一例晚期新型冠状病毒肺炎肺移植手术感染防控实践

Safety and nosocomial infection control in lung transplantation for a case of COVID-19 with end-stage ARDS

目的:总结和探索新型冠状病毒肺炎终末期呼吸衰竭患者行肺移植手术感染防控措施。方法:1例新型冠状病毒肺炎终末期呼吸衰竭患者,核酸转阴后实施了抢救性肺移植术。手术前所有人员进行医院感染培训和模拟训练。手术在负压手术室内进行,术前30 min开启高净化和负压系统。手术人员均实施三级防护措施,佩戴电动送风正压防护面罩。术中按照医院感染防护流程管理。术后对环境和医疗器械进行消毒处理。结果:手术过程顺利,术后对受者多次核酸检测均呈阴性。参与手术人员术后进行14 d医学隔离观察,期间2次核酸检测均为阴性。结论:作为一种探索性的救治技术,在专用的负压手术室内和三级防护条件下,肺移植治疗COVID-19终末期呼吸衰竭患者是一种安全的方法。

Objective To explore the safety and nosocomial infection control measures of COVID-19 patients of end-stage respiratory failure after lung transplantation.Methods Lung transplantation was performed for a COVID-19 patient with end-stage respiratory failure after a negative conversion of 2019-nCoV nucleic acid.Before operation,all medical staff received simulated training on nosocomial infection.The procedures were performed in an operation room with a negative pressure environment.The three-grade preventive strategy was implemented and wearing positive pressure protective mask of electric air supply required.During operation,the patient was managed according to the in-hospital protection process.The environment and medical instruments were disinfected after operation.Results The operation was completed successfully.The 2019-nCoV nucleic acid test was negative for many times after operation.Participants were placed in medical isolation for 14 days after surgery.During the period,nucleic acid test was negative twice.Conclusions As an exploratory treatment,lung transplantation is a safe option for end-stage respiratory failure in COVID-19 in operation room with a negative pressure environment and implementations of three-grade preventive strategy.