特殊手术:为艾滋患者取出身上12年钢针 |
http://www.tianshannet.com 2009年01月09日 10:25:42 天山网 ![]() |
亚心网讯(记者王前喜 张万德 通讯员刘婷婷摄影报道)1月8日11时45分,新疆维吾尔自治区传染病医院感染手术室一片肃静,4名医生神色凝重地步入手术室。 防护眼镜是医生为艾滋病人手术时必须的防护。据了解,该患者为2009年新疆首例艾滋病人手术,此前已有18名艾滋病患者在这里进行过手术并取得成功。 手术医生戴着防护眼镜、双层手套,小心翼翼地为艾滋病患者手术取钢针。 34岁的古丽(化名)静静地躺在手术台上,等待医生将她12年前刺入身体内的一枚钢针取出。 这原本是个小手术,但因为古丽是一名艾滋病患者,这让医护人员丝毫不敢大意。清洗双手,戴两层乳胶手套,防护服包裹严密,手术开始了。 感冒查出艾滋病 古丽曾是一名杂技演员,12年前,她染上了毒瘾。为了戒掉毒瘾,她将一根长约5厘米的钢针刺进了自己的左胳膊,随后,她最终戒掉了毒瘾。 2008年12月17日,因感冒一直不见好,古丽在家人的陪同下到乌鲁木齐市一家医院就诊时,被查出“HIV”呈阳性,并已进入发病期。 “得知消息的那一刻,我惊得全身瘫软。”古丽说。 古丽的丈夫告诉亚心网记者,得知爱人得了这种病后,家里犹如遭遇晴天霹雳。他是一名下岗工人,全家一直都靠租房子过日子,现在19岁的儿子还不知道母亲得了这种病。 古丽随后被转到自治区传染病医院治疗。医院对古丽进行了全身检查,发现了隐藏在其左胳膊二肱肌里的一根钢针。经询问,这根钢针已在古丽的身体里藏了12年。 担心古丽病情恶化,医院决定为其进行手术,将钢针取出来。 半小时取出钢针 昨日上午10时许,医院对古丽进行了拍片、透视、B超等检查,为手术做准备。 11时45分左右,4名医务人员进入更衣室换上了手术服。进入手术室前,他们用洗手液连续3遍清洗双手,然后用消毒液对手术中易暴露的部分皮肤进行涂抹。 手术开始了,医生为古丽进行了局部麻醉和静脉复合麻醉,随后用手术刀切开了古丽左臂的二肱肌外侧。血迅速从刀口流出,一旁的医生迅速用纱布将血清理。随后,医生又用电刀、止血钳等器具小心翼翼地寻找着那根钢针。 12时23分,手持电刀的医生朝其他3名医生点了一下头。得到回应后,约一分钟后,只见手术室的弯盘里多了一根长约4厘米,已严重生锈的钢针。 此前,医务人员从X光片中看到的是一根完整的缝衣针,而取出来的却是一根断针,这让手术人员有些惊疑。 手术医生稍稍停顿后又操起了止血钳,重新进入古丽被切开的部位。12时28分左右,医务人员从距其肌层下约4厘米处取出了约1厘米长的带有针眼的断针尾部。 “古丽,你胳膊里的针取出来了,手术很成功,放心吧。”“是吗?我一点都没感到疼。”古丽说。 随即,两名人员对古丽的伤口处,用“美容针”进行了缝合。 12时30分,古丽被推出了手术室,参与手术的医生退出手术室前,将手套脱下,检查自己双手暴露部分是否有异样,然后清洗消毒双手。保洁人员将手术一次性用品收集好后,进行封闭处理。 高度紧绷的神经 已为50位艾滋病患者做手术 “这本来是个小手术,如是正常人,15分钟就可以结束,但患者特殊,时间长了点。”丁毅说。 丁毅是从去年3月份开始做第一例艾滋病手术的。他清楚地记得,当时患者也是一名年轻女性。对方因急性阑尾炎在一家医院进行手术前,被查出“HIV”呈阳性。给这名患者做手术,丁毅用了半个多小时完成,比正常手术多用了近半时间。 “不紧张是假的,毕竟稍有疏忽很容易被传染上。”丁毅笑了笑说,虽然医生都经过系统的职业培训,做手术前,手上套着两双乳胶手套,但心理还是特别紧张。 如今,丁毅已为50余位艾滋病患者做了手术,都很成功,他的心理也越来越放松了。但面对艾滋病患者,做手术时,他仍保持高度警惕。 “平时,父母和女友经常提醒我,手术中千万小心,不要受伤。”丁毅说。 当亚心网记者与其正在交谈时,丁毅又接到从乌市一家医院因为准备做痔疮手术时,在检查中发现的一名艾滋病患者而转到他们的医院进行处理。 “职业暴露”是最大风险 亚心网记者从自治区传染病医院了解到,该院自2006年11月23日从自治区疾控中心分离出来后,作为全疆惟一一家可以接诊艾滋病患者的医院,该院先后接诊了全疆乃至全国的艾滋病患者2.8万人。 医院感染二科护士长关建萍依稀记得,他们接诊的第一例艾滋病患者是在2004年。她说:“当时,因吸毒感染艾滋病的患者占医院所有艾滋病患者的六成至七成。然而近年来,通过性传播感染的病例有上升趋势。” 关建萍说,2007年10月,他们接诊了一位女性艾滋病患者,得知其还有一对1岁8个月的龙凤胎婴儿。随后,医院对两个孩子进行检查,也发现“HIV”呈阳性,这是目前新疆确诊的年龄最小的艾滋病患者。 丁毅告诉亚心网记者,目前,在手术中,虽然对医务人员的防护器具配备得比较齐全,但“职业暴露”还是手术时的最大风险。“手术过程中,不免会出现裸露皮肤被划伤、或患者血管被切开后血液喷溅等现象。这对于医护人员都是极其危险的。万一出现这种情况,医护人员需在两个小时内服用应急药品或打应急针,而且必须在规定的期限内定期进行复查。 |
01 years http://www.tianshannet.com 2009 on 09 day 10:25:42 Enditem
