我们怀著喜悦的心情，在告别2020年之际欢迎玛丽医院儿童心脏科及心胸外科团队的加入。其服务全面调迁是一个重要里程碑，标志香港儿童医院第一阶段的临床服务开展已经完成。
团队历年开创了多项突破性技术，为心脏病童带来新生与希望。我期望透过成功推行轴辐模式，令儿童心脏病的治疗质素和科研发展更上层楼。
不少心脏病童同时有多重器官毛病，香港儿童医院正正能为他们提供最安全的治疗环境。除了尖端设备，这里齐集不同专业团队，对处理儿童病人独有的临床问题富有经验，亦专注照顾儿童的需要，能给予最全面支援。
另外，我们的专科门诊近期陆续推出视像诊症服务。合适的病童足不出户就可以覆诊，省时方便，疫情下更加安全。
新年新开始，我们预备了全新设计的医生袍，希望同事喜欢。
香港儿童医院行政总监李子良医生
刚过去的圣诞节相信大家都留在家中庆祝。对于一班病童来说，医院便是他们在这佳节中的家。病人资源中心及一众同事在感染控制措施许可下，精心设计富有圣诞气氛的活动，为病童送上温暖。
对于经常前来覆诊或住院的病童，医护人员仿佛是亲切的家人。他们用心为圣诞明信片填上颜色并写上祝福字句，感谢医护人员的悉心照顾。
每张圣诞明信片都写满病童感谢医护人员的纯真祝福。病童亲自投进小邮筒，将心意寄给医护人员。
圣诞老人今年要戴上口罩，与大家保持社交距离，但病童也很兴奋能跟他快闪合照。医院同事亦大派礼物，更录制圣诞歌片段，让病童一边观看，一边品尝圣诞限定甜点。
膳食服务部特意改良配方制作的朱古力布甸蛋糕，经高温翻热后仍能保持松软湿润，既安全又美味。有吞咽困难的病童则可吃香甜炖奶。
玛丽医院的儿童心脏科及心胸外科服务由去年10月起分阶段迁进香港儿童医院，首先提供门诊、日间、简单手术及介入服务。至12月8日，心脏科中心启用，五名住院病童顺利转院，标志调迁完成，相关服务全面开展。
香港儿童医院现已成为儿童先天及后天性心脏病的第三层转介中心，亦是医管局唯一为全港儿童提供心脏手术、体外膜氧合器、心室辅助器，及心肺移植服务的医院。
为配合服务，院内设有相关硬件和先进仪器。心脏科的顾问医生伦建成说：「特别是复合式心导管室／手术室，它让一些极度复杂、高风险的程序变为可行，可更安全地进行。」
心胸外科的顾问医生罗冠中则认为，本院集中照顾儿童，深切治疗部病床调配比较灵活，可为术后病童提供更佳照顾，而这里的环境亦有利内外科团队合作。他说：「未来我们会进行更多微创及复合式心脏手术，提升治疗质素。」
伦医生指会著力为本港的儿童心脏科服务建立一个有效的轴辐模式，同时肩负培训医护人员的责任；另外会继续发展人工智能的应用，例如为植入了心脏电子装置的病人作遥距监测、个人化医疗和临床研究方面。
来自玛丽医院的专业团队经验丰富，但服务搬家，亦得适应新环境，因此要进行演练去熟习手术室器材、运作流程及交接安排，与其他部门建立默契。
本院设有高规格的复合式心导管室／手术室，结合先进影像、心导管介入及手术设备，让心脏科、心胸外科及放射科医生可在同一地点进行诊断、介入治疗及手术，减低病人运送、创伤和感染风险，加快复原。
部份复杂的先天性心脏病需靠传统外科手术及心导管介入治疗双管齐下，复合式手术室正好发挥优势。举例来说，心脏科医生可在手术期间施行介入程序，如以球囊或支架扩张狭窄血管，及于心室周围植入仪器（如人工心瓣、心房间隔缺损关闭器、血管封堵器等），即使接驳了体外膜氧合器的危重病童也可以受惠。另一方面，如介入期间遇上困难情况，心胸外科医生亦可先剖开相关部位，心脏科医生便可随即置入导管以完成程序。
