我們懷著喜悅的心情，在告別2020年之際歡迎瑪麗醫院兒童心臟科及心胸外科團隊的加入。其服務全面調遷是一個重要里程碑，標誌香港兒童醫院第一階段的臨床服務開展已經完成。
團隊歷年開創了多項突破性技術，為心臟病童帶來新生與希望。我期望透過成功推行軸輻模式，令兒童心臟病的治療質素和科研發展更上層樓。
不少心臟病童同時有多重器官毛病，香港兒童醫院正正能為他們提供最安全的治療環境。除了尖端設備，這裡齊集不同專業團隊，對處理兒童病人獨有的臨床問題富有經驗，亦專注照顧兒童的需要，能給予最全面支援。
另外，我們的專科門診近期陸續推出視像診症服務。合適的病童足不出戶就可以覆診，省時方便，疫情下更加安全。
新年新開始，我們預備了全新設計的醫生袍，希望同事喜歡。
香港兒童醫院行政總監李子良醫生
剛過去的聖誕節相信大家都留在家中慶祝。對於一班病童來說，醫院便是他們在這佳節中的家。病人資源中心及一眾同事在感染控制措施許可下，精心設計富有聖誕氣氛的活動，為病童送上溫暖。
對於經常前來覆診或住院的病童，醫護人員彷彿是親切的家人。他們用心為聖誕明信片填上顏色並寫上祝福字句，感謝醫護人員的悉心照顧。
每張聖誕明信片都寫滿病童感謝醫護人員的純真祝福。病童親自投進小郵筒，將心意寄給醫護人員。
聖誕老人今年要戴上口罩，與大家保持社交距離，但病童也很興奮能跟他快閃合照。醫院同事亦大派禮物，更錄製聖誕歌片段，讓病童一邊觀看，一邊品嚐聖誕限定甜點。
膳食服務部特意改良配方製作的朱古力布甸蛋糕，經高溫翻熱後仍能保持鬆軟濕潤，既安全又美味。有吞嚥困難的病童則可吃香甜燉奶。
瑪麗醫院的兒童心臟科及心胸外科服務由去年10月起分階段遷進香港兒童醫院，首先提供門診、日間、簡單手術及介入服務。至12月8日，心臟科中心啟用，五名住院病童順利轉院，標誌調遷完成，相關服務全面開展。
香港兒童醫院現已成為兒童先天及後天性心臟病的第三層轉介中心，亦是醫管局唯一為全港兒童提供心臟手術、體外膜氧合器、心室輔助器，及心肺移植服務的醫院。
為配合服務，院內設有相關硬件和先進儀器。心臟科的顧問醫生倫建成說：「特別是複合式心導管室／手術室，它讓一些極度複雜、高風險的程序變為可行，可更安全地進行。」
心胸外科的顧問醫生羅冠中則認為，本院集中照顧兒童，深切治療部病床調配比較靈活，可為術後病童提供更佳照顧，而這裡的環境亦有利內外科團隊合作。他說：「未來我們會進行更多微創及複合式心臟手術，提升治療質素。」
倫醫生指會著力為本港的兒童心臟科服務建立一個有效的軸輻模式，同時肩負培訓醫護人員的責任；另外會繼續發展人工智能的應用，例如為植入了心臟電子裝置的病人作遙距監測、個人化醫療和臨床研究方面。
來自瑪麗醫院的專業團隊經驗豐富，但服務搬家，亦得適應新環境，因此要進行演練去熟習手術室器材、運作流程及交接安排，與其他部門建立默契。
本院設有高規格的複合式心導管室／手術室，結合先進影像、心導管介入及手術設備，讓心臟科、心胸外科及放射科醫生可在同一地點進行診斷、介入治療及手術，減低病人運送、創傷和感染風險，加快復原。
部份複雜的先天性心臟病需靠傳統外科手術及心導管介入治療雙管齊下，複合式手術室正好發揮優勢。舉例來說，心臟科醫生可在手術期間施行介入程序，如以球囊或支架擴張狹窄血管，及於心室周圍植入儀器（如人工心瓣、心房間隔缺損關閉器、血管封堵器等），即使接駁了體外膜氧合器的危重病童也可以受惠。另一方面，如介入期間遇上困難情況，心胸外科醫生亦可先剖開相關部位，心臟科醫生便可隨即置入導管以完成程序。
