The people in the mountains have a "doctor" by Dr. Lishui and colleagues on a new road to prevent birth defects.

Zhejiang News Client reporter Jin Liang

Liu Yan

The chief physician of the Eugenic Genetics Consultation Section of Lishui City Maternal and Child Health Hospital, director of the Office of Lishui Birth Defect Prevention and Control Center, and the leader of the "Eugenics" of the key discipline of Lishui City.

Lishui, there are many places that are difficult to compare with blue sky, blue water, and green mountains, but there were hard to speak here -due to the lack of awareness of pre -pregnancy examination in the mountains, the incidence of defects in birth in the birth of newborns was higher.

How to change this situation? In recent years, Lishui City Maternal and Child Health Hospital has used the forces such as Shanhai and Sea Covisions to produce a new road to prevent and control, deaf gene testing, fetal congenital heart disease ultrasound diagnosis, etc., and incorporated into Lishui City's "people's livelihood" ...

According to statistics, the incidence of birth defects in Lishui City decreased year by year, and in 2021, it decreased by nearly 40%compared with 2017. In the process, Liu Yan, chief physician of the Outpatient Medical Consultation Expert of Lishui Maternal and Child Health Hospital, is both a witness and a participant and promoter.

Control from the source

Go to the mountains and go to the countryside to conduct free consultations

It is not easy to interview with Liu Yan. When you choose not to go to the clinic, you cannot "grab" doctors with pregnant women and patients, but also choose the days when she does not go down to the countryside. Being around.

In the early morning of the summer, the reporter followed a group of pregnant women into the Lishui Maternal and Child Health Hospital, which was inevitable for a while. "Comrade male, just get used to it." Liu Yan and the reporter with a ponytail joked. She wore a white coat and smiled brightly.

"Do you know the defect of birth?" As soon as he sat down, Liu Yan threw out this problem, and then began to explain that the birth defect refers to the body structure, function or metabolic abnormalities that occurred before the baby was born. With the comprehensive implementation of the "three -child policy", the proportion of elderly and high -risk pregnant women has increased, and the risks of birth defects should pay more attention.

This seems uncommon, but it was more obvious in the mountains. In addition to the lack of consciousness of the people, there are also reasons such as insufficient detection capacity and high cost of maternal and child institutions that undertake the prevention and control of birth defects. Liu Yan, who was born in the science class, understood that the first step to prevent birth defects was to control from the source.

Where is the source? Mainly in mountain township. Almost every month, Liu Yan and his colleagues will send the hospital to the countryside, carrying various instruments and equipment to the basic -level township health centers to conduct free free consultations. "Many births of birth are derived from genetic diseases, and ordinary people often do not know themselves, or it is difficult to open up. As a doctor, you must run down." Regardless of the heat or cold winter, sending the hospital to the countryside has become the habit of many doctors in Lishui Maternal and Child Health Hospital.

One year, Liu Yan took a genetic consulting expert to use the National Day break to a mountain village in Qingyuan. There is a special family here. 13 people suffer from the same "strange disease": some walking postures are weird, some of the lower limbs are weak, some of them are weak. Some lower limbs are weak. Some were even paralyzed in bed and suffered from illness.

"We sought free genetic testing, and finally found the genetic cause -hereditary gastrocnemius atrophy syndrome, and then formulated a comprehensive intervention plan for prevention, treatment, rehabilitation, and fertility guidance. Under the premise of not giving up fertility, finding a way to end or reduce the probability of genetic diseases is the original intention of them to go to the countryside.

There are many similar stories. In a free clinic, Liu Yan found that a pregnant woman's hair was all white and the eyes were blue. After genetic testing, it was found that this was a very special genetic disease; once chatting with the family members of the patient, it was found that the family members were very tall and fingers fingers. The joint is a bit deformed, and it is likely to get Ma Fan syndrome, and half the chance to be inherited to the next generation ... After genetic testing and verification, Liu Yan and colleagues formulated the corresponding treatment intervention plan for these patients.

The appearance of Liu Yan, for many patients, like a beam of light in the black sky. There is a couple in Qingyuan who wants to have a baby, but there is some kind of genetic disease in the family, and they never dare to give birth. After many inspections, they found Liu Yan. After consultation, Liu Yan found that the disease was a genetic mutation, and the possibility of mutation in this couple was very small, which made the other party feel at ease.

Liu Yan and the team's friends sometimes encounter resistance.

