Affairs doctors in the eyes of a Tibetan obstetrician and gynecologist

Fang Yuan has tutoring hysteroscopy surgery.The pictures of this article are all pictures of the People’s Hospital of Shigatse City

In June of this year, the People’s Hospital of Shigatse City, Tibet Autonomous Region completed the first local hysteroscopy tubal intubation pseudo -liquid surgery.Director of obstetrics and gynecology at the People’s Hospital.

"There is no nervousness." This was the first time Pu Chi had performed the operation. Fang Yuan gave her guidance and move together.Puchi has worked for the obstetrics and gynecology department of the People’s Hospital of Shigatse for 21 years. There are many patients, many problems, and less manpower.

This hospital is mainly covered in 17 counties in Shigatse, and some areas of Ali and Naitou.70%-80%of patients are high-risk pregnant women.

Surgery is not difficult, but pay attention to experience.Fang Yuan said that Dr. Shanghai Aid Tibetan had perceled hysteroscopy surgery in Shigatse, but as the counterpine doctor left, this technology was put on hold in the local area. This timePass liquid.

A new breakthrough exposes a problem -it is impossible to rely on helping doctors in Tibetan to treat diseases and save people. Only by improving the professional capabilities of local medical staff can hospitals form a motivation to sustainable development.

In July and August 2022, Shanghai’s eighth batch of "group -type" aid medical teams came to the People’s Hospital of Shigatse.According to the "Hospital of the Hospital" model, the key departments of 13 three three hospitals in Shanghai contracted the 13 departments of the hospital, and each department dispatched a doctor for one year.In the past year, teachers and apprentices have become one of the focus of medical aid in Tibet. "Create a team that cannot be taken away" is the goal of a batch of struggle for the Tibetan team.

Pu Chi’s wish is also similar: I hope that under the guidance of Teacher Tibet, I will work hard to develop obstetrics and gynecology to better contribute to the people.

"We can’t go out by ourselves, but the expert is here"

"The doctors on our side have to do a good job of gynecologists and obstetricians, but to catch them together, but large mainland hospitals are particularly detailed." Pu Chi introduced that the hospital had previously undergone hysteroscopy surgery,However, the aid doctors in the previous two years were obstetrics, and they could not be performed by the surgery. In 2022, the hospital applied for a doctors with minimally invasive surgery of gynecological science.Ligoscopic tubal intubation flux surgery.

On June 19, Pu Chi performed the operation for the first time, "there was no nervousness", and Fang Yuan gave her guidance and operated together.Patients are a secondary infertility woman. The fallopian tube is blocked. After hysteroscopic examination and the tubal tube intubation pseudo -liquid surgery, the clogging side becomes smooth, and the patient has the hope of fertility.

Shanghai Aid Dr. Li Feng is teaching endoscopic simulation operations.

There is no main equipment required for hysteroscopic surgery in the hospital.Fang Yuan believes that the difficulty of surgery is that doctors must have a certain basis for hysteroscopy surgery. The lens requires a certain sense of feel and operating skills in the uterine cavity to find the opening of the fallopian tube on both sides in the uterine cavity.The liquid tube is inserted to the opening position, and it is generally some more fine operations.Local doctors lack clinical experience, so they dare not do it.

Dr. Aid Tibetan doctors’ operations are operated by local doctors. Such a "teacher with apprenticeship" mechanism exists widely in the process of aid in Tibet.Specifically, after the doctors in Shanghai entered Tibet, according to the situation of the department and personal expertise, the 1-2 doctors in the department signed a "teacher with apprentice" agreement with 1-2 doctors in the department.The agreement is gradually carried out, including the usual lectures, teaching, inspection and scientific research guidance.

Fang Yuan taught two apprentices. He said that because of about 80%of obstetrics, only 20%of gynecological patients, there are fewer gynecological patients in contact with local doctors, and lack of experience in hysteroscopy and other operations.Occasionally, patients who need uterine cavity operations may take older treatment methods such as curettage, or recommend to other hospitals. There are not many new technologies.However, various online learning and video resources have also given them understanding of new technologies, but they lack in -depth learning and practical operations.

Every morning, Fang Yuan checked the house with the local doctor. There were about 70 or eighty patients. By the way, the theory was explained by the inspection process.After checking the room, if there are arranged surgery and need to be guided, he will go to the operating table to continue teaching.Compared with the personal consultation, the more important job of helping doctors in Tibet is to convey knowledge and experience, enhance the business capabilities of local doctors, and help local departments to establish rules and regulations, and improve the level of scientific research.

