擦亮醫(yī)療援外這塊“金字招牌”

溫韜

2018年2月3日，在成都飛往埃塞俄比亞的ET637航班上，一名乘客突然暈倒在后艙，臉色蒼白，嘴唇發(fā)紺。情況萬分緊急，幸好有一支中國醫(yī)療隊(duì)在這次航班上。在隊(duì)長李昂的帶領(lǐng)下，經(jīng)過近20分鐘的緊急救治，患者癥狀緩解，轉(zhuǎn)危為安。

這支醫(yī)療隊(duì)是四川省第3批援圣多美和普林西比（以下簡稱“圣普”）的醫(yī)療隊(duì)，這次萬米高空上的營救是醫(yī)療隊(duì)立的“首功”，為此次援外醫(yī)療工作開了個(gè)好頭。

1年的援外工作，醫(yī)療隊(duì)得到各方認(rèn)可，作為隊(duì)長的四川大學(xué)華西醫(yī)院胰腺外科副主任李昂以無私大愛、醫(yī)者仁心、精湛技術(shù)獲得了“全國援外醫(yī)療工作先進(jìn)個(gè)人”榮譽(yù)稱號。

談及榮譽(yù)，李昂表示這是對他工作的肯定，他說：“醫(yī)療援外是我國援外工作的一塊‘金字招牌’，通過醫(yī)療援外，能在受援國建立良好的信譽(yù)?！?/p>

為了擦亮這塊“金字招牌”，李昂在思想與業(yè)務(wù)上都做了充分準(zhǔn)備?！霸馊蝿?wù)下達(dá)到醫(yī)院后，我主動遞交了申請，因?yàn)槲颐靼赘冻鍪侨松鞓纷畲蟮脑慈?。另外，國家和黨培養(yǎng)了我，在需要我去付出與回報(bào)的時(shí)候，我也應(yīng)該去做這樣一件有意義的事情。”

出發(fā)前，李昂認(rèn)真學(xué)習(xí)了葡萄牙語以及當(dāng)?shù)氐姆煞ㄒ?guī)，也詳細(xì)了解了當(dāng)?shù)氐尼t(yī)療條件與衛(wèi)生狀況，力求做到心中有數(shù)。然而，援外醫(yī)療工作在實(shí)際開展中仍然困難重重。

由于受援國經(jīng)濟(jì)相對落后，醫(yī)療條件差，整體的行業(yè)環(huán)境令人擔(dān)憂。

“需要這份責(zé)任心，以治好病人為宗旨來做好醫(yī)療援外這份工作。同時(shí)，作為一名受過嚴(yán)格培訓(xùn)的醫(yī)生，更要用自己的行動去影響當(dāng)?shù)馗嗟尼t(yī)生。”李昂是這么說的，也是這么做的。在援圣普期間，他帶領(lǐng)隊(duì)員們不畏艱苦、真抓實(shí)干，共接診患者2588人次，義診12次，為中國醫(yī)療援助在圣普開辟了陣地；協(xié)助四川省衛(wèi)生健康委員會推進(jìn)“三年對口醫(yī)院援建項(xiàng)目”——腹腔鏡技術(shù)援助項(xiàng)目，擬定了該項(xiàng)目的計(jì)劃書和腹腔鏡器械捐贈目錄，為高技術(shù)醫(yī)療服務(wù)貼上了中國援助的標(biāo)簽；協(xié)助推進(jìn)外交部捐贈圣普“移動診療車”項(xiàng)目，李昂負(fù)責(zé)擬定該項(xiàng)目醫(yī)療設(shè)備與車輛配置的參數(shù)，保障了援外醫(yī)療工作的縱深發(fā)展。

圣普總?cè)丝诩s20萬，當(dāng)?shù)赝饪漆t(yī)療水平十分有限，而中國醫(yī)療隊(duì)的到來，正在慢慢改善這一局面。

2018年7月的一天，一名“肚子已挺出足球大小包塊”的患者來到圣普國家醫(yī)院求醫(yī)，這讓當(dāng)?shù)蒯t(yī)生犯了難。他們擔(dān)心腫瘤情況復(fù)雜，開腹手術(shù)難度太大。

李昂知曉情況后，對患者進(jìn)行了診斷，判斷腫瘤極有可能是胃腸道間質(zhì)瘤。他建議，盡快采取手術(shù)為患者爭得生機(jī)。

7月11日，由李昂“操刀”，在圣普國家醫(yī)院開展了當(dāng)?shù)厥桌薮笪搁g質(zhì)瘤切除術(shù)。術(shù)中證實(shí)，該腫瘤正是生長于胃外壁，具有包膜，符合胃間質(zhì)瘤的臨床診斷特征。在當(dāng)?shù)蒯t(yī)生的配合下，李昂順利切除了直徑達(dá)20cm的腫瘤，患者術(shù)后沒有出現(xiàn)并發(fā)癥，恢復(fù)良好。

