病房故事：不放弃每一个娇嫩的小生命
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">3月的北京，风仍旧有些凛冽，但北京儿童医院新生儿重症监护室（NICU）却满是暖意，<span style="color: black;">这儿</span>常年吹着24℃~26℃的暖风，<span style="color: black;">供给</span>最适宜新生儿成长的温度。新生儿中心副<span style="color: black;">专家</span>医师沈艳华在这一干<span style="color: black;">便是</span>22年，和同事们精心“养大”<span style="color: black;">没</span>数个<span style="color: black;">孩儿</span>。</span></p>
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<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">北京儿童医院新生儿重症监护室里，沈艳华(右)、邹楠正在为新生儿治疗。</span></p>
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<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">有些患儿只有手掌大</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">一瓶矿泉水的重量</strong></p>
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<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">北京儿童医院新生儿重症监护室<span style="color: black;">位置于</span>一栋新建急救大楼的5层。一走进去就能看到一排明亮的病房。新生儿重症监护室<span style="color: black;">通常</span>收治出生28天内（或纠正胎龄后28天内）的患儿，大<span style="color: black;">大都是</span>患<span style="color: black;">严重</span>症的新生儿及早产儿。护士邹楠说：</span><strong style="color: blue;"><span style="color: black;">“<span style="color: black;">咱们</span>收治的<span style="color: black;">孩儿</span>有的<span style="color: black;">尤其</span>小，<span style="color: black;">乃至</span><span style="color: black;">仅有</span>手掌<span style="color: black;">体积</span>，体重仅450克，约一瓶矿泉水的重量。<span style="color: black;">她们</span>的心脏仅鸽子蛋<span style="color: black;">体积</span>，血管细如发丝。”</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">沈艳华介绍，住到<span style="color: black;">这儿</span>的超早产儿大部分要闯</span><strong style="color: blue;"><span style="color: black;">三道难关</span></strong><span style="color: black;">——<span style="color: black;">呼气</span>关、喂养关、感染关。早产儿各器官<span style="color: black;">生长</span>不成熟，出生后可能<span style="color: black;">显现</span><span style="color: black;">呼气</span>困难，需医护人员<span style="color: black;">经过</span><span style="color: black;">呼气</span>机、<span style="color: black;">药品</span>等手段<span style="color: black;">帮忙</span><span style="color: black;">她们</span>。孕周<span style="color: black;">尤其</span>小的早产儿因吸吮力弱、吞咽功能不协调，自己<span style="color: black;">不可</span>吃奶，<span style="color: black;">必须</span>医护经胃肠管饲法耐心喂养，一点点<span style="color: black;">增多</span>奶量，促进体重慢慢增长。为了监测<span style="color: black;">每一个</span><span style="color: black;">孩儿</span>的生长趋势，主管<span style="color: black;">大夫</span>会给<span style="color: black;">她们</span>画生长曲线图，<span style="color: black;">每日</span>看到“小宝贝”沿生长趋势茁壮成长是医护最开心的事。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">思虑</span><span style="color: black;">区别</span><span style="color: black;">周期</span>患儿“闯关”对环境的需求，<span style="color: black;">亦</span>为了方便救治，NICU分为重症室、早产儿监护室、普通病室及隔离室等区域。</span><strong style="color: blue;"><span style="color: black;">每间病房内置4个暖箱，容纳4位患儿，全科室40张床位。</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">NICU为<span style="color: black;">没</span>陪护病房，<span style="color: black;">由于</span><span style="color: black;">这儿</span>的新生儿大多病情<span style="color: black;">严重</span>，<span style="color: black;">必须</span>安静、干净的环境。</span><strong style="color: blue;"><span style="color: black;">但为了<span style="color: black;">加强</span>早产儿<span style="color: black;">存活</span>质量，会安排妈妈参与“袋鼠式护理”</span></strong><span style="color: black;">。沈艳华介绍，<span style="color: black;">她们</span>单独开辟了一个房间，对符合<span style="color: black;">需求</span>的<span style="color: black;">孩儿</span>，会邀请新手妈妈进病房，鼓励其给<span style="color: black;">孩儿</span>抚触、喂奶等，医护人员会手把手教。她说：“<span style="color: black;">非常多</span>新手妈妈<span style="color: black;">第1</span>次见到<span style="color: black;">孩儿</span>时觉得太小了，都不敢碰，慢慢就熟悉了。看着宝宝安静地趴在自己怀里，妈妈的焦虑<span style="color: black;">亦</span>缓解了。”</span></p>
