普通隔离病房新冠肺炎危重症患者救治防护经验(附1例报道)

The experience of treatment and protection for very serious case with the Corona Virus Disease 2019 in regular quarantine ward(attached a case report)

目的探讨普通无负压病房使用ECMO+呼吸机+CRRT等高度生命支持技术治疗新冠肺炎过程中避免医护人员交叉感染风险的相关措施。方法遵循《医疗机构内新型冠状病毒感染预防与控制技术指南》(第一版)要求,成立由感染科、重症医学科、心脏外科ICU及外科ICU组成的护理抢救小组,每组3人,保证ECMO+呼吸机+CRRT的专科护士2名,感染科护士1名。3人有详细分工、合作,每班次工作6 h。患者住单人间病室,持续打开病室排气扇、空气消毒机和空气净化机,医护严格、正确穿戴合格防护服,感染科护士全程监督各种防护和操作过程。结果患者经21 d加强救治,生命体征平稳,神志清楚,肺部病变好转;期间医护人员工作2周隔离观察7 d,无感染。结论在普通隔离病房,较长时间使用多种生命支持设备救治呼吸道烈性传染病,防护措施得当,亦可取得满意疗效,并能防止医护人员被感染,经验值得参考。

Objective To discuss how to protect medical staff from infection while saving a patient with Corona Virus Disease 2019 which used advanced life support technologies like ECMO+ventilator+CRRT machine in a non-negative pressure ward.Methods According to Technical Guidelines for Prevention and Control of Corona Virus Disease 2019 in Medical Institutions(1st edition),nursing teams was made up with infectious disease department,intensive medicine department,cardiac surgery ICU and surgical ICU,which included 3 specialists in a group.There were two specialized nurses who were responsible for ECMO+ventilator+CRRT machine,and a nurse was from the infectious disease department.They both have a detailed division of labor and cooperate with each other to complete various tasks within the shift of 6 hours.The patient lived in a single room ward with the exhaust fan,air sterilizer and air purifier continuously on.The medical staff worn protective clothing under the special one's inspection.During the work and the process of removing protective equipment,nurses from the infectious department would supervise and assist.Results After 21 days of intensive treatment,the patient had stable vital signs,clear consciousness and improved pulmonary lesions.During this period,the medical staff worked for 2 weeks and quarantined for 7 days without infection.Conclusion In regular quarantine ward,a variety of life support equipment can be used to treat respiratory tract infectious diseases for a long time.Proper protective measures can also achieve satisfactory curative effects and prevent medical staff from being infected.The experience is worth referring to.