C形機械臂雙向X光造影系統能從側面及正面拍攝，即時在屏幕顯示清晰影像，醫生可多角度看清楚血管狀況，提高治療精準度。
中心設有不同儀器，可進行心臟超聲波檢查、運動測試及傾斜床測試等，以診斷各種心臟問題和評估治療成效。
心臟超聲波掃描可了解心臟結構和功能，如形狀、大小和泵血情況，偵測有沒有心漏和心瓣膜狹窄等缺陷。本院亦有提供產前胎兒心臟超聲波檢查及經胎盤治療。
病童在踏板機上跑步時，儀器會記錄心電圖、血壓及呼吸數據，用作評估心血管功能，或心肺疾病（如心律不整、心肌缺血等）引起的症狀。
心胸外科遷入一星期便進行了首宗心臟手術。受疫情影響，挑戰又多了一項。
手術進行期間需靠人工心肺機在病人體外維持血液循環和呼吸功能。負責操作的灌注師雖經驗豐富及已通過評核，但由於屬新型機種，首次在本院臨床使用時，如有相關專家在場督導會更理想。然而疫情之下，專家卻未能由澳洲來港！
手術團隊立即變陣，在心肺機周圍設置多部直播攝影機，灌注師亦戴上智能眼鏡，實時傳送手術情況，讓專家遙距督導，手術最後順利完成。
最新型號的人工心肺機針對體型細小的嬰幼兒，有助穩定血流，及減低血液稀釋風險。其自動化功能亦可更緊密監測病人各項指數。
一些罕見的先天性骨骼疾病，如俗稱玻璃骨的成骨不全症、俗稱石頭症的進行性骨化性纖維發育不良，和俗稱侏儒症的軟骨發育不全，可導致兒童骨骼變形，甚至喪失活動能力。香港兒童醫院設有骨骼發展跨專科門診為患者改善病情，提升生活質素。
內分泌科的副顧問醫生童月玲表示：「以玻璃骨為例，其病因通常是由於第一型膠原纖維蛋白的基因產生變異。患者骨質會較脆弱，常因輕微碰撞便骨折。他們一般較矮小，並因韌帶鬆動和肌肉張力低而容易跌倒，牙齒及聽力亦可能受損。」
本院會為這些病童提供內分泌科、骨科、遺傳科、牙科及口腔頜面外科和放射科跨專科會診，制定全面及個人化治療計劃，包括用藥、手術及專職醫療服務等。舉例來說，病理學部可為其進行基因測試，找出致病基因，而內分泌科會定期注輸藥物以改善骨質密度去預防骨折，病童亦可在水療池鍛練肌力，及根據營養師建議調節飲食。若有需要，會與其他公立醫院共同治療。
童醫生稱：「目前未有藥物根治玻璃骨，但及早治療有助改善身體狀況，讓小朋友有機會做想做的事，快樂地成長。我們會與病童家庭坐在同一條船，一起克服挑戰。看著他們由經常骨折，至慢慢學會走路、踏入校園，我很開心和感恩。」
明仔未出生已確診玻璃骨，出生後兩周內曾七次骨折。父親林先生記得，當時明仔每次郁動都會哭，至一個月大起注射藥物，並持續接受物理治療、職業治療和手術，鞏固骨骼和肌力，再配合營養師建議，攝取充足鈣質。
明仔一年多前被轉介到香港兒童醫院，轉眼已經三歲，情況逐漸好轉，並學會走路。林先生說：「感謝不同醫院的醫護人員與我們一起同行，不會剩下我們獨自面對困難。兒童醫院各人都很細心，能洞察我們的需要，支援充足，例如會與學校講解兒子的情況，在課室安排合適的座椅。」
活潑愛笑的明仔持續接受治療和訓練，日益健壯，父母可放心帶他到公園玩耍，一家樂也融融。
本院今年將開展骨質密度檢查服務，運用雙能量X光吸收測量儀，持續評估病童的骨質密度發展或流失情況，有助醫生制定適切的治療方案。
內分泌科去年七月推出「與糖童行」計劃，為血糖控制未如理想，及需要較多支援的糖尿病童提供更全面的個人化服務，提升疾病管理能力。
此計劃與其他公立醫院兒科部門合作，病童經醫生轉介便可參加。合適的病童會植入皮下監測儀，24小時測量血糖水平。他們需要輸入全日吃過甚麼、胰島素注射劑量等，資料會即時上載至網上平台。