Subcordiformis Network (Reporter Wang Xi Zhang Wande former correspondent Ting-Ting Liu photographic coverage) at 11:45 on January 8, Xinjiang Uygur Autonomous Region, an infectious disease hospital infection in the operating room was quiet, dignified four doctors to look into the operating room.
Protective glasses to be a doctor for AIDS must be protective surgery. It is understood that the patient was in 2009 the first case of AIDS in Xinjiang surgery, after 18 AIDS patients have been here and had surgery a success.
Surgeon wearing protective glasses, double gloves, carefully check for AIDS patients with wire.
34-year-old GU (a pseudonym), quietly lying on the operating table, waiting for the doctor, she was 12 years ago, body piercing out of a pin.
This was a minor operation, but because AIDS is a GU, which allow health care workers dare not the slightest effect. Wash their hands, wearing two layers of latex gloves, protective clothing wrapped tightly, surgery began.
AIDS flu found
Guli, a former acrobat, 12 years ago, she contracted a drug addiction. In order to quit drug addiction, she will be one of about five centimeters of wire刺进his left arm, and then, she eventually quit the addiction.
December 17, 2008 cases of influenza have been no good, GU, accompanied by family members to a hospital in Urumqi, when they seek medical treatment, was found to "HIV" positive, and has entered the incidence period.
"Hearing the news at the moment, I惊得limp body." Guli said.
GU's husband told reporters subcordiformis network and was informed that the wife had the disease after the encounter at home like a bolt from the blue. He is a laid-off workers, the whole family has been renting an apartment to live on, and now 19-year-old son did not know his mother had this disease.
GU was subsequently transferred to the regional infectious disease hospital for treatment. Hospital conducted a thorough medical check-GU, found hidden in his left arm in the second brachii muscle a pin. Upon inquiry, which has been the root pin GU possession of the body for 12 years.
GU worried for his condition to deteriorate, the hospital decided to carry out surgery, will be out of wire.
Remove the wire a half-hour
At about 10 am yesterday, the hospital carried out on GU film, perspective, B extra fine checks in preparation for surgery.
