中华麻醉学杂志最新文献

英文中文

Constructing the system of epidemic prevention training to help the construction of the disciplinary connotation 构建防疫培训体系助力学科内涵建设

Q4 Medicine

中华麻醉学杂志

Pub Date : 2020-11-20 DOI: 10.3760/CMA.J.CN131073.20200310.01109

Xiang-yang Guo, Tianzuo Li, W. Mi, Yuguang Huang

引用次数: 0

Pediatric anesthesia-related specification during coronavirus disease 2019 epidemic 2019冠状病毒病流行期间小儿麻醉相关规范

Q4 Medicine

中华麻醉学杂志

Pub Date : 2020-03-20 DOI: 10.3760/CMA.J.CN131073.20200219.00306

Weifeng Yu, Yuguang Huang, L. Yang

Coronavirus disease 2019 is highly infectious and generally susceptible to all human beings Pediatric patients, as a special group which is prone to various respiratory infectious diseases, need more people to nurse and care and may cause a higher risk of cross-infection Therefore, greater attention should be paid to this group During the prevention and control of coronavirus disease 2019, it is an urgency to ensure the safety of children and medical staff, avoid cross-infection, reduce anesthesia-related complications, and accelerate the rehabilitation of pediatric patients The article introduces the following aspects based on the problem mentioned above: (1) perioperative treatment of surgery, involving preoperative consultation and assessment, necessity of surgery, arrangement of operating room, precautions during surgery, protection of children and medical staff, and the transportation route planning;(2) anesthesia process, including pick-up of the pediatric patient, preoperative sedation, choice of anesthesia method, anesthesia induction, identification and management of difficult airways, intraoperative management, as well as problems related to the extubation;(3) the disinfection of the ground, air and medical equipment after surgery, and registration and follow-up of the children;(4) protection and preparation of emergency tracheal intubation, selection and performance of intubation, precautions in intubation and judgement after intubation outside the operating room;(5) protection and preparation of central vein catheterization, selection of the catheter, anesthesia management of the central vein catheterization and relevant precautions;(6) protection of medical staff, sedation program and sedation procedure during the comfort treatment in outpatient sedation center;(7) problems of family signature of the in-hospital treatment for pediatric patients during special epidemic period © 2020 Chinese Medical Association

小儿患者作为易患各种呼吸道传染病的特殊群体，需要更多的人护理和护理，并可能造成较高的交叉感染风险，因此，在2019冠状病毒病的防控过程中，迫切需要确保儿童和医护人员的安全，避免交叉感染。减少麻醉相关并发症，加快小儿患者康复。针对上述问题，本文介绍了以下几个方面:(1)手术围术期处理，包括术前会诊评估、手术必要性、手术室布置、术中注意事项、患儿及医护人员保护、运输路线规划等;(2)麻醉过程，包括儿科患者的接送、术前镇静、麻醉方式的选择、麻醉诱导、困难气道的识别与处理、术中管理等;(3)术后地面、空气及医疗设备的消毒，患儿的登记与随访;(4)急诊气管插管的保护与准备，插管的选择与操作，插管时的注意事项，手术室外插管后的判断;(5)中心静脉置管的保护与准备，导管的选择，中心静脉置管麻醉管理及注意事项;(6)门诊镇静中心舒适治疗期间医护人员的保护、镇静方案及镇静程序;(7)特殊疫情期间儿科患者住院治疗家属签名问题©2020中华医学会

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引用次数: 0

Anesthesia management for cesarean section during coronavirus disease 2019 epidemic 2019冠状病毒病流行期间剖宫产的麻醉管理