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<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">手机24小时开机</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">睡前将铃声开到最大</strong></p>
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<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">夜晚</span>睡觉前，将手机关机或静音是<span style="color: black;">非常多</span>人的习惯。但24小时开机的沈艳华正好相反，负责NICU<span style="color: black;">时期</span>的<span style="color: black;">每一个</span><span style="color: black;">夜晚</span>，</span><strong style="color: blue;"><span style="color: black;">她睡前都会特意把手机铃开到最大，生怕病房里的宝宝有紧急<span style="color: black;">状况</span>时同事找不到她。</span></strong><span style="color: black;"><span style="color: black;">非常多</span>个<span style="color: black;">半夜</span>零点后，<span style="color: black;">tel</span>铃在睡梦中响起，沈艳华听着同事的<span style="color: black;">报告</span>，<span style="color: black;">快速</span>给出诊疗<span style="color: black;">意见</span>，判断自己<span style="color: black;">是不是</span><span style="color: black;">必须</span>马上赶往医院<span style="color: black;">救治</span>。自幼怕黑的她，<span style="color: black;">由于</span>对<span style="color: black;">孩儿</span>和职业的热爱，习惯了一个人半夜打车赶往医院。即便是春节假期，她<span style="color: black;">亦</span>会主动来医院看<span style="color: black;">孩儿</span>们。她说：</span><strong style="color: blue;"><span style="color: black;">“既然<span style="color: black;">孩儿</span>们‘养’在这儿，<span style="color: black;">咱们</span>就得负起责任。”</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">在沈艳华办公室里有一条白色哈达，这是一位西藏重症患儿小希（化名）家长送的。小希出生17天时<span style="color: black;">显现</span><span style="color: black;">呼气</span>困难，当地医院救治<span style="color: black;">不睬</span>想，就转到北京儿童医院。到达当天，<span style="color: black;">检测</span><span style="color: black;">发掘</span><span style="color: black;">孩儿</span>右侧肺气肿严重，<span style="color: black;">导致</span>左肺受压<span style="color: black;">显著</span>，<span style="color: black;">显现</span>严重的<span style="color: black;">呼气</span>困难，<span style="color: black;">必须</span>气管插管<span style="color: black;">呼气</span>机治疗。沈艳华深知<span style="color: black;">孩儿</span>右侧大叶性肺气肿，在机械通气下可能使肺气肿更严重，但若<span style="color: black;">不消</span><span style="color: black;">呼气</span>机，患儿可能就会因<span style="color: black;">呼气</span>困难<span style="color: black;">火速</span>死亡。时间紧迫，她积极安排支气管镜和肺CT等<span style="color: black;">检测</span>，并去影像中心请<span style="color: black;">专家</span><span style="color: black;">帮忙</span>阅片。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">与此<span style="color: black;">同期</span>，一场涵盖胸外、<span style="color: black;">呼气</span>、影像等多学科的会诊<span style="color: black;">快速</span>开展，<span style="color: black;">孩儿</span>确诊为先天性支气管闭锁，大叶性肺气肿，专家们<span style="color: black;">最后</span>达成手术决定。但小希父母为藏族，不会说普通话，最后在远程翻译人员的<span style="color: black;">帮忙</span>下，经多次沟通，家长<span style="color: black;">最后</span>同意手术。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">手术非常顺利，但术后的监护仍是道难关。患儿右上肺叶切除，剩下的右侧中下肺还<span style="color: black;">生长</span>不良，患儿能否闯过这一关、脱离<span style="color: black;">呼气</span>机是巨大的挑战。NICU的医护<span style="color: black;">每日</span>24小时不间断监护<span style="color: black;">孩儿</span>的生命体征，时时<span style="color: black;">评定</span>患儿<span style="color: black;">状况</span>，沈艳华<span style="color: black;">每日</span>下班后仍继续守在病房，她说：“回家<span style="color: black;">亦</span>不踏实，还不如在医院安心。”</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">在NICU医护的精心照料下，小希住了20余天院，恢复得不错，撤下了<span style="color: black;">呼气</span>机，体重<span style="color: black;">亦</span>长了上来。小希父母非常开心，出院前特意送来哈达感谢。沈艳华笑着说：</span><strong style="color: blue;"><span style="color: black;">“小希妈妈<span style="color: black;">此刻</span>还会给我发<span style="color: black;">微X</span>，分享<span style="color: black;">孩儿</span>的进步。