新型冠状病毒肺炎疫情期间眼科手术安全性及防控对策

Safety and protective measures on performing ophthalmic surgeries during the epidemic of COVID-19

目的:探讨新型冠状病毒肺炎疫情期间开展眼科手术的安全性,并提出相关防控对策。方法:收集2020年1月25日至2020年2月28日新型冠状病毒肺炎疫情期间,在天津医科大学总医院眼科接受手术治疗者11例(12眼)的资料。其中眼球破裂,角膜穿孔伤,角膜穿孔伤合并外伤性白内障,眼内异物各1例(1眼),泪小管断裂2例(2眼),孔源性视网膜脱离4例(4眼),青光眼1例(2眼)。所有患者进行体温监测和流行病学调查。按照国家疫情防控要求和医院的应急管理流程,制订了眼科诊疗流程,所有患者均严格按照此流程进行管理,围手术期严格监测体温、呼吸道等全身情况。结果:11名患者就诊前行体温监测、流行病学调查、临床及影像学检查均正常,并请感染科专家会诊排除新型冠状病毒肺炎。所有患者均为眼外伤和急性眼病,包括急诊手术6眼,限期手术6眼,严格遵照眼科诊疗流程进行手术治疗,术后恢复良好,均未出现严重手术并发症。住院及随访期间患者、家属及医护人员均未发生新型冠状病毒肺炎。结论:新型冠状病毒肺炎疫情期间严格筛查患者,严格按照疫情期间防控工作流程要求,眼科手术是安全可行的。

Objective To investigate the safety of ophthalmic surgery during the epidemic of COVID-19 and to make related protective measures.Methods The clinical data of 12 eyes of 11 patients who underwent ophthalmic surgeries from Jan.25th to Feb.28th in Tianjin Medical University General Hospital were collected during the outbreak of COVID-19.There were 1 eye of 1 case with rupture of eyeball,1 eye of 1 case with corneal perforating injury,1 eye of 1 case of corneal perforating injury with traumatic cataract,1 eye of 1 case with intraocular foreign body,2 eyes of 2 cases of canalicular laceration,4 eyes of 4 cases of rhegmatogenous retinal detachment,and 2 eyes of 1 case of glaucoma.All patients were monitored temperature and made epidemiological investigations.According to the national epidemic prevention and control requirements and hospital’s emergency management process,an ophthalmologic diagnosis and treatment process had been formulated.All patients were strictly managed in accordance with this process.Body temperature,respiratory tract and other general conditions were monitored on the perioperative period.Results The temperature monitoring,epidemiological investigation,clinical and imaging examinations before consultation in all cases were normal,and all cases were treaded by infectious experts consultation to eliminate COVID-19.Ophthalmic surgeries were performed in 12 eyes of 11 patients with ocular trauma and acute eye diseases,included 6 eyes of emergency surgery,6 eyes of limited-term surgery,and strictly followed the ophthalmologic diagnosis and treatment process for surgical treatment.All patients recovered well postoperatively,and no serious complication occurred.No COVID-19 occurred among patients,family members and medical staff during the hospitalization and follow-up period.Conclusion The ophthalmic surgeries can be safely performed after strict screening and in accordance with the requirements of prevention and control workflow during the epidemic of the novel coronavirus pneumonia.