Q4 Medicine

中华麻醉学杂志

Pub Date : 2020-03-20 DOI: 10.3760/CMA.J.CN131073.20200210.00308

Zhi-qiang Zhou, Xingxing Sun, Shiyong Li, L. Wan, A. Luo, Dongji Han

Thirty-six puerperas who underwent emergency cesarean section at Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology from January 24, 2020 to February 9, 2020, who all wore medical surgical masks, were retrospectively included in this study Anesthesia management was performed under tertiary medical protection measures A dedicated anesthesia equipment was separately sterilized Narcotic drugs were used for one patient only, and disposable medical supplies were used for anesthetic supplies Contact transmission should be avoided when a neonate required resuscitation, and early isolation and nucleic acid testing were provided for the neonates The rate of suspected cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was 11% , and the rate of clinically diagnosed cases was 17% before surgery The rate of clinically diagnosed cases of SARS-CoV-2 was 22%, the rate of confirmed cases was 8%, and the total positive rate of diagnosis was 31% after surgery The rate of neuraxial anesthesia was 86%, the rate of general anesthesia was 14%, the time of spinal puncture was (15±7) min, the time of tracheal intubation under general anesthesia was (2 1±1 3) min, the operation time was (95±36) min, and blood loss was (276±166) ml The Apgar score of newborns was 8 8±0 5 There was 1 neonate whose mother was diagnosed as having coronavirus disease 2019 after operation, an oropharyngeal swab specimen was obtained at 36 h of birth, and the swab was tested positive for SARS-CoV-2 by nucleic acid testing As of February 10, 2020, an anesthesiologist involved in the operation was diagnosed to have infection by SARS-CoV-2 In conclusion, diagnosis of coronavirus disease 2019 during pregnancy is more difficult, it is necessary to perform anesthesia management for cesarean section under tertiary medical protection Although the difficulty in anesthesia operation is increased under tertiary medical protection, anesthesiologists can carry out standardized anesthesia management and guarantee the safety of maternal and infants and anesthesiologists themselves as long as they are rigorously trained and adhere to protective protocols © 2020 Chinese Medical Association

2020年1月24日至2020年2月9日在华中科技大学同济医学院附属同济医院急诊剖宫产的36名产妇，均佩戴医用外科口罩，回顾性纳入本研究。麻醉管理是在三级医疗保护措施下进行的。专用麻醉设备单独消毒。麻醉药品仅用于一名患者，麻醉用品使用一次性医疗用品。当新生儿需要复苏时，应避免接触传播，为新生儿提供早期隔离和核酸检测严重急性呼吸综合征冠状病毒2型疑似病例率为11%，术前临床诊断病例率为17%，术后诊断总阳性率为31%。神经轴麻醉率为86%，全麻率为14%，脊椎穿刺时间为（15±7）min，全麻下气管插管时间为（2 1±1 3）min，手术时间为（95±36）min，失血量为（276±166）ml。新生儿Apgar评分为8.8±0.5。有1名新生儿的母亲在手术后被诊断为2019冠状病毒病，出生36小时时采集口咽拭子样本，核酸检测拭子检测出严重急性呼吸系统综合征冠状病毒2型阳性。截至2020年2月10日，一名参与手术的麻醉师被诊断为感染了严重急性呼吸系统综合征冠状病毒2型。总之，2019年妊娠期间冠状病毒疾病的诊断更困难，有必要在三级医疗保护下对剖宫产进行麻醉管理。尽管在三级医疗保护下麻醉手术的难度增加，麻醉师只要经过严格的培训并遵守防护规程，就可以进行规范的麻醉管理，保障母婴和麻醉师自身的安全©2020中华医学会

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引用次数: 0

Fighting against coronavirus disease 2019 outbreak: improvement in anesthesia-related infection control 抗击2019冠状病毒病爆发：麻醉相关感染控制的改进

Q4 Medicine

中华麻醉学杂志

Pub Date : 2020-03-20 DOI: 10.3760/CMA.J.CN131073.20200213.00301

Guyan Wang, Xiang-yang Guo

引用次数: 0

Recommendations for obstetric anesthesia during coronavirus disease 2019 epidemic 2019冠状病毒病流行期间产科麻醉建议