能帮到<span style="color: black;">孩儿</span>，我<span style="color: black;">尤其</span>开心、欣慰，感觉一切辛苦都值了。”</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><img src="//q5.itc.cn/q_70/images03/20240325/69b9983c9bb24546ac342fbadc5e4585.jpeg" style="width: 50%; margin-bottom: 20px;"></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">沈艳华说，每年11月到次年2月是最忙的时候，今年年初最忙时有20多个病人要上<span style="color: black;">呼气</span>机。<span style="color: black;">每一个</span><span style="color: black;">孩儿</span>都<span style="color: black;">必须</span>精心照料，<span style="color: black;">大众</span><span style="color: black;">亦</span>都习惯了忙碌的生活。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">除了<span style="color: black;">孩儿</span>们的<span style="color: black;">平常</span>救治工作，北京儿童医院新生儿中心还是北京市重症新生儿转运中心，承担重症新生儿转运工作。有暖箱、<span style="color: black;">呼气</span>机等设备的转运<span style="color: black;">救治</span>床，就停放在NICU，和医护<span style="color: black;">一块</span>随时待命。只要24小时待机的转运<span style="color: black;">tel</span>一响，值班医护就<span style="color: black;">快速</span>出动，<span style="color: black;">由于</span><span style="color: black;">她们</span><span style="color: black;">晓得</span>时间<span style="color: black;">便是</span>生命，要<span style="color: black;">第1</span>时间把娇嫩的新生命接到<span style="color: black;">这儿</span>，进行<span style="color: black;">救治</span>。忙的时候，<span style="color: black;">她们</span><span style="color: black;">一月</span>要转运40多个<span style="color: black;">孩儿</span>，不少在夜间。<span style="color: black;">倘若</span><span style="color: black;">孩儿</span>病情重，当时就要紧急救治，转运花的时间就更长。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">时刻观察<span style="color: black;">每一个</span><span style="color: black;">孩儿</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">不放过任何细枝末节</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">重症新生儿的护理比<span style="color: black;">通常</span>护理工作<span style="color: black;">需求</span>更高。</span><strong style="color: blue;"><span style="color: black;">邹楠感觉自己<span style="color: black;">每日</span>都像在走钢丝，需时刻专业在线，又保持最大的专心、耐心、细心，照料好<span style="color: black;">孩儿</span>的<span style="color: black;">同期</span>不放过任何一个问题信号。</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">每日</span>，邹楠和其他护士会给宝宝洗澡、护理口腔、消毒脐部，<span style="color: black;">而后</span>量体重、测血糖，<span style="color: black;">定时</span>修剪指甲，避免患儿抓伤自己。每隔2~3小时，她们还要给<span style="color: black;">孩儿</span>们喂一次奶，由配奶室配送，一部分是配方奶，一部分是家长送来的母乳，奶量需<span style="color: black;">按照</span>宝宝体重<span style="color: black;">精细</span>计算。邹楠介绍，有些患儿<span style="color: black;">因为</span><span style="color: black;">生长</span>不完善，喂奶时会呛咳，就需<span style="color: black;">运用</span>“重力喂养”技术，即将胃管缓慢<span style="color: black;">安置</span>于患儿胃内，再把注射器针筒与胃管连接，<span style="color: black;">经过</span>重力<span style="color: black;">功效</span>使奶液匀速、缓慢流入胃中。医护操作过程中须密切观察患儿面色、经皮氧饱和度等生命体征参数，避免<span style="color: black;">显现</span>胃食管反流窒息的危险。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">除了护理，<span style="color: black;">她们</span>还要时刻观察患儿的变化，将宝宝每日体重、摄入奶量、尿裤重量等<span style="color: black;">仔细</span>记录，以便计算全天的摄入和排出。沈艳华介绍，</span><strong style="color: blue;"><span style="color: black;">新生儿跟其他<span style="color: black;">病人</span>最大的区别<span style="color: black;">便是</span>不会语言表达，<span style="color: black;">因此呢</span><span style="color: black;">她们</span><span style="color: black;">必须</span>更加细致地全面查体、观察病情，结合护士记录的数据来判断病情的<span style="color: black;">发展</span>。</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">另外</span>，宝宝的每一次哭闹、嗜睡、吃不进奶等反应<span style="color: black;">亦</span>需医护人员<span style="color: black;">注意</span>并<span style="color: black;">小心</span>对待，监护室里的<span style="color: black;">大夫</span>护士时刻都在观察记录着每个<span style="color: black;">孩儿</span>的<span style="color: black;">状况</span>。