苏国海:“心内”论道步步险 巧创复生三字诀

2018-03-26 佚名 健康界

医生如何将职业和作为人性化?济南市中心医院院长兼心内科主任苏国海做到了,他的努力结出累累硕果,​不在案头,而在脚下。

忙碌不在案头,而在脚下。

从见到济南市中心医院院长兼心内科主任苏国海的第一眼起到采访结束,他停下脚步的时间加起来只有十分钟。

除了离开办公室去参加行政会议外,患者向他咨询病情的电话也络绎不绝。

“心脏病患者的整个生命历程,会在瞬间颠覆。”面对不断中断的采访,苏国海做了一个翻手的动作后向记者解释,所以,“介入科医生有三大——压力大、风险大,病人病情变化大”。

做介入科医生岂不是费力难得好?

苏国海抬高语调“唉”了一声,同时摇了摇头,“手下有生死之术,救人便是义不容辞。”

穿上白大褂、戴上听诊器,医生往往会被“脸谱化”。而在与苏国海的交流中,身为医生的他却把自己的职业和作为都人性化起来,并用三个字——“快”、“全”、“领”做“药引”,让他的半生经历跨出圈壁,窦性跳动。

“心事”无大小 唯“快”不破

“心梗发生率高,病情变化快,是关系到成人死亡的主要疾病。”苏国海介绍,目前,国内外的指南都要求对心梗患者尽早进行再血管化,“一个‘快’字,几乎决定一切。”

然而被称为“猝死杀手”的心梗,常在平日里潜伏,却在夜间、周六日、节假日等休息时间急性发病,患者被送到医院后,无论是用药物溶栓,或者做介入手术,走正常的就医、诊断、治疗、会诊、谈话、缴费等流程,都会延误治疗时间。

“患者不该等。”为了达到“尽早”的要求,苏国海经过测算,把从接触病人到开通血管的时间定到了90分钟之内。而这就归功于一项将重点前移的创举——开通绿色通道,使治疗先行。

“即使没有医保覆盖,我们也必须先救治。”苏国海斩钉截铁的说。而绿色通道开通至今,未发生一例患者逃费事件。

将心比心,换来硕果累累。

“患者的死亡率显着下降是最大的获益。”随后苏国海用数据来解读:在没有再血管化的时代,心肌梗死的死亡率能达到20%到30%;到了溶拴年代,在10%左右;有了介入治疗时期,通过绿色通道,使死亡率降到5%以下。

“通过绿色通道也帮急诊科建立起了整个学术团队。”苏国海在回忆中休憩一秒,即刻抽回思绪,“现在急诊科十五位医生,有冠外、介入和心脑中心3个团队随时待命,保证24小时、365天准备施救。”

为了做到对技术的把握和对整体团队发展的支持,苏国海设立相关亚专科,包括心力衰竭、心脏康复、高血压等,还建立国家药物临床实验基地,参与国际和国内的大型的临床实验。

“全”培养打造复合型人才

在抢救的过程中,在战斗的不只是患者,还有医生。

苏国海有两项超人般的从医经历:在北京进修6个月,他做了500例手术;在济南中心医院工作,一个月的时间,他接了20次夜间急诊。

几乎从来没有节假日的苏国海,无论是对自己还是对科室的年轻人都没有过放松。

但每个人的性格、特长都有异,如何培养出高水平的战斗力?

“在我们科,施行全培养人才计划,”苏国海介绍,他要求医生要当“多面手”——既要做临床,也要做科研。因为,“科研的思维来自于临床经验的积累;而科研可以为临床解决问题”。

在医院,医生日常的工作都在临床,科研的时间从何而来?

“介入医生首先要能吃苦,其次要懂奉献,”苏国海总结,“吃进去”和“拿出来”的就是自己的业余时间。

除此以外,为了打造出高端的团队,成就高层次的专家,苏国海在培训方面也不遗余力,“除了在国内各大医院进行学习外,普林斯顿医学中心,克利夫兰心脏中心,都有我科医生的身影。”而将科室人才送出国门的目的就是“轻装上路,武装回归”,苏国海认为,海外学习的经历,首先能拓宽视野,其次能及时掌握学科前沿动态。

而在接受了国内外的培养,专业积累有了全面提升后,每个医生都要为自己设定亚专科的方向,不断打磨自己,成就专长。

经过多年的建设,目前苏国海率领心内科拿到四项国家自然科研基金,并被评为济南市创新团队,山东省示范科室。“我们科室现在30多名医生,其中博导一名,硕导十几人,”苏国海用手从前向后理了下头发,颇为欣慰,“这也保证了对治疗的全覆盖,对患者的全负责。”

“领”创新 造精准特色

“创新难,难在发现;创新苦,苦在埋没。”苏国海认为,要摆脱这两点,就需有领先的意识。

细节决定人的成败,对创新也一样,要冲到浪前,不被拍在沙滩上,就必须“站成山岭”。

在不计付出的前提下,苏国海将目光投向科室的特色打造方面,随着靶向治疗的发展,对心脏的精准治疗燃起他灵感的火苗。

虽然心内科并没有靶向治疗药物,但是每个患者的“心病”都有各自的特点。

“这就需要根据指南,对同类疾病进行规范化、同质化的治疗,但是,在我们科又要加一步——个体化的精准治疗。”苏国海的眼中,闪出一道光。

利事,必有利器。

想做到领先,方法也必不同寻常。

幸好,墨守成规,从不是苏国海的习惯。这次,他除了带领自己的科室,还要带领山东地区,通过共同研究、学习,推广心脏的精准治疗。

在超声方面,“我们刚刚举办了山东省的第一次集中的超声培训。”通过类似的活动,把治疗精细化、规范化,同时动用整体的力量,对如严重症状性主动脉瓣狭窄等疾病的治疗进行攻关。

在介入手术方面,通过群力群策,“让病人发生介入治疗再狭窄的机会,或出现急性血栓的机会大幅度下降。”

“现在医疗资源竞争很激烈,”苏国海分析,“这就逼迫你不仅要快速发展,还要发出自己的声音。”他介绍发展的方向,“不仅要大而全,还要一马当先”。

首先,就是把关注点扩大到心内科的各方面,包括成人和儿童的所有心脏疾病,如循环超声的研究和诊断;小儿先天性疾病的外科治疗等。

其次,就是要有“握新”的观念。“紧跟国际最新技术,并快速引进。”

最后,就是要主动发声,得到关注,才能扩大合作。“近年来,我们科在国内各种大型会议上,都有自己的声音和见解,如长城国际心脏病会,东方心脏病会等。”

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    学习了新知识

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    2018-03-30 Y—xianghai

    学习了新知识

    0

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    2018-03-30 Y—xianghai

    学习了新知识

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    2018-03-30 Y—xianghai

    学习了新知识

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    2018-03-30 Y—xianghai

    学习了新知识

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    2018-03-30 Y—xianghai

    学习了新知识

    0

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    2018-03-28 虈亣靌

    学习了.谢谢作者分享!

    0

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    2018-03-26 沙漠浪人

    手下有生死之术.救人便是义不容辞

    0