新型冠状病毒肺炎疫情防控一级响应对经内镜建立肠内营养通路时机的影响

Impact of the Health Emergency Response Level one for COVID-19 on the Timing of Endoscopic Enteral Nutrition Access Establishment

目的评价新型冠状病毒肺炎(COVID-19)疫情防控一级响应对经胃肠内镜建立肠内营养通路(EENA)时机的影响。方法回顾性分析笔者医院在福建省COVID-19疫情防控一级响应期内(一级响应组)、疫情发生前1 a(常态诊疗组)及既往5 a春节期间(历年春节组)急诊胃肠内镜中EENA病例的构成比。结果一级响应期间完成急诊胃肠镜123例,无院内感染发生。一级响应组EENA比例为37.40%(46/123),与常态诊疗组的35.31%(510/1444)比较,差别无统计学意义(P>0.05),较历年春节组的2.17%(1/46,1例为肠梗阻导管置管)增高(P<0.05);常态诊疗组和一级响应组小肠营养置管的比例分别为6.65%(96/1444)和11.38%(14/123)(P<0.05),其中上消化道肿瘤分别占12.28%(7/57)和38.46%(5/13)(P<0.05);因消化道狭窄行内镜下切开或球囊扩张的比例分别为9.00%(130/1444)和3.25%(4/123)(P<0.05);经鼻/经肛肠梗阻导管置管、食管/胃/肠道自膨式支架置入和经皮内镜胃肠造口比例相当(P>0.05)。结论在一级响应期间仍存在经内镜EENA的现实需求,有必要将其调整为急诊胃肠镜适应证。

Objective To evaluate the impact of health emergency response level one(HER1)for COVID-2019 on the timing of endoscopic enteral nutrition access(EENA)establishment.Methods Emergency endoscopic cases during HER1(HER1 group),one year before the COVID-2019 outbreak(normal group)and Spring Festival holidays for 5 consecutive years(SF group)were enrolled,while the percentages of EENA were analyzed,respectively.EENA cases included intestine nutritional tube placement(INT),stenosis with endoscopic incision and/or balloon dilation(EI/BD),nasal/anal bowel obstruction catheter placement(BOC),esophageal/stomach/intestinal self-expanding stent placement(SES)and percutaneous endoscopic gastrostomy(PEG).Results During HER1 period,a total of 123 cases of emergency gastrointestinal endoscopy were performed,while no hospital infection case was found.The percentage of EENA was 37.40%(46/123)in HER1 group,which showed no significant difference(P>0.05)when compared with normal group(35.31%,510/1444),but higher(P<0.05)than that in SF group(2.17%,1/46).The percentages of INT in HER1 group and normal group were 6.65%(96/1444)and 11.38%(14/123)(P<0.05),respectively,while the percentages of upper gastrointestinal tumor cases with INT were 12.28%(7/57)and 38.46%(5/13)(P<0.05),respectively.In HER1 group and normal group,EI/BD cases were 9.00%(130/1444)and 3.25%(4/123),respectively(P<0.05),while the percentages of BOC,SES and PEG showed no significant difference(P>0.05).Conclusion EENA has been shown as a real demand even during HER1 period,and should be added to emergency endoscopic indications during this kind of situation.