新型冠状病毒核酸检测在眼科医院疫情防控中的实践与有效性研究

The Practice and Effectiveness of 2019-nCoV RNA Detection for Prevention and Control Procedures in Ophthalmic Hospitals

目的:探索以系统化、标准化的新型冠状病毒核酸检测为核心和重要组成部分,建立适合于眼科医院新冠疫情精准防控切实可行的防控体系。方法:系列病例研究。自2020年2月24日至3月2日期间,以标准化病毒核酸检测联合血常规、C反应蛋白(CRP)、血清淀粉样蛋白A(SAA)等检测作为所有眼科手术患者术前筛查常规检测项目,同时也为返岗员工提供病毒核酸检测。设计调查问卷了解受检者对鼻咽拭子采样的接受度以及核酸检测结果对其心理状态的影响。结果:99例患者血液学检测结果有一定的异常比例,其中SAA检测结果增高13例,淋巴细胞计数减低12例、增高5例,白细胞计数增高11例、减低1例,CRP增高2例,新型冠状病毒核酸检测均阴性。33例本院职工新型冠状病毒核酸检测均阴性。12%的受访者对鼻咽拭子采样接受度评分较低。受检者在核酸检测前后思想压力评分较高的比例分别为46.7%和6.7%。结论:该项举措一方面为术前新冠病毒肺炎筛查及鉴别诊断提供了客观依据,很大程度上排除了隐性无症状感染者传播的可能,有利于减少二次传播的风险,降低院内交叉感染的概率;另一方面,核酸检测阴性结果有利于调整患者术前的心理状态并缓解医护人员在疫情防控期间的心理压力。

Objective:To explore a practical system for precision prevention and control against coronavirus disease 2019(COVID-19)for eye hospitals by emphasizing systematic and standardized virus RNA detection procedures.Methods:In this case series study,standardized virus RNA detection along with a routine blood test(BRT),C-reactive protein(CRP)and serum amyloid A(SAA)were included in preoperative screening test items for ocular surgical patients and to provide virus RNA detection for returning employees between 24 February 2020 and 2 March 2020.In addition,a questionnaire was designed to investigate the acceptability of nasopharyngeal swab sampling and the influence of virus RNA detection results on the mental status of the examinee.Results:Ninety-nine examination results showed a certain percentage of abnormal test results,among which 13 cases showed an increase in SAA,12 cases showed a decrease in lymphocyte count(LYM)while 5 cases showed an increase,1 case showed a decrease in white blood count(WBC)while 11 cases showed an increase,and 2 cases showed an increase in CRP.All cases tested negative for novel coronavirus(2019-nCoV)RNA detection,including examined patients and 33 employees of the Eye Hospital.11.7%of respondents reported a low acceptance score for nasopharyngeal swab sampling.The proportion of the examinees with higher mental stress scores before and after the virus RNA detection test was 46.7%and 6.7%,respectively.Conclusions:The detection procedures can offer an objective basis for preoperative screening and differential diagnosis,while largely eliminating the possibility of transmission via asymptomatic infected individuals.On the other hand,the negative result of virus RNA detection is beneficial in adjusting a patient's preoperative psychological state and relieving the mental stress of medical staff during the epidemic.