內分泌科的副顧問醫生李勵嘉表示：「我們會查閱網上平台的數據，若發現血糖水平異常，便會致電病童或家長，教他們調節用餐時間、份量及胰島素劑量等。他們如有疑問，也可致電或電郵我們。」
專責護士亦會支援護理需要，如舉辦工作坊，讓病童透過遊戲學習如何管理糖尿病，包括「篤手指」測血糖、計算膳食的碳水化合物含量、打胰島素針等。
資深護師潘綺雯稱，照顧病童的心靈同樣重要：「病童擔心在學校打胰島素針會引來同學的奇異目光，我們會鼓勵他們不用怕，患病不是因自己做錯事。我們亦會到學校舉行糖尿病講座，消除師生的誤解。」
物理治療師對病童進行高強度間歇式訓練，改善血糖情況。護士亦會在場教導病童如何預防運動後低血糖。
疫情反覆，小朋友多了時間留在家中。不如全家一起製作曲奇，在家抗疫也可食得健康！
營養部 營養師楊嘉敏
可做36塊曲奇
| 中筋麵粉 | 1¾杯 |
| 即食燕麥 | 3湯匙 |
| 雞蛋 | 1隻 |
| 糖粉（可以3湯匙甜菊糖代替） | ⅓ 杯 |
| 黃糖 | 3湯匙 |
| 植物油 | 125毫升 |
| 鹽 | ⅛ 茶匙 |
| 雲尼拿香油 | 1¼ 茶匙 |
將一般食譜稍作改動，就能製作出健康又美味的曲奇。
我們的病童雖然身患重病，仍然勇於探索，展現才華，發光發亮。請大家聽聽三位參加了病人資源中心「Project I-Can」病童的心聲，給他們一點鼓勵！
「治療過程雖艱苦漫長，但不要放棄，要堅持下去！」
Curry在化療期間除了承受身體不適，更因日後不能再短跑，田徑生涯中斷而一度意志消沉。後來，他在護士的鼓勵下開始自學撲克魔術，還會在病房表演給醫護人員和其他病童看。當中的樂趣和成功感讓他重拾笑顏，堅強完成治療。
「不要讓病魔影響你發展興趣，繼續做自己熱愛的事情！」
Forest自小熱愛舞蹈，除了自學K-pop舞，更開設YouTube頻道分享自己的跳舞影片，錄影剪接一手包辦。即使得知患病的惡耗，Forest仍然樂觀面對，臉上總掛著笑容的她談起K-pop時興奮不已，你甚至會見到她在病房起舞！
「我想成為醫生，幫助其他患病的小朋友！」
在家人的支持下，Brandon挺過大大小小的手術和治療，身體漸漸康復。疾病令他容易跌倒受傷，不能像一般孩子跑跑跳跳，亦無阻他嘗試新事物。喜愛表演的他除了加入合唱團，亦有學習鋼琴和做小童軍呢！
醫院行政總監李子良醫生
麻醉及全期手術醫學科副顧問醫生郭蕙漩
行政事務總經理郭慧敏
專職醫療行政經理陳娜智
護理部高級護士長馮靜雅
高級人力資源經理吳海寧
高級行政主任（對外關係及籌募）杜蘊慧
一級行政主任（對外關係及籌募）董潔欣
二級行政主任（對外關係及籌募）吳文諾
二級行政主任（對外關係及籌募）溫嘉敏
二級行政主任（對外關係及籌募）邱雅錡
© 2021 醫院管理局版權所有
如對本通訊有任何意見，歡迎電郵至 enquiry_hkch@ha.org.hk
網上版請瀏覽 www.ha.org.hk/hkch
HKCH joyfully welcomed Queen Mary Hospital’s paediatric cardiology and cardiothoracic surgery teams on board as the turbulent 2020 concluded. The smooth service translocation was an important milestone for HKCH, marking the completion of the first phase of our service commencement.
