China.com
When talking about the snowy plateau, we are always fascinated by its mystery and majesty, but the relatively backward development status of the local area, especially education and medical care, is the top priority that plagues local Tibetan compatriots. The author came into this group and interviewed Xu Kuibin, an anesthesiologist from Tianjin Cancer Hospital. In just half a year, he gave the local people a satisfactory answer.
Changdu Blood Bank is in a hurry. I got off the operating table and walked onto the blood donation table.
On July 15, 2019, Xu Kuibin, an anesthesiologist from Tianjin Cancer Hospital, was sent to Chamdo, a small plateau town with an altitude of 3,500 meters. On the first day he went to Tibet, he "experienced" his career difficulties. The patient is old and has a severe hypertension crisis, with a systolic blood pressure of up to 220mmHg or more, with saphenous varicose veins on the right, free knee joints on the left, unbearable pain in the calf, and difficulty walking. This is an absolute taboo in low-altitude areas in the mainland, but due to the special nature of its region, it is difficult to lower the basic blood pressure level in the short term. Finally, he led the Tibetan Hospital medical team to successfully complete the operation under strict and fine tissue and monitoring anesthesia, and the patient recovered.
Chambo local medical resources are relatively scarce, especially the clinical blood resources are very small, and many patients have to delay treatment in order to wait for the blood source. As the director of the operating room of Tibetan Hospital, he knew the importance of blood resources in saving patients' lives. "Once, he had an operation that took 10 hours. At that time, the entire blood bank in the Chamdo area had only 2,600 ml of blood, and the risk of surgery was very high. Although there was altitude reversal, I immediately donated 300 ml of blood after the operation, which was the upper limit of blood donation in the plateau. Physical discomfort can be overcome, but the lack of blood in the blood bank is a disaster for patients."
Performing general anesthesia surgery on the plateau. The risk is so high
Xu Kuibin not only dedicated blood donation to local medical care, but also used medical skills to bring health. During the "Ophthalmologists' Tibet Guangming Tour Project" event, the operating room team led by him performed preoperative screening of 679 patients and performed crystal implant surgery on 198 cataract patients, which took only five days. Among them, patients are free from preoperative examination, admission to surgery. "There are two things that I have impressed me deeply. One patient is a mentally retarded group. We performed a crystal replacement surgery under general anesthesia. This is the first artificial lens replacement surgery under general anesthesia in Chamdo. Another time, I worked on the operating table for 20 hours in a row. Just as I was about to rest, I suddenly came to another emergency patient. I asked other doctors to rest and insisted on standing for three more hours for the operation. It was dawn when I looked up." Dr. Xu Kuibin said.
Surgery site
When Xu Kuibin mentioned the difficulty of plateau work, he said: "The oxygen content in the plateau is very low. Usually, the blood oxygen saturation of mainlanders reaches about 98%, while the blood oxygen saturation of patients in Tibetan areas is only about 88%. This is the taboo line for mainland anesthesia. The possibility of low oxygen surgery on the plateau is extremely high, and it also brings great risks to anesthesia, and the risk of general anesthesia is even greater."
In addition, the people in Tibetan areas have their own national beliefs, customs and habits, as well as the diagnosis and treatment methods of Tibetan medicine. As doctors, we must not only treat and save patients from the perspective of professionalism, but also respect their religious beliefs from the perspective of patients. This requires running-in with local Tibetan doctors. "The concept of medical treatment in Tibetan areas is also completely different. An 80-year-old grandmother I treated needed anesthesia. She actually took 108 stones from her body at a time. The pain she endured in daily life is unimaginable to us ordinary people. Also, common diseases in Tibetan areas are also different from those in the mainland. The aging degree of Tibetan joint tissue will be significantly faster than that in the plains. These have brought challenges to our doctors entering Tibet."
Master-apprentice system Scientific management. Since one person was fighting
0 assisted the operating room of the Changdu Tibetan Hospital, Xu Kuibin has improved the department's various anesthesia-related rules and regulations in a short period of time, completing more than 30 routine surgeries per month. Compared with the same period last year, the number of surgeries increased by nearly 40%. Emergency patients at night accounted for about 10% of the total number of surgeries. The surgeries increased sharply. It was normal for him to work until late at night.
Take good apprentice well is also a hard indicator given to him by Xu Kuibin. He taught two doctors, Slangwangmu and Zhao Guilin, to fill in the anesthesia with cervical plexus block, brachial plexus block, internal jugular venous puncture catheterization, controlled antihypertensiveness, laryngeal mask ventilation, cardiopulmonary resuscitation, and patient postoperative automatic analgesics. Many of these technologies fill the gap in Changdu City medical technology, change the previous single anesthesia method, and make patients who require long-term surgery more safe.
Although he did not mention his family, the author found a famous postcard written by his five-year-old son in his circle of friends. As a doctor, he devoted himself to the plateau, but as a father, he lost the time to accompany his children to grow up. Doctors are kind and the doctors who aid Tibetans bring recovery to patients, hope to patients, and joy to their lives. "What I hope most is that the people in Chamdo have more cures and the doctors in Chamdo have better means." (End)