C形机械臂双向X光造影系统能从侧面及正面拍摄，即时在屏幕显示清晰影像，医生可多角度看清楚血管状况，提高治疗精准度。
中心设有不同仪器，可进行心脏超声波检查、运动测试及倾斜床测试等，以诊断各种心脏问题和评估治疗成效。
心脏超声波扫描可了解心脏结构和功能，如形状、大小和泵血情况，侦测有没有心漏和心瓣膜狭窄等缺陷。本院亦有提供产前胎儿心脏超声波检查及经胎盘治疗。
病童在踏板机上跑步时，仪器会记录心电图、血压及呼吸数据，用作评估心血管功能，或心肺疾病（如心律不整、心肌缺血等）引起的症状。
心胸外科迁入一星期便进行了首宗心脏手术。受疫情影响，挑战又多了一项。
手术进行期间需靠人工心肺机在病人体外维持血液循环和呼吸功能。负责操作的灌注师虽经验丰富及已通过评核，但由于属新型机种，首次在本院临床使用时，如有相关专家在场督导会更理想。然而疫情之下，专家却未能由澳洲来港！
手术团队立即变阵，在心肺机周围设置多部直播摄影机，灌注师亦戴上智能眼镜，实时传送手术情况，让专家遥距督导，手术最后顺利完成。
最新型号的人工心肺机针对体型细小的婴幼儿，有助稳定血流，及减低血液稀释风险。其自动化功能亦可更紧密监测病人各项指数。
一些罕见的先天性骨骼疾病，如俗称玻璃骨的成骨不全症、俗称石头症的进行性骨化性纤维发育不良，和俗称侏儒症的软骨发育不全，可导致儿童骨骼变形，甚至丧失活动能力。香港儿童医院设有骨骼发展跨专科门诊为患者改善病情，提升生活质素。
内分泌科的副顾问医生童月玲表示：「以玻璃骨为例，其病因通常是由于第一型胶原纤维蛋白的基因产生变异。患者骨质会较脆弱，常因轻微碰撞便骨折。他们一般较矮小，并因韧带松动和肌肉张力低而容易跌倒，牙齿及听力亦可能受损。」
本院会为这些病童提供内分泌科、骨科、遗传科、牙科及口腔颌面外科和放射科跨专科会诊，制定全面及个人化治疗计划，包括用药、手术及专职医疗服务等。举例来说，病理学部可为其进行基因测试，找出致病基因，而内分泌科会定期注输药物以改善骨质密度去预防骨折，病童亦可在水疗池锻练肌力，及根据营养师建议调节饮食。若有需要，会与其他公立医院共同治疗。
童医生称：「目前未有药物根治玻璃骨，但及早治疗有助改善身体状况，让小朋友有机会做想做的事，快乐地成长。我们会与病童家庭坐在同一条船，一起克服挑战。看著他们由经常骨折，至慢慢学会走路、踏入校园，我很开心和感恩。」
明仔未出生已确诊玻璃骨，出生后两周内曾七次骨折。父亲林先生记得，当时明仔每次郁动都会哭，至一个月大起注射药物，并持续接受物理治疗、职业治疗和手术，巩固骨骼和肌力，再配合营养师建议，摄取充足钙质。
明仔一年多前被转介到香港儿童医院，转眼已经三岁，情况逐渐好转，并学会走路。林先生说：「感谢不同医院的医护人员与我们一起同行，不会剩下我们独自面对困难。儿童医院各人都很细心，能洞察我们的需要，支援充足，例如会与学校讲解儿子的情况，在课室安排合适的座椅。」
活泼爱笑的明仔持续接受治疗和训练，日益健壮，父母可放心带他到公园玩耍，一家乐也融融。
本院今年将开展骨质密度检查服务，运用双能量X光吸收测量仪，持续评估病童的骨质密度发展或流失情况，有助医生制定适切的治疗方案。
内分泌科去年七月推出「与糖童行」计划，为血糖控制未如理想，及需要较多支援的糖尿病童提供更全面的个人化服务，提升疾病管理能力。