Around 11:45, four medical staff put into the locker room gowns. Before entering the operating room, they used the hand sanitizer to clean hands for 3 times, and then used disinfectant on the surgery part of exposed skin prone to smearing.
Surgery began, doctors carried out for GU local anesthesia and intravenous anesthesia, and then cut with a scalpel left arm GU Second brachii lateral muscle. The rapid outflow of blood from the knife-edge, the side of doctors promptly with gauze to clean up blood. Subsequently, the doctors also electric knives, forceps and other equipment to stop bleeding carefully searching for Flanagan wire.
12:23, handheld electric knife doctors towards other three doctors point nod. Response, about a minute, I saw the curved plate in the operating room more than a four centimeters in length, has been seriously rusty wire.
Prior to this, medical staff from the X-ray film to see is a complete缝衣针, and check out is a Broken Needle, which allow some staff惊疑surgery.
Surgeon and then a little pause操起a clamp, to re-enter the GU was the site of incision. 12:28 or so, medical personnel from its muscularis from about 4 centimeters Department removed about 1-centimeter-long tail with a Broken Needle in the eye of a needle.
"Guli, your arm where the needle out of the surgery was a success and worry." "Is it? I do not feel pain." Guli said.
Immediately, two members of the wounds of the GU, with "cosmetic acupuncture" a suture.
12:30, GU was launched operating room, the doctors involved in the operation to withdraw from the operating room before the take off the gloves to check their own hands exposed parts of abnormal, and then cleaning and disinfecting hands. Cleaning supplies will be a one-time collection of good operation was conducted after the deal closed.
Highly strained nerves are 50 AIDS patients for surgery
"This is a minor operation would have, in the case of normal, 15 minutes to an end, the patients with special, time trifle generous." Ding said.
Ding Yi in March last year started the first AIDS case surgery. He clearly remembers when a young female patient is. Each other due to acute appendicitis in a hospital before the surgery, was found to "HIV" positive. The surgery to patients, Ding spent half an hour to complete, normal operation and more than half of the time spent.
"No tension is false, after all, a little neglect can easily be transmitted on." Smiled Ding said that although doctors have been the system of vocational training, pre-surgery, the hands of the two pairs of latex gloves sets, but the psychological or particularly tense.
Today, Ding has been more than 50 AIDS patients have done a surgery, have been successful, and his more relaxed psychological. But in the face of AIDS patients, surgery, he remained on high alert.
"Normally, the parents and girlfriend constantly remind me that tens of millions of surgery careful not injured." Ding said.
When subcordiformis network is talking with its reporters, Ding also received from a hospital in Urumqi because hemorrhoids are prepared to do surgery, was found during an inspection of an AIDS patient and go to the hospital for processing.
"Occupational exposure" is the biggest risk
Subcordiformis Network reporter learned from the autonomous regions of infectious diseases hospital, the hospital since November 23, 2006 separated from the autonomous region after the CDC, as Xinjiang may be the only one reception AIDS Hospital which has the entire reception Xinjiang as well as the country's 28,000 people with AIDS.
Hospital infection Second Section matron Jianping Guan vaguely remember their reception of the first case of AIDS in 2004. She said: "At that time, the result of drug abuse in patients with HIV infection accounted for all hospitals to六成AIDS七成. However, in recent years by cases of sexually transmitted infections, there is an upward trend."
Guan Jian-ping said that in October 2007, their reception of a female AIDS patients, knowing how they have a pair of 1-year-old 8-month baby龙凤胎. Subsequently, the hospital to check on the two children, also found that "HIV" positive, which is diagnosed in Xinjiang youngest AIDS.
Ding told reporters subcordiformis network, at present, in the surgery, although medical personnel protective equipment is equipped with a relatively complete, but "occupational exposure" or the greatest risk of surgery. "The operation process, there will always be exposed to the skin was scratched, or in patients with vascular blood splash after being cut and so on. This is all medical personnel are extremely dangerous. In case this happens, health care workers need to 2 hours in taking emergency contingency needle drugs or fighting, and must be provided for periodic review period.