急诊和发热门诊新型冠状病毒奥密克戎变异株感染诊治方案

Diagnosis and treatment recommendations for SARS-CoV-2Omicron variant infection in emergency and fever clinics

目的制定新型冠状病毒奥密克戎(Omicron)变异株感染的急诊和发热门诊诊治方案。方法总结解放军总医院第一医学中心急诊科和发热门诊救治新型冠状病毒Omicron变异株感染患者经验,参考国内外相关指南和诊疗建议,结合文献报道撰写本文。结果新型冠状病毒Omicron变异株感染患者临床表现具有“双峰五层”显著特点,提出了不同病程阶段和层级患者的糖皮质激素和抗菌药物使用方案,并就治疗过程中需要关注的抗凝、血糖升高和医务人员自身防护等特殊问题提出建议。结论新型冠状病毒Omicron变异株感染,是综合性医院急诊科和发热门诊面临的新的临床挑战,“双峰五层”的急诊和发热门诊诊治方案,可以对提高救治水平、降低病死率有所帮助。

OBJECTIVE To put forward the diagnosis and treatment programs for SARS-CoV-2Omicron variant infection in emergency and fever clinics.METHODS The experiences in diagnosis and treatment of patients with SARS-CoV-2Omicron variant infection of emergency department and fever clinics of the First Medical Center of Chinese PLA General Hospital were summarized.The article was completed based on related guidelines and treatment recommendations at home and abroad,with the combination of literature report.RESULTS The patients with SARS-CoV-2Omicron variant infection showed remarkable clinical manifestations as‘doublet and five-layer’.The programs for use of glucocorticoids and antibiotics were proposed for the patients in different stages of disease course and levels,and proposals were raised for some special problems such as anticoagulation,rise of blood glucose and self-protection of health care workers.CONCLUSION The SARS-CoV-2Omicron variant infection is a new clinical challenge that the emergency department and fever clinic of a general hospital should be confronted with.The‘doublet and five-layer’diagnosis and treatment programs may help to raise the treatment level and reduce the mortality rate.