此计划与其他公立医院儿科部门合作，病童经医生转介便可参加。合适的病童会植入皮下监测仪，24小时测量血糖水平。他们需要输入全日吃过甚么、胰岛素注射剂量等，资料会即时上载至网上平台。
内分泌科的副顾问医生李励嘉表示：「我们会查阅网上平台的数据，若发现血糖水平异常，便会致电病童或家长，教他们调节用餐时间、份量及胰岛素剂量等。他们如有疑问，也可致电或电邮我们。」
专责护士亦会支援护理需要，如举办工作坊，让病童透过游戏学习如何管理糖尿病，包括「笃手指」测血糖、计算膳食的碳水化合物含量、打胰岛素针等。
资深护师潘绮雯称，照顾病童的心灵同样重要：「病童担心在学校打胰岛素针会引来同学的奇异目光，我们会鼓励他们不用怕，患病不是因自己做错事。我们亦会到学校举行糖尿病讲座，消除师生的误解。」
物理治疗师对病童进行高强度间歇式训练，改善血糖情况。护士亦会在场教导病童如何预防运动后低血糖。
疫情反复，小朋友多了时间留在家中。不如全家一起制作曲奇，在家抗疫也可食得健康！
营养部 营养师杨嘉敏
可做36块曲奇
| 中筋面粉 | 1¾杯 |
| 即食燕麦 | 3汤匙 |
| 鸡蛋 | 1只 |
| 糖粉（可以3汤匙甜菊糖代替） | ⅓ 杯 |
| 黄糖 | 3汤匙 |
| 植物油 | 125毫升 |
| 盐 | ⅛ 茶匙 |
| 云尼拿香油 | 1¼ 茶匙 |
将一般食谱稍作改动，就能制作出健康又美味的曲奇。
我们的病童虽然身患重病，仍然勇于探索，展现才华，发光发亮。请大家听听三位参加了病人资源中心「Project I-Can」病童的心声，给他们一点鼓励！
「治疗过程虽艰苦漫长，但不要放弃，要坚持下去！」
Curry在化疗期间除了承受身体不适，更因日后不能再短跑，田径生涯中断而一度意志消沉。后来，他在护士的鼓励下开始自学扑克魔术，还会在病房表演给医护人员和其他病童看。当中的乐趣和成功感让他重拾笑颜，坚强完成治疗。
「不要让病魔影响你发展兴趣，继续做自己热爱的事情！」
Forest自小热爱舞蹈，除了自学K-pop舞，更开设YouTube频道分享自己的跳舞影片，录影剪接一手包办。即使得知患病的恶耗，Forest仍然乐观面对，脸上总挂著笑容的她谈起K-pop时兴奋不已，你甚至会见到她在病房起舞！
「我想成为医生，帮助其他患病的小朋友！」
在家人的支持下，Brandon挺过大大小小的手术和治疗，身体渐渐康复。疾病令他容易跌倒受伤，不能像一般孩子跑跑跳跳，亦无阻他尝试新事物。喜爱表演的他除了加入合唱团，亦有学习钢琴和做小童军呢！
医院行政总监李子良医生
麻醉及全期手术医学科副顾问医生郭蕙漩
行政事务总经理郭慧敏
专职医疗行政经理陈娜智
护理部高级护士长冯静雅
高级人力资源经理吴海宁
高级行政主任（对外关系及筹募）杜蕴慧
一级行政主任（对外关系及筹募）董洁欣
二级行政主任（对外关系及筹募）吴文诺
二级行政主任（对外关系及筹募）温嘉敏
二级行政主任（对外关系及筹募）邱雅锜
© 2021 医院管理局版权所有
如对本通讯有任何意见，欢迎电邮至 enquiry_hkch@ha.org.hk
网上版请浏览 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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