也在述寫著:這是一位好醫生。

               

              作者單位:北京清華長庚醫院

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