術(shù)后，李昂還為當(dāng)?shù)蒯t(yī)生講解了胃腸道間質(zhì)瘤的診療標(biāo)準(zhǔn)等知識……援外期間，李昂先后開展手術(shù)300多臺，獲得了當(dāng)?shù)蒯t(yī)生與患者的一致贊揚(yáng)。

除為當(dāng)?shù)乩习傩罩委熗?，李昂還為該國前總理特羅瓦達(dá)成功實(shí)施了足底封閉術(shù)，緩解了他足底筋膜炎導(dǎo)致行走困難的問題。

那是2018年4月的一天，李昂接到了特羅瓦達(dá)的“求助”。原來，特羅瓦達(dá)受足底筋膜炎影響已一個(gè)多月，嚴(yán)重到難以行走，彼時(shí)又剛好需要出訪，時(shí)間緊迫。

李昂前往其官邸進(jìn)行診斷后，立即與國內(nèi)華西醫(yī)院疼痛科專家楊邦祥教授取得聯(lián)系，并制定了診療方案，在特羅瓦達(dá)出訪臨行前為他做了封閉治療。術(shù)中，還通過手機(jī)軟件準(zhǔn)備了3D的解剖圖形，講解疾病區(qū)域的解剖結(jié)構(gòu)，讓特羅瓦達(dá)在治療中保持放松。

“做完治療是下午5點(diǎn)，特羅瓦達(dá)的航班是晚上8點(diǎn)。治療結(jié)束后，他馬上就可以下地行走，整個(gè)出訪期間也沒有復(fù)發(fā)，治療效果很理想?！崩畎汉髞砹私獾?。

對李昂及其團(tuán)隊(duì)來說，如何提高圣普醫(yī)務(wù)工作者的醫(yī)療水平是此次援助工作的重中之重。

“外科手術(shù)無菌操作是最基本的，但當(dāng)?shù)蒯t(yī)護(hù)人員普遍缺乏這樣的觀念?！崩畎好靼?，提倡無菌操作要注意方式方法，還應(yīng)維護(hù)當(dāng)?shù)蒯t(yī)務(wù)工作者的自尊心。

援外期間，李昂為當(dāng)?shù)蒯t(yī)生針對常見病診療指南的培訓(xùn)近20次，推動了當(dāng)?shù)嘏R床醫(yī)療的規(guī)范化和標(biāo)準(zhǔn)化，當(dāng)?shù)蒯t(yī)務(wù)工作者的業(yè)務(wù)水平得到顯著提升。

除了工作上面臨諸多困難，需要不斷尋求突破外，醫(yī)療隊(duì)在生活中也會遭受停水停電及“巨大昆蟲”的困擾，好在隊(duì)員們善于自我調(diào)節(jié)。

在醫(yī)療隊(duì)駐地，一棵芒果樹就能給醫(yī)療隊(duì)帶來極大的樂趣。那是一棵沒人管理的果樹，到了成熟期，每天都會掉落很多新鮮的果子，大家撿起來擦一擦就能吃?！疤貏e開心，這里的菠蘿蜜也好吃，隊(duì)員們都愛吃?！被叵肫鹪谑テ盏臅r(shí)光，李昂面帶笑意。

2018年8月6日，是李昂39歲生日，醫(yī)療隊(duì)的翻譯莫鵬彈起了尤克里里，為他送上生日祝福?！昂臀以诔啥嫉慕诸^走一走，直到所有的燈都熄滅了，也不停留……”一曲《成都》讓李昂眼眶微紅。

情灑非洲，心盼故鄉(xiāng)。為期一年的醫(yī)療援助已于2019年2月結(jié)束，醫(yī)療隊(duì)也返回國內(nèi)?；貞浽谑テ张c隊(duì)友“并肩作戰(zhàn)”的日子，李昂說，“這是對我的考驗(yàn)，是我職業(yè)生涯的催化劑，也是人生中一筆寶貴財(cái)富?！?/p>

On the flight ET637 from Chengdu to Ethiopia on February 3， 2018， a passenger suddenly fainted in the cabin. He was looking pale and his lips were turning bluish. Fortunately， there was a Chinese medical team on board in the urgent situation. After nearly 20 minutes of emergency treatment administered by the team led by Li Ang， the passenger was out of danger.

As the third batch of medical team sent by Sichuan Province to assist Sao Tome and Principe （STP）， this team“won the first battle” at the rescue， starting the foreign medical aid work on a good note.

Outstanding achievements were garnered in the medical aid work in STP over the past year. As the team leader， Li Ang， deputy director of the Department of Pancreatic Surgery of West China Hospital， Sichuan University， won the honorary title of “model individual of China’s foreign medical aid work” by right of his selfless love and benevolence for patients and superb skills.

When talking about honor， Li regarded it as a recognition of his work. He said， “Medical aid， serving as a ‘goldlettered signboard’ of China’s foreign aid work， can earn a good reputation for China from the recipient countries.”