Pu Chi said that in the long -term lack of people in the hospital, there are not many opportunities for local doctors to go out to learn.During the peak period of the obstetrics and gynecology department of the hospital, more than 400 patients were treated in one month. The emergency department of obstetrics and gynecology took 24 hours from 2020, and there were only 15 doctors in the obstetrics and gynecology department, and their hands were very nervous.

For many years, Pu Chi only left Tibet in 2019 to study painless delivery for a week. However, after returning, the equipment was not in place. Later, it was a lack of staff and anesthesia, so he failed to carry out this operation.

"We can’t go out by ourselves, but the experts are here and transmitted us a lot of the latest treatment plans and surgical skills to help us quickly update our thinking and technology and broaden our horizons." Pu Chi believesWhen the hospital is running normally, medical staff can improve their professionalism.

Wang Qinghua, the eighth batch of "group -style" group of "group -style" aid medical team and secretary of the Party Committee of the People’s Hospital of Shigatse, introduced that the hospital currently has 24 Tibetan doctors and has a total of 47 local doctors.In the past two years, the local director can basically become the leader, and the third and fourth -level surgery can be won.

Mastery to cultivate talents

In the final analysis, the development of hospitals depends on talent construction, especially local talents.

In 2015, Shanghai’s first batch of "group -style" aid medical teams arrived at the People’s Hospital of Shigatse. Their original intention was to create a medical team that could not be taken away, so that local doctors had advanced medical knowledge and skills to solve various local diseases.Essence

Now the eighth batch of "group -style" aid medical teams is about to end the task. The local backbone doctors can basically perform surgery independently. Unless the extremely complicated surgery needs to help the Tibetan doctors.However, the talent problem still restricts the development of local medical care. Sun Xicai, chief physician of the Department of Ear -Nose, Nose, Nose, Nose, Nasal and Nose, Fudan University, and Deputy Dean of the People’s Hospital of Shigatse, and found that one of them is not enough talent and serious losses; the second is that the quality of talents are not enough quality.High; Third, local medical staff lacks self -growth platforms.

In Tibet, doctors are recruited according to the civil service mechanism. The medical institution has no qualifications for independent recruitment. The person in charge cannot even participate in the interview. Wang Qinghua hopes to break this mechanism and recruit more suitable talents.The employment agreement is usually 5 years, and many people leave after the agreement expires. The hospital usually finds ways to retain -providing good living conditions and even introducing objects, but the loss of talents is inevitable.

Improving the quality of talents is an important means such as Fang Yuan and Puchi. A aid doctor aid Tibetan doctors to teach one or two apprentices from theory to practical teaching to teach, and cooperate with scientific research topics.

In addition, the "group -style" medical aid work is expanding to the township township of Shigatse City.A total of 20 experts in Shanghai aid and Tibetan and Shigatse City People’s Hospital signed an apprentice agreement with 51 students in the five counties to assist in the development of subjects and talents in the county and townships.

Sun Xicai explained that in addition to regular contact, doctors from the Municipal People’s Hospital go to the countryside to help. The doctor in the county and township can also follow the patient to the People’s Hospital of Shigatse City. The patient can see a doctor.

"Not only the lack of people in the city of Shigatse, but the county and township are missing people. It is very difficult to send someone to study outside for a year. Secondly, it was difficult to send it for a year.I ca n’t come back for half a year, and I ’m all gone.” Sun Xicai analyzed that it was difficult to send personnel and how the training effect was not sure. Under the leadership of the teacher, there was often no problem.Bar obstacles, and patients will not be rusty for a long time.The incidence of many diseases in Tibet is much higher than other places in the country, but people are not aware of health. "He does not enter the hospital if he is not in danger. It is really necessary to get sick and not saved at first glance." It will not be cured.

After studying, doctors need to grow platforms.At present, the People’s Hospital of Shigatse has completed the first step -simulation platform construction, from bronchial mirrors to pregnant women’s difficulty in giving birth. Doctors can practice on the simulation platform and then combat.

Shanghai aid doctor Ouyang Huoiu in neurosurgery.

This year, it is planned to enter the second platform -the "head and neck skull underlying anatomy laboratory", and doctors operate on the anatomical specimen.Sun Xicai said, "Young attending doctors in the Department of ENT and neurosurgery must be able to pass the anatomical specimen before surgery for patients, instead of the previous approach. With the apprentice, they can do it.God gives neurosurgeons to explore the brains of others with one hand, and otolaryngologists to do fine operations on the patient’s head and face. We must undergo strict training. We must create platforms and environments that can meet these needs."

From July 1st to 2nd, the Eighth Medical Mount Everest Forum Hospital Infection Management Sub-Forum was held at the People’s Hospital of Shigatse.

