2019冠状病毒病老年患者双肺移植围手术期感染防护策略

Perioperative infection prevention strategies for double-lung transplantation in elderly patients with COVID-19

目的:总结2例2019冠状病毒病(COVID-19)老年患者双肺移植围手术期的感染防护经验。方法:回顾性分析2020年3月浙江大学医学院附属第一医院收治的2例COVID-19老年患者双肺移植的临床资料,基于医护人员配备、呼吸道、压力性损伤、手术室空气、仪器设备、手术器械、病理标本以及信息化管理等,构建医护患防护体系。结果:2例患者双肺移植手术均顺利完成,患者无手术相关并发症,术后2~4 d顺利撤除体外膜氧合器,恢复良好。所有手术相关医护人员均无严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染。结论:充分进行术前准备、完善病理标本转运流程、妥善防护仪器设备、强化术中护理管理、重视预防压力性损伤并发症等措施,能够最大限度保障COVID-19手术患者及医护人员安全。

Objective:To summarize the experience of perioperative prevention during double-lung transplantation for elderly patients with coronavirus disease 2019(COVID-19).Methods:Clinical data of 2 elderly patients with COVID-19 who underwent double-lung transplantation in the First Affiliated Hospital of Zhejiang University School of Medicine in March 2020 were retrospectively reviewed.Perioperative protective measures were introduced in terms of medical staffing,respiratory tract,pressure injuries,air in operating room,instruments and equipment,pathological specimens,and information management.Results:Two cases of double-lung transplantation were successfully completed,and the patients had no operation-related complications.Extracorporeal membrane oxygenator was successfully removed 2 to 4 days after surgery and the patients recovered well.There was no infection among medical staff.Conclusion:Adequate preoperative preparation,complete patient transfer procedures,proper placement of instruments and equipment,strengthening of intraoperative care management,and attention to prevention of pressure injury complications can maximize the safety of COVID-19 patients and medical staff.