大型综合性医院疑似新型冠状病毒感染患者急诊手术的应急管理

Emergency management of emergency surgery for patients with suspected COVID-19 in a large-scale general hospital

目的探讨大型综合医院开展疑似新型冠状病毒感染患者急诊手术应急管理方法和经验。方法依据国家卫生健康委员会出台的关于新型冠状病毒感染患者防控诊治指南规范,于2020年2月2日-3月14日医院开展5例疑似新型冠状病毒感染患者急诊手术,从患者的病情评估、术前准备、手术间及器材设备准备、手术人员管控、麻醉防护特点、术中护理关键点及术后环境、器械、用物处置的特殊性进行积极探索。严格核查血常规、胸部X线片和CT结果并报备科室登记。不断优化应急管理能力和措施。结果5例患者手术过程顺利,手术效果良好,无手术并发症,患者及所有参与手术人员均未出现交叉感染。结论卫健委出台的关于新型冠状病毒感染患者防控诊治指南规范实施效果良好,疑似新型冠状病毒感染患者急诊手术期间医务人员提高警惕,加强感染控制观念和手术室管理,既能保证急诊手术的顺利进行,又能避免出现院内交叉感染。

OBJECTIVE To explore the measures and experience of emergency management of emergency surgery for the patients with suspected COVID-19.METHODS On the basis of the guidelines for prevention,control,diagnosis and treatment of patients with COVID-19 released by the National Health Committee of the People′s Republic of China,the emergency surgeries were carried out for 5 patients with suspected COVID-19 in the hospital from Feb.2,2020 to Mar.14,2020.The emergency surgeries,involving the evaluation of illness condition,preoperative preparation,preparation of operating room and equipment,management and control of personnel,characteristics of anesthesia protection,key points of postoperative nursing and particularities of postoperative environment,equipment and disposal of materials,were actively explored.The results of blood routine test,chest X-ray and CT were carefully checked and reported for registration.The capability and measures of the emergency management were continuously optimized.RESULTS The surgeries of the 5 patients were successful and achieved favorable effect,and the patients did not have the surgery-induced complications.Neither the patients nor the surgery staff had cross infection.CONCLUSION The guidelines for prevention,control,diagnosis and treatment of the COVID-19 patients released by the National Health Committee of the People′s Republic of China achieves remarkable effect.It is necessary for the health care workers to raise their vigilance during the emergency surgery for the patients with suspected COVID-19 and intensify the concept of control of infection and management of operating room so as to ensure the smooth progress of emergency surgery and prevent cross infection in the hospital.