新型冠状病毒肺炎疫情下创伤显微外科管理及规范化诊治的初步经验

Preliminary experience of management and standardised procedure of department of trauma and microsurgery during the outbreak of COVID-19

目的 探讨在新型冠状病毒肺炎(COVID-19)疫情期间创伤显微骨科病房管理、医护防护及规范化诊治流程的初步经验. 方法 以武汉大学中南医院创伤与显微骨科为例,回顾性分析自2019年12月31日至2020年3月1日收治的合并COVID-19的患者及医、技、护人员,包括临床诊断病例与确诊病例,收集其一般信息,包括年龄、性别、基础疾病、接触史、症状、肺部CT及预后,并通过防护意识及措施的变化来分析.自2020年1月20日明确“肯定人传人”,根据本科前、后病房患者及医护人员感染情况,制定创伤显微外科的科室管理、医护防护及规范化手术流程. 结果 共纳入COVID-19临床诊断及确诊病例5例,其中,住院患者1例,医技护人员4例,年龄25~81岁,3例确诊,2例疑似病例;经感染科和呼吸内科专科治疗,已治愈4例,死亡1例.自2020年1月20日后,根据多学科协作对病房管理及手术流程进行规范化后,未出现新的医护人员及住院患者感染的病例. 结论 遵循创伤显微外科手术管理及病房管理遵循标准化、规范化诊治流程,可有效控制疫情传播.

Objective To summarize the preliminary experience in ward management,medical protection,standardised diagnosis and treatment procedures in trauma microsurgery during the outbreak of COVID-19.Methods Taking an example from the Department of Trauma and Microsurgery at Zhongnan Hospital of Wuhan University,the orthopedic patients and medical staff with COVID-19 admitted from Decemberm 31,2019 to March 1,2020,in-cluding clinical diagnosis and confirmed cases,were analyzed retrospectively.General information,including age,gen-der,basic diseases,contact history,symptoms,lung CT and prognosis,were collected and analysed preliminarily.On January 20,2020,the COVID-19 outbreak was confirmed as"human to human transmission".COVID-19 infection of patients and medical staff in the wards were analysed,through the update of protection awareness and control measures.Department management,medical protection and standardized control procedures of trauma microsurgery were explored.Results Five cases with clinical diagnosis or confirmed COVID-19 were included.One was inpatient and the rest 4 were medical staff,aged 25-81 years,3 with confirmed and 2 with clinical diagnosis of COVID-19.After the treatment by specialists from Department of Infectious Disease and Department of Respiratory Disease,4 of infected persons were cured and 1 died.Since January 20,2020,when it was clear that the virus transmitted to people,there was no new case of infection among the medical staff and inpatients after the multidisciplinary collaboration in the ward prevention and control procedures were standardized and took in action.Conclusion The spread of the COVID-19 can be effectively controlled by standardised diagnosis and treatment procedurs in the word of trauma microsurgery.