邹楠说：“跟宝宝的每一次接触都是观察和<span style="color: black;">发掘</span>问题的机会，任何细枝末节都<span style="color: black;">不可</span>放过。”</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">“我感受到生命的伟大和顽强”</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">守在病房外的家长，最挂念的<span style="color: black;">便是</span><span style="color: black;">孩儿</span>的生命。沈艳华<span style="color: black;">叫作</span>，<span style="color: black;">日前</span>北京儿童医院NICU一年约能收治1000例患儿，治愈率达98%以上。她感慨道：“<span style="color: black;">大众</span>可能觉得，在<span style="color: black;">这儿</span>工作会看到生命的脆弱，但我在<span style="color: black;">这儿</span>看到的反而是生命的伟大和顽强。”</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">已工作22年的沈艳华说，虽然辛苦，但从不<span style="color: black;">懊悔</span><span style="color: black;">选取</span>这份职业，反而<span style="color: black;">更加多</span>的是<span style="color: black;">幸运</span>，</span><strong style="color: blue;"><span style="color: black;"><span style="color: black;">幸运</span>这份工作让自己有机会去<span style="color: black;">帮忙</span>和见证这么多<span style="color: black;">孩儿</span>慢慢痊愈，<span style="color: black;">幸运</span>自己的人生<span style="color: black;">因此呢</span>收获<span style="color: black;">更加多</span>感动。</span></strong><span style="color: black;">她还记得12年前和同事救治过一对26周早产儿双胞胎，<span style="color: black;">她们</span><span style="color: black;">此刻</span>完全和正常<span style="color: black;">孩儿</span><span style="color: black;">同样</span>。每年过生日时，<span style="color: black;">她们</span>都会来科室看望医护，每次都像过年<span style="color: black;">同样</span>，<span style="color: black;">尤其</span>开心。邹楠说：“虽然我还<span style="color: black;">无</span><span style="color: black;">孩儿</span>，但<span style="color: black;">每日</span>都在承担‘妈妈’这一角色，<span style="color: black;">亦</span>愿意将母爱分给<span style="color: black;">每一个</span>患儿。”</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;">对家长<span style="color: black;">怎样</span>更好地<span style="color: black;">协同</span>救治工作，沈艳华给出了<span style="color: black;">意见</span>：</strong><span style="color: black;">一是<strong style="color: blue;"><span style="color: black;">创立</span><span style="color: black;">自信心</span></strong>。新生患儿闯关，关关<span style="color: black;">很难</span>，家长要相信<span style="color: black;">孩儿</span>顽强的生命力，<span style="color: black;">亦</span>要相信<span style="color: black;">大夫</span>。二是<strong style="color: blue;">避免过于焦虑。</strong><span style="color: black;">孩儿</span>是家长的心头肉，家长焦虑在所难免，但<span style="color: black;">亦</span><span style="color: black;">意见</span>学会调节，<span style="color: black;">心情</span>低落会影响母乳。临床中，<span style="color: black;">大夫</span>时常<span style="color: black;">必须</span>先安慰家属，再沟通<span style="color: black;">孩儿</span>的治疗细节。三是<strong style="color: blue;">学会沟通。</strong><span style="color: black;">意见</span>家长与医护人员沟通时避免<span style="color: black;">心情</span>激动，保持理性，积极<span style="color: black;">协同</span><span style="color: black;">大夫</span>，<span style="color: black;">保持</span>给<span style="color: black;">孩儿</span>送母乳，医患<span style="color: black;">一起</span>与<span style="color: black;">孩儿</span>渡过难关。</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://q3.itc.cn/q_70/images03/20240325/92ba8c2304d8459fa69c654e90eba921.gif" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">源自</span>：环球时报</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"> <a style="color: black;"><span style="color: black;">返回<span style="color: black;">外链论坛：http://www.fok120.com/</span>，查看<span style="color: black;">更加多</span></span></a></p>
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楼主节操掉了，还不快捡起来！ 感谢您的精彩评论，为我带来了新的思考角度。
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