The teams are well-known for pioneering cutting-edge techniques and achieving many firsts. Their work has significantly improved the life expectancy and quality of life of many cardiac patients over the years. With their expertise and dedication, I am sure the implementation of hub-and-spoke model would take service quality and research output to an unprecedented level.
Children with heart problems may also have multi-organ involvement. HKCH offers them the safest therapeutic environment, as they could benefit from our state-of-the-art infrastructure, and receive holistic care jointly provided by different specialties, sub-specialties and professionals who are experienced and focused in taking care of the specific needs of children.
Recently, our specialist outpatient clinic has gradually rolled out its tele-consultation service for suitable patients. Follow-up now becomes more convenient and contact-free.
We have also designed a new white coat for our medical colleagues. Hope this would bring a fresh start for 2021.
Dr Lee Tsz-leung, HKCH Hospital Chief Executive
“It’s the most wonderful time of the year.” For many of us, the past Christmas was spent at home. And for some child patients, HKCH was their home during the festive season. The Patient Resource Centre and hospital colleagues prepared a series of fun programmes to bring holiday cheers to children while adhering to infection control requirements.
What better way to show your gratitude than a handwritten card? For children who attend the outpatient clinic or stay in the hospital often, our staff have practically become their families. Our patients got creative when making Christmas postcards to thank healthcare staff for their work.
Lovely Christmas postcards filled with heartwarming wishes from patients. A little post box was set up for patients to mail their postcards to our staff.
Santa put on a mask and kept social distance when visiting children who had been nice all year. Patients were thrilled to take a quick snap with him and receive gifts from ward staff. A group of staff singers also recorded a Christmas song for patients to watch online while enjoying a yummy Christmas dessert.
Safe and delicious holiday treats specially prepared by the Catering Services: chocolate pudding cake which maintained moist and fluffy after reheating at high temperature, and double boiled milk for patients with swallowing difficulty.
The Queen Mary Hospital’s paediatric cardiology and cardiothoracic services had begun to move into HKCH since last October, starting with outpatient and ambulatory services, as well as simple surgeries and intervention. Service translocation was fully completed on 8 December when five inpatients were transferred to HKCH smoothly.
The HKCH is now the tertiary referral centre for children with congenital and acquired heart diseases. It is also the only public hospital to provide cardiac surgery, extracorporeal membrane oxygenation (ECMO), ventricular assist device, and thoracic organ transplant services to children in the whole of Hong Kong.
The hospital is equipped with relevant infrastructure and advanced technologies to provide comprehensive cardiac services. Dr Lun Kin-shing, Consultant-in-charge of the Cardiology team said, “Like the hybrid cardiac catheterization laboratory / theatre, it makes complicated and dangerous therapeutic procedures possible with significantly reduced risk.”
Dr Barnabe Antonio Rocha, Consultant in the Cardiothoracic Surgery team said that ICU beds allocation is relatively flexible in HKCH, and this could provide cardiac patients with better postoperative care. The facilities here also facilitate closer collaboration between surgeons and physicians. He remarked, “We would perform more minimally invasive heart surgeries and hybrid procedures in future to enhance service quality.”
Dr Lun shared that the team would strive to establish an effective hub-and-spoke service model for paediatric cardiology in Hong Kong, and enhance training of the future generation of healthcare professionals. Further development of artificial intelligence is also foreseen in areas such as tele-consultancy for patients with cardiac implantable electronic devices, personalized medicine and clinical research.
The teams from QMH conducting drills to familiarize with the workflow in the new environment.
