新型冠状病毒肺炎患者手术应急预案的建立与实施

Establishment and implementation of emergency plan for surgery to COVID-19 patients

目的建立新型冠状病毒肺炎患者手术应急预案,并评价实施效果。方法解放军总医院第五医学中心是一所三级甲等传染病医院,在近期突发传染病期间收治了确诊和疑似新型冠状病毒感染的患者,其中一些患者有需要手术治疗的可能。通过对这些病例和疾病特点进行分析,我们制订相关的手术应急预案,包括术前评估、术中护理、术后对环境物表的消毒处理等,并规范医务人员个人防护。制订的手术应急预案在一例气管插管中实施。结果进行气管插管时启动新型病冠状毒肺炎手术应急预案,两名麻醉医生应用三级防护,操作结束后进行隔离15 d,隔离期间所有观察指标均正常,未发现被感染。结论建立了新型冠状病毒肺炎手术应急预案并得到实施,操作性强,流程明确,实施效果满意,医务人员零感染。

Objective To establish a new emergency plan for surgery to COVID-19 patients and evaluate the effect of its implementation.Methods As a military-led grade A tertiary hospital for infectious diseases,the fifth medical center of Chinese PLA General Hospital had received many confirmed/suspected COVID-19 cases recently,so surgical treatment might be needed.By analyzing the clinical condition of these cases and the characteristics of the disease,we formulated relevant emergency plans for surgery to COVID-19 patients,including preoperative evaluation,intraoperative care,post-operative disinfection of environment,etc.,and standardized personal protection of medical staff.The prepared emergency plan for surgery was implemented in one case required tracheal intubation.Results The emergency plan for the surgery to COVID-19 patients was applied during the tracheal intubation,and the intubation was successful.Two anesthesiologists were defined as at high-risk of exposure and used all the personal protective equipments including respirator.They were isolated for 15 days after the operation.All observation indicators were normal during the isolation and no infection was identified.Conclusion The new emergency plan for surgery to COVID-19 patients has been established and implemented,with strong operability,clear procedures,satisfactory implementation results,and zero infection in medical staff.