To brighten the gold-lettered signboard， Li was fully prepared both mentally and professionally. “As soon as my hospital received the foreign aid assignment， I submitted my application voluntarily， because I believe that in our life， happiness comes from giving. Moreover， it is China and the Party that has cultivated me and I should do something meaningful when I am required to give and return.”

Before setting out， Li earnestly studied Portuguese and local laws and regulations of STP， and gained detailed understanding of local medical and sanitary conditions. Although he made every effort to prepare， there was still a hardship in actual practice.

Thwarted by relatively backward economy and poor medical conditions， the recipient country suffered from a worrisome industry environment.

“We view the cure of patients as our own responsibility to delivery medical aid work. And as a doctor who has received strict training， I need to spur more local doctors with my own behavior，” Li said.

That’s what Li said and did. Under his leadership during in STP， the team worked hard and made solid efforts. They received 2，588 medical cases and provided 12 free medical treatments in total， which broke new grounds for China’s medical aid undertaking in STP； they also helped the Health Commission of Sichuan Province promote its threeyear project of counterpart hospital assistance – Laparoscopic Technical Assistance Project， drafted the project plan and the donation list of laparoscopic instruments， which labeled high-tech medical services as China’s aid work； in addition， they also assisted in advancing the project of donating “Mobile Medical Vehicles” to STP， which was proposed by the Ministry of Foreign Affairs of PRC， and drew up the parameters of medical equipment and vehicle configuration of the project， by which they boosted the indepth development of China’s medical aid work to foreign countries.

The arrival of Chinese medical teams has slowly improved the limited surgical level of STP， which has a population of about 200，000.

One day in July 2018， a patient“with a tumor the size of a football in his stomach” came to STP National Hospital， putting local doctors in a quandary. They were unable to do any operation given the complexity of the tumor and the difficulty of laparotomy.

Having known the situation， Li diagnosed the patient and asserted that his tumor was most likely the gastrointestinal stromal tumor. He suggested a surgery as soon as possible to save the patient’s life.

On July 11， Li personally carried out the first local giant gastric stromal tumor resection in STP National Hospital. Intraoperatively， it was confirmed that the tumor grew in the outer wall of the stomach and had an envelope， which was in line with the clinical diagnostic features of gastric stromal tumor. With the cooperation of local doctors， Li successfully removed the tumor with a diameter of up to 20cm. The patient had no complications after the surgery and recovered well.

After the surgery， Li also explained the diagnosis and treatment criteria of gastrointestinal stromal tumors for local doctors. With over 300 surgeries carried out during the foreign aid in STP， Li has earned himself the praise from both local doctors and patients.

In addition to treating locals in STP， Li also successfully implemented a plantar fasciitis surgery for the country’s former Prime Minister Patrice Trovoada to alleviate his pain in walking.

One day in April 2018， Li received a message from Trovoada for help. Severe plantar fasciitis over more than a month made Trovoada hard to walk. And he was time-starved for the treatment as a state visit was on the schedule.

Li， after diagnosing Trovoada in his official residence， immediately contacted professor Yang Bangxiang， expert in the Department of Pain Treatment at West China Hospital， and developed a treatment scheme to be operated on him before the visit. During the surgery， 3D anatomical drawings were displayed through mobile phone software to explain the anatomy of the disease for Trovoada and keep him relaxed.

“The treatment was done at 5 p.m. and Trovoada’s flight was at 8 p.m. He could walk on the ground immediately after the surgery， and there was no recurrence during his visit. The therapeutic effect was satisfactory，” Li later learned.

For Li and his team， how to improve the medical skills of local medical workers in STP was a top priority.

“Aseptic technique is the most basic requirement during surgical operations to keep patients safe from infection. But there is a general lack of such awareness among local healthcare workers.” Li understood that it is necessary to take right approaches that can protect the self-esteem of local medical workers while promoting aseptic technique.

By far Li has conducted trainings for local doctors on common disease diagnosis and treatment for about 20 times， which has driven the standardization of local clinical treatment and significantly improved the performance of local medical workers.

Apart from many difficulties at work that required them constantly reinvent themselves， Li and his team also suffered from water and power outages and “giant insects” in life. Fortunately， all team members are very self-regulating.

A mango tree in the area where the medical team was stationed can bring great joy to them. It was an unmanaged fruit tree. Fruits would fall off when it was getting ripe and they would pick up and eat. “I really enjoy it and the jackfruit here is delicious too. We all love it.” Recalling the time in STP， Li smiled.

On Li’s 39th birthday on August 6， 2018， the team’s interpreter Mo Peng played ukulele to send him a birthday blessing. “In the Chengdu streets we wander and wander， until all the lights go out but we still linger，” lyrics of Chengdu， a folk song recorded by the musician Zhao Lei， touched his heart.

They worked with might and main in Africa to soothe their homesick heart. The one-year medical aid work ended in February 2019 and the medical team returned home. As he recalled the extraordinary journey he had taken with his teammates in STP， Li said， “It is definitely a test for me， a valuable asset in my life， and also a catalyst for my career.”