自2月16日凌晨完成第一例新冠肺炎逝者遗体解剖之后,同济医学院法医系教授、湖北省司法鉴定协会会长刘良与其团队至今已经获得了9例逝者的病理样本。2月24日,央视记者就关于新冠肺炎逝者遗体解剖一系列问题专访了刘良。记者:解剖新冠肺炎逝者遗体,并对一些重要信息进行研究,是出于什么目的?
刘良:目的就是要搞清楚这个病毒伤害了病人的什么地方,我们叫靶器官。第一,我们可以探讨它的传播途径。第二,我们要针对这个地方,研究用药。还有就是弄明白这个病毒是通过什么机制让肺受到损伤的。如果找准的话,就可以针对性地采取保护性措施。没有尸体解剖的话,基本上就搞不清楚对手,也搞不清楚它打击你的方向,整个是茫然的。
Two cadavers of patients who died from the novel coronavirus pneumonia (COVID-19) were dissected on February 16 at Wuhan Jinyintan Hospital in China, which are the first dissections made to study this disease. Understanding COVID-19 through dissections could significantly help clinical treatments.Liu Liang, a forensic specialist at the Tongji Medical College in Huazhong University of Science and Technology, and his team submitted an urgent report to relevant departments as early as January 22, which called for the dissections of cadavers with COVID-19.Why weren't the dissections of the cadavers conducted until February 16?早在1月22日,刘良就呼吁对新冠肺炎逝者进行病理解剖,并联合团队向相关部门递交紧急报告,强调病理解剖的重要性。然而第一例新冠肺炎逝者遗体解剖手术一直到2月16日才进行,这期间刘良团队遇到了什么难题?刘良:首先,场地保证不了,解剖场地必须是要负压的,但我们国家只有负压的实验室,没有负压的解剖室。伦理方面,我们要征求死者家属的同意,我们得面对面去沟通。这里包括时间、空间上的问题,所以难度很大。
记者:您在等待的过程中心态是怎样的?
刘良:我着急,因为不断有人死去,然后都很茫然。如果早一天知道他的病变,对临床治疗是非常有价值的。
Liu said in a CCTV interview that they had to get permission from the bereaved before the operation."We weren't able to meet the bereaved and talk to them at the hospital under this special circumstance (outbreak), and telephone contact cannot be counted as evidence… it was very hard to contact them," Liu said, adding that he was very anxious while waiting for the replies because patients were dying.In the afternoon of February 15, Liu received the notice that there were family members who agreed to donate their loved ones' cadavers for dissections.2月15日下午刘良接到通知,有家属同意捐献亲人的遗体做病理解剖,武汉金银潭医院同意将一间小手术室改造为解剖间。
刘良:刚好这个医院的手术室是一个带负压的空间,所以它是比较适合我们做的。我们把里面非必要的东西全部清走了,还有一个要注意的是,不造成室内一些血迹的污染。因为除了空气以外,它还对地面、对下水有影响。
记者:您进去之前要做什么样的防护?
刘良:我们跟临床医生一样,要做各种防护,当然我们的防护级别要高。我们戴三层手套,两层口罩,帽子戴两层或者三层,然后护目镜加上防护屏。服装的规格也很高,密封性特别好,不透风不透气。这样就能把全身暴露的位置全部给封闭掉。
In order to prevent cross-contamination, the dissections of bodies of infectious disease like COVID-19 must be operated in negative pressure operating rooms.
"We only have negative pressure labs in China, but not operating rooms," Liu explained.Wuhan Jinyintan Hospital agreed on February 15 to provide an operating room for Liu's team to conduct the dissections. The room is suitable for the dissections because it has the function of negative pressure, and it's small and sealed, Liu told CCTV.Before the operation, Liu and his team cleaned out everything that was unnecessary. "We worked very carefully to not to cause any contamination to the air, the ground, and the drain," Liu said, stressing that their protection level is higher than regular dissections. "We put on three layers of gloves, two layers of masks, two to three layers of hats, plus protection suits and goggles."2月16日凌晨一点左右,刘良团队三人进入解剖间,开始新冠肺炎逝者的第一例病理解剖。刘良:解剖前,我们集体给他鞠躬,鞠躬时间特别长。我们对这位逝者是非常非常地尊敬,发自内心非常感谢这些人,他们是大爱。
平时做一例解剖手术,刘良大概需要一个小时左右。而第一例新冠肺炎患者遗体解剖却持续了将近三个小时,几乎是平日的三倍,到凌晨三点五十分才结束。记者:这次时间长的原因是什么?
刘良:第一是第一例,要谨慎小心一点;第二确实是很难受。人在里面缺氧,到后面缝一针就大喘气,腰也不舒服。穿上那个服装,就跟宇航员一样,闷在里面汗不停地往下掉,会有脱水的情况。下半夜,也有饥饿的状态。Liu and his team spent nearly three hours to complete the first dissection."Everyone in the room took a bow spontaneously before the dissection," he said. "They (deceased patients) contributed their bodies to pave the way for healthy people."由解剖获得的新冠肺炎病理已送检,有望寻找到新冠肺炎的致病性、致死性病理,给未来临床治疗危重症患者提供依据。刘良:今天(24日)早上钟南山院士给我打过电话,他说他们前线的医生就等我这个结果了,否则不知道治疗到底怎么办,治疗效果怎么评估。
记者:您接到这个电话,心里怎么想?
刘良:我着急,赶快抓紧时间,到今天(24日),其实已经开始有初步结果了。初步结果我们内部在讨论,形成一个共识,近几天就会发出来。发出来以后,会尽快给一线医生。
The results of the dissections have been sent for inspection in the hope to provide the pathology of COVID-19 for further treatment of patients."We have been discussing the preliminary findings and will send them to the frontline doctors in the next couple of days," Liu said.