摘要
新近在中国武汉集中暴发的新型冠状病毒(SARS-CoV-2)所致肺炎(新冠肺炎,WHO定名:COVID-19)疫情严重威胁人民健康,目前已累及25个国家和地区。截至2020年2月13日,中国累计确诊病例63 946例,疑似病例10 109例,病死率2.06%。目前认为SARS-CoV-2传播途径主要是飞沫传播和密切接触,尚不能排除气溶胶和粪-口传播的可能。最新研究表明,新冠肺炎具有非常高的传播效率(R0为3.77)。按照国家卫生健康委员会的要求,疫情暴发期间外科手术的开展限于急诊手术和限期手术。对于疑似或确诊感染新冠肺炎患者外科手术时如何进行围手术期的防护,目前国内外尚无相关指南和共识,缺乏可借鉴的成熟经验。据不完全统计武汉大学中南医院与武汉大学人民医院在疫情期间共收治50例围手术期新冠肺炎患者,其中2例为术后确诊新冠肺炎,围手术期导致16名医务等相关人员感染;48例为术前新冠肺炎疑似或确诊患者,围手术期采取针对性的防护措施后未出现医务相关人员的感染。笔者根据中南大学湘雅医院在新冠肺炎流行期间制定的隔离措施和防护经验,结合上述武汉市两所医院的病例资料,探讨在新冠肺炎流行期间医务人员如何进行围手术期规范操作,制定有效的防护措施。
The outbreak of novel coronavirus (SARS-CoV-2)-infected pneumonia (NCP,WHO named as COVID-19) with a concentrated eruption in Wuhan,China has posed a serious threat to the health of people,which has so far spread to 25 countries and regions.As of 13 February 2020,the cumulative number of confirmed cases was63 946 and the cumulative number of suspected cases was 10 109,with a fatality rate of 2.06%.The main routes of transmission of SARS-CoV-2 are currently considered to be by droplets and close contacts,while the possibility of aerosol or fecal oral transmission still cannot be ruled out.The latest study indicated that the NCP has a very high transmission rate (R0=3.77).According to regulations issued by the National Health Commission,the surgical operations should be confined to emergency or urgent cases during the epidemic period.At present time,there are no relevant guidelines or recommendations as well as available experiences in China and abroad for when the operations are performed and how the perioperative prevention and protection are carried out in patients with suspected or confirmed NCP.According to incomplete statistics,there were a total of 50 perioperative patients with NCP admitted in the Zhongnan Hospital of Wuhan University and Renmin Hospital of Wuhan University during the epidemic period.Of the patients,2 cases with NCP diagnosed after operation infected 16 people who were medical staff or relevant personnel,and 48 cases with suspected or confirmed NCP before operation did not infect any of the medical staff or relevant individuals after specific prevention and protection measures were implemented.Here,the authors based on the quarantine measures framed during the NCP epidemic and the prevention and protection experiences of Xiangya Hospital,and combined with the data of cases from the above two hospitals in Wuhan,discuss how to carry out a standard operation and make effective prevention and protection measures during perioperative period under the epidemic situation of NCP.
作者
李新营
王琦
何跃明
李春辉
贺吉群
黄长盛
LI Xinying;WANG Qi;HE Yueming;LI Chunhui;HE Jiqun;HUANG Changsheng(Department of Thyroid Surgery,Xiangya Hospital,Central South University,Changsha 410008,China;Department of Gastrointestinal Surgery,Renmin Hospital,Wuhan University,Wuhan 430060,China;Department of Hepatopancreatobiliary Surgery,Zhongnan Hospital,Wuhan University,Wuhan 430071,China;Department of Infectious Disease,Xiangya Hospital,Central South University,Changsha 410008,China;Operating Room,Xiangya Hospital,Central South University,Changsha 410008,China;Department of Anaesthesia/Surgery,Xiangya Hospital,Central South University,Changsha 410008,China)
出处
《中国普通外科杂志》
CAS
CSCD
北大核心
2020年第2期142-146,共5页
China Journal of General Surgery