HKCH has a hybrid cardiac cath lab / theatre that is equipped with advanced imaging, catheterization and surgical facilities. It allows cardiologists, cardiothoracic surgeons and radiologists to perform diagnostic, interventional and surgical procedures in the same location simultaneously. This could lower the risks of patient transfer, trauma and infection, and speed up recovery.
This facility offers a solution to treat some complex congenital heart diseases which require both conventional surgery and interventional procedures. For example, cardiologists can conduct intra-operative balloon dilation and stent insertion for narrowed blood vessels, and perventricular placement of cardiac devices (e.g. artificial cardiac valve, ventricular septal defect occluder, vascular plug). Even patients on ECMO can also benefit. On the other hand, surgeons can first operate on a patient to provide accessible vascular site for cardiologists to continue their intervention.
The bi-plane C-arm imaging system can instantly capture clear images of blood vessels from two axes for enhanced visualization and precision.
Various equipment is available in the lab for an array of investigations such as echocardiography, exercise test and tilt table test to diagnose heart problems and evaluate treatment outcome.
Echocardiography is performed to assess the structure and function of the heart, including its size, shape and pumping ability, and detect heart defects such as holes on the chamber wall and narrowing of valves. Fetal echocardiography and transplacental treatment are also available.
As patients run on the treadmill, their heart rate and blood pressure are recorded to assess their cardiovascular functions and symptoms of heart and lung diseases, such as arrhythmia and myocardial ischaemia.
The Cardiothoracic Surgery team did their first operation just one week after moving in, and they had to face a new challenge due to COVID-19.
During the operation, a cardiopulmonary bypass machine was used to maintain the patient’s circulatory and respiratory functions. Although the perfusionist had been fully trained, it was preferable to have a relevant expert on-site for the first time this new model was used in HKCH. However, the expert could not come from Australia due to the pandemic.
The teams responded swiftly by setting up multiple cameras around the machine. The perfusionist also put on smart glasses. As a result, the expert was able to watch the operation and provide real-time guidance.
The new model of cardiopulmonary bypass machine has special features to achieve stable haemodynamics and reduce haemodiluation in infants who have small blood volume. Its automation functions also facilitate close monitoring of patient parameters.
Osteogenesis imperfecta (OI, commonly known as brittle bone disease), fibrodysplasia ossificans progressiva, and achondroplasia are examples of rare bone diseases which can cause bone deformity and immobility. HKCH has a designated multidisciplinary bone clinic managing children with such conditions to improve their quality of life.
Dr Joanna Tung, Associate Consultant of the Endocrinology team said, “Take OI as an example, it’s usually caused by a mutation in the Type I collagen gene. This makes patients’ bones fragile and prone to fracture. They usually have short stature and high falling risk related to ligament laxity and muscle weakness. Teeth problems and hearing loss are also common.”
Multidisciplinary consultation will be arranged for OI patients to meet endocrinology, orthopaedics, genetics, dentistry & maxillofacial surgery and radiology teams in one visit. A comprehensive and personalized care plan would be designed for each patient, covering necessary medications, surgical intervention and allied health services. For instance, genetic tests will be performed by the Pathology Department to identify the problematic gene, and the Endocrinology team will prescribe medications to prevent bone loss and fracture. Patients can exercise in the hydrotherapy pool to strengthen their muscles and follow up their nutrition problems with dieticians. Joint care with other public hospitals will be arranged if necessary.
“Although there is no cure for OI, early treatment can improve children’s conditions, enabling them to embrace their dreams and grow up happily. I feel so grateful to witness their progress, from having frequent fractures to taking the first steps and attending school.” said Dr Tung.
Little Ming was diagnosed with OI in the womb, and had experienced seven bone fractures in the first two weeks after birth. His father Mr Lam remembered how Ming would cry at every move. Starting from one-month old, he has been receiving medication infusion, physiotherapy, occupational therapy and surgeries to strengthen his bones and muscles. Dietary advice is also followed.