Q4 Medicine

中华麻醉学杂志

Pub Date : 2020-03-20 DOI: 10.3760/CMA.J.CN131073.20200228.00305

Shoujun Li, Yuguang Huang, Hailong Dong, Z. Lu

Obstetric anesthesia is an important part of clinical anesthesia during the coronavirus disease 2019(COVID-19 )epidemic Obstetric anesthesia management faces challenges such as difficulty in evaluation, in managing patients with emergent or fluctuating conditions, and in taking care of both the mother and the fetus/newborn Obstetric anesthesia should focus on the following aspects First, detailed evaluation of COVID-19 should be carried out Except for epidemic-related evaluation, the effect of physiologic changes during pregnancy and complex condition of the parturient and critical condition on COVID-19 evaluation should be considered The possible effects of maternal lung conditions on the fetus should be paid attention to simultaneously to determine the optimal timing for delivery, delivery mode and degree of protection Second, tight infection control of the environment, staff and devices is necessary Delivery of the suspected or diagnosed cases of novel coronavirus infection should be performed in an isolation delivery room or in a negative pressure operating room Anesthetic personnel should be minimized, and skilled anesthetists should be arranged in priority Medical staff should wear personal protective equipment according to standards Third, the keypoint of optimizing anesthesia management is to maintain sufficient oxygenation and stable circulation For neuraxial anesthesia, coughing and hypotension should be minimized For general anesthesia, protection from infection during airway management is essential Fourth, humanistic care should be implemented, and psychological health education and psychological crisis intervention should be conducted for parturients Fifth, though no evidence supported the vertical transmission yet, the newborn of the suspected or diagnosed mother of novel coronavirus infection should be isolated, and breastfeeding is not permitted until the mother recover To minimize the risk of infection and optimize clinical safety, multi-discipline-based teamwork by the obstetricians, anesthetists, neonatologists, infect-control experts and intensive care unit staff on infection control and maternal-fetal management is important © 2020 Chinese Medical Association

产科麻醉是2019冠状病毒病(COVID-19)流行期间临床麻醉的重要组成部分。产科麻醉管理面临着评估困难、急救或波动患者管理困难、兼顾母婴/新生儿等挑战。产科麻醉应重点做好以下几个方面的工作:一是对COVID-19进行详细评估，除疫情相关评估外;应考虑妊娠期生理变化、产妇复杂情况及危重情况对COVID-19评估的影响，同时关注产妇肺部状况对胎儿可能产生的影响，确定最佳分娩时机、分娩方式及防护程度。新型冠状病毒感染疑似病例或确诊病例的接生应在隔离产房或负压手术室进行，尽量减少麻醉人员，优先安排熟练麻醉师。医务人员应按标准穿戴个人防护用品。优化麻醉管理的关键是保持充足的氧供和稳定的循环。对于轴向麻醉，应尽量减少咳嗽和低血压。对于全麻，气道管理过程中应防止感染。第四，应实施人文关怀，对产妇进行心理健康教育和心理危机干预。第五，虽然目前还没有证据支持垂直传播。对于疑似或确诊为新型冠状病毒感染的母亲，应对其新生儿进行隔离，在母亲康复前不允许母乳喂养。为最大限度地降低感染风险，优化临床安全，产科医生、麻醉师、新生儿科医生、感染控制专家和重症监护病房工作人员开展多学科合作，控制感染和母婴管理是重要的©2020中华医学会

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引用次数: 0

Expert recommendations for tracheal intubation in critically ill patients with coronavirus disease 2019 (Version 1.0) 2019冠状病毒病危重患者气管插管专家建议（1.0版）

Q4 Medicine

中华麻醉学杂志

Pub Date : 2020-03-20 DOI: 10.3760/CMA.J.CN131073.20200218.00307

M. Zuo, Yuguang Huang

引用次数: 2

Anesthesiologist’s learning from experience of participating in the treatment of critically ill patients with COVID-19 in isolation wards 麻醉师参与隔离病房新冠肺炎危重患者救治经验的学习

Q4 Medicine

中华麻醉学杂志

Pub Date : 2020-03-13 DOI: 10.3760/CMA.J.ISSN.0254-1416.2020.0011

Xueyin Chen, Gang Wang, Kai Yang, Jing Wu, Xiangdong Chen

After the outbreak of 2019 novel coronavirus diseases (COVID-19), the number of severe cases in Wuhan increased dramatically, which was far beyond the load of ICU. As a result, the isolation ward became the place for the treatment of severe cases. Because the important role of anesthesiologists, more than 20 anesthesiologists from Union Hospital of Tongji Medical College, Huazhong University of Science and Technology have been sent to eight isolation wards of severe patients. They have participated in the treatment of more than 800 severe COVID-19 patients, including more than 300 critical cases and more than 120 cases were getting better recovery. Their work included endotracheal intubation, central venous catheterization, artery cannulation and blood gas analysis, and bedside cardiopulmonary ultrasound examination, and more importantly they have played an important role in respiratory management after endotracheal intubation, the treatment of cardiovascular events and precise fluid therapy. During these works, anesthesiologists improved their own professional skills through the cooperation with other specialists, including the standard writing skills of medical records and prescription, appropriate protection against infectious diseases, standard medication and oxygen therapy for respiratory diseases, and the capability of continuously management of critical cases. Key words: Anesthesiologists; Hospitals, isolation; Critical care; COVID-19

2019年新型冠