Every year, the Tibet Shigatse Medical Mount Everest Forum will also bring advanced technologies to local doctors.Since May of this year, the 8th Everest Forum has been held for 16 issues. 184 experts from different majors across the country have conducted academic lecture training. Shanghai Baoke hospitals have also brought offline training for teams.

Wang Qinghua said: "We have to let the professional and technical staff here be busy and learn." Sun Xicai bluntly said: "5+2, white and black, the doctor is like this. I ask a few young neurosurgery, ear noseThe laryngeal doctor, in addition to falling in love, is to learn something in the hospital, while being young. "

The hospital is also preparing for the flexible flow of talents.Wang Qinghua said that Dr. Tibetan is a one -year period, and cadres are three years.Therefore, the hospital considers signing an agreement with some medical teams, and the team took turns to send people to support. The individual aid time does not need to be very long, but the overall time of the team must meet a certain standard. This can also introduce different sub -disciplines.

"People are the main factors we consider. There are many ways to think in all aspects. These details will not be written on the planning, but they are the most worrying." Sun Xicai said.

"It’s not just a mission of a doctors in Tibet"

In April of this year, the People’s Hospital of Shigatse City was awarded the cure center of the dangerous maternal maternity cure and re -born treatment center of the autonomous region.

"Now, our obstetrics and gynecology department is not just the obstetrics and gynecology department of a people’s hospital, but the obstetrics and gynecology department of the entire Shigatsuze and even the Tibet Autonomous Region. We must radiate 17 counties in the 1st district and nearby areas.70%-80%of patients are high-risk pregnant women. "Pu Chi said that the burden on her body is even more important, and fortunately, her experience is also very rich.

Dangerous pregnant women, even patients with death, can be encountered in almost a few days at the People’s Hospital of Shigatse.On May 28th, a pregnant woman with acute left heart failure was at about 29 weeks of pregnancy. From Rinba County to Shigatse People’s Hospital, the car was more than an hour and a half. Patients may stop their heartbeat at any time during the referral.The Salvation Center of the People’s Hospital of Shigatse fed a series of rescue measures during the referral of referrals to Rinbu County for the first time. At the same time, the critical heavy treatment team in the hospital immediately launched and urgently called Fang Yuan.

After the pregnant woman was admitted to the hospital, the medical staff who were waiting early began to rescue. Unexpectedly, her heartbeat and breathing arrest were stopped.Patients do tracheal intubation and persistent chest heart compressors, and eventually pulled the patient back from the death line.The fetus had died, and gave birth through the emergency cesarean section. Then the patient turned to the intensive care unit to observe. After a few days, he returned to the women’s obstetric examination and was eventually discharged from the hospital.

"In the plateau area, our treatment team worked together. This is a particularly profound memory in the process of treatment." Pu Chi said that with the guidance and support of doctors in TibetIt is more and more handy, and the transfer mechanism of county and township hospitals to urban hospitals is also very unblocked.

However, a doctors’ teachings are short -lived. Even though Shigato carried out the first uterine laparoscopic tubal intubation general fluid surgery, the subsequent development was still long -term.

Puchi (first from left) is involved in laparoscopic surgery.

"A medical technology is not to say that it is right once or twice.The tubal intubation pseudo -liquid surgery was also difficult to get multiple training within one year. Therefore, she recorded the entire process of surgery with her mobile phone and continued to explore practice in the future.Laparoscopic surgery is also the same, and now she and another deputy director can already perform independently.

Shanghai Cloud Consultation, the emergency department of the People’s Hospital of Shigatse.

In August 2023, Fang Yuan will return to Shanghai after the first anniversary of the aid of Tibet, but this contact will not be broken.Pu Chi did not think about the name of the first batch of "group" aid medical teams in Shanghai. Every time she encountered professional problems, she and other obstetrics and gynecologists would consult Shanghai Baoke Hospital or to support the Tibetan doctors.Seek help.In response to difficulty, doctors in Shanghai can conduct remote consultations.

Wang Qinghua said that in the "Book of Courts" model, the construction of any discipline is not just a mission of a doctors in Tibetan, but the entire department of the Shanghai Hospital that supports the counterpart continues to develop in the rear.

At the end of the interview, Pu Chi expressed a simple desire: "We hope to develop the obstetrics and gynecology department by ourselves under the guidance of a teacher of Tibetan. In the case of not helping the teacher in Tibet, in the face of the critical patients who cannot be treated,We can only suggest that they go to the higher -level hospital for treatment, and many patients go to the Mainland. For a truly difficult common people, going to the Mainland for medical treatment is not only a problem of linguistics, and the cost is also a big problem.Those who can do as much as possible to do better to the people better. "

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