Ming was subsequently referred to the HKCH. He is now three and making good progress. Mr Lam said, “We are very thankful to the healthcare staff from different hospitals who walk through the treatment journey with us so we need not face it on our own. People at the HKCH are very attentive to our needs and provide good support. They talked to my son’s school about his condition, so a special chair was arranged in the classroom.”
With continuous treatment and training, Ming is getting stronger. He has learnt how to walk and can have fun in the playground with his parents.
HKCH will launch a new service this year using dual-energy X-ray absorptiometry (DEXA) scanner to evaluate the progress of patients’ bone mineral density accrual or severity of bone loss, which can help doctors determine appropriate treatment plan.
The Endocrinology team has launched a new programme called “Walk with Diabetes” which provides comprehensive personalized care for diabetic children with suboptimal control or requiring additional support. It aims at empowering them for better disease management.
It is a joint care programme with the paediatric departments under HA and patients can join through doctor’s referral. Indicated patients will have a monitoring sensor inserted under the skin to measure their blood glucose level round the clock. They also need to input what they eat and how much insulin is injected each day into a device. The information is then transmitted to an online platform.
Dr Samantha Lee, Associate Consultant said, “If abnormal blood glucose level is spotted, we will call up the patient or parents to tell them what to do, such as adjusting meal time, portion and insulin dosage.”
Workshops and games are arranged by nurses where children learn how to self-manage, such as pricking finger to test blood glucose level, calculating carbohydrate intake and injecting insulin.
Said Advanced Practiced Nurse Iris Poon, “Some patients are worried what their classmates may think if they are seen injecting insulin. We would reassure them there is no need to feel ashamed. We can also organize school talks so that teachers and students know what diabetes is really about.”
Physiotherapists help patients improve their blood glucose condition with high intensity interval training exercise. Nurses are also around to educate patients on preventing low glucose after exercise.
Running out of ideas to keep your kids busy at home during the pandemic? Why not spend some quality time making healthy cookies together?
Dietetics Carmen Yeung, Dietitian
Can make 36 cookies
| All-purpose flour | 1¾ cup |
| Instant oats | 3 tablespoons |
| Egg | 1 piece |
| Caster sugar (may replace with 3 tablespoons of Stevia) | ⅓ cup |
| Brown sugar | 3 tablespoons |
| Vegetable oil | 125 ml |
| Salt | ⅛ teaspoon |
| Vanilla essence | 1¼ teaspoons |
That’s how we modify regular recipes to make healthier cookies.
Despite suffering from serious illnesses, our patients continue to discover their talents and shine. Let’s meet three talented members of “Project I-Can” organized by the Patient Resource Centre!
“Although treatment is a long and tough journey, don’t give up!”
Curry felt beaten down when he underwent painful chemotherapy and realized that he would not be able to pursue his athletics dream. With the encouragement of a nurse, Curry started learning card tricks and has performed for ward staff and fellow patients. That feeling of success has given him much joy and courage to complete his treatment.
“Don’t let the disease stop you from doing things you love!”
Forest loves dancing. She learns K-pop dances on her own, and has a YouTube channel where she shares videos filmed and edited by herself. Even with sickness, Forest stays positive and passionate about K-pop. You may even catch her dancing in the ward!
“I want to be a doctor and help other sick kids!”
With family support, Brandon has overcome numerous surgeries and treatments, and is now on the road to recovery. Although Brandon cannot run and jump as other kids, he is always keen to try something new. He is a choir member, a Scout, and is learning how to play the piano.
Dr Lee Tsz-leung, Hospital Chief Executive
Dr Vansie Kwok, Associate Consultant(Anaesthesiology and Perioperative Medicine)
Miscelle Kwok, General Manager (Administrative Services)
Nerita Chan, Manager (Allied Health)
May Fung, Senior Nursing Officer (Nursing Services Division)
Elaine Ng, Senior Human Resources Manager
Vivian To, SEO (External Relations & Donation Management)
Haze Tung, EOI (External Relations & Donation Management)
Mandy Ng, EOII (External Relations & Donation Management)
Kyra Wan, EOII (External Relations & Donation Management)
Karis Yau, EOII (External Relations & Donation Management)
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