Porcelain dolls, puppet people, pockets, butterfly babies ... behind these seemingly beautiful nouns are actually some genetic diseases. Some people know nothing about this, and even think that this is a "family curse". Not easy to enter.

What Liu Yan was pleased was that many people worked together. Promoted by various forces, the provincial and municipalities have taken the initiative to undertake various types of fees. Today, there have been 10 free -than -free projects involving the entire process of preventing the three -level prevention process of birth defects. The free groups are still expanding.

Only improve the medical level

In order to dispel people's concerns

In the archive cabinet of Liu Yan's office, there are many related records of incurable diseases, and one of them is a lively story:

One year, a pregnant woman found that the fetus had a "huge urethra" at 32 weeks of pregnancy. She had been thinking again and again, and she decided to protect the fetus.

After consultation with many disciplinary experts in the hospital, Liu Yan suggested that the pregnant woman ended her pregnancy in advance at 37 weeks, and for the first time for pediatric surgery to correct ureteral malformations. "There is a very realistic problem. The family of pregnant women does not trust the local medical level." Liu Yan said, so the hospital worked hard to communicate and do with the urology of the provincial children's hospital, and finally helped the pregnant woman to give birth to a child.

In this regard, Liu Yan is deeply touched: Only by continuously improving the local medical level can they truly dispel the concerns of ordinary people and avoid the suffering of them to see a doctor. To Liu Yan, she was pleased that she witnessed and promoted positive changes over the years -provincial and municipal -level comprehensive comprehensive provincial and municipal -level comprehensive comprehensive provincial and municipal -level hospitals such as the Provincial Obstetrics and Gynecology Hospital, the Provincial Cancer Hospital, Hangzhou Obstetrics and Gynecology Hospital, etc. He has set up 11 expert workstations in Lishui Maternal and Child Health Hospital at Lishui City, forming a health consortium of maternity and childhood, which allows people in the mountains and counties to have "medical".

With 5G and other technologies

The big coffee "Cloud Clinic"

Located on the video conference room on the 5th floor of Lishui Maternal and Child Health Hospital, there will be a video connection everywhere in the three forks. The provincial women's hereditary expert Dong Yanyue and Hu Wensheng, a fetal medical expert in Hangzhou Obstetrics and Gynecology Hospital, often appear on the large screen in the middle of the conference room. Cure ability.

With technology iterative, interaction between mountains and seas is also iterating. Not long ago, a remote consultation was conducted at the ultrasound department of Lishui City Maternal and Child Health Hospital. Experts from provincial hospitals were used to move the 5G+remote ultrasound synergy platform to guide local doctors to perform "cloud clinics".

借助5G等技术，时间、空间的限制被打破，各医疗机构被整合成一个生态共同体——对于这一点，刘姣有着更深的体会：“一些龙泉、庆元等地的患者赶到丽水做B Super, three or four hours of drive back and forth, sometimes make an appointment. Moving 5G+remote ultrasound collaborative platform has opened up the provincial, city, and county -level medical service system, effectively improving the level of ultrasound medical diagnosis of gynecology and gynecology at grassroots hospitals. "

According to statistics, from 2019 to 2021, the Lishui Maternal and Child Health Hospital and the forces of all parties will conduct more than 300 cases of disciplines of dysfunction. Among them, Jiaxing and Lishui focus on the construction of the construction of the defect prevention and control system. The leadership group of the Shanhai Association of Zhejiang Province is rated as the "Best Practical Case" of Shanhai Association.

The "homework" of eugenics can not be done overnight. Liu Yan admits that taking the genetic diagnosis of genetic disease as an example, it is not the blood drawing tube blood, and the machine can get the answer. The key is how to choose the correct gene screening items, how to interpret genetic testing reports, how to further check, and clarify the type of disease. Through the "scriptures" to the superiors or brother hospitals, the case sharing of experts in the hospital, and the technical support of the prenatal diagnosis laboratory, the comprehensive ability of Lishui's birth defect prevention and control has been significantly improved.

"Sometimes too many pregnant women diagnosed before giving birth, exceeding our hospital's genetic testing and processing capacity, need to be sent to the Shanhai Association to complete the test through express delivery, especially some rare disease testing. Technical support. "Liu Yan added.

Similar cooperation is further practical. Not long ago, the Jiaxing -Lishui Health Commission, Jiaxing -Lishui Maternal and Child Health Hospital signed a Shanhai Alliance Agreement Agreement for birth defects. In -depth cooperation.

Liu Yan glanced at the friendship between mountains and the sea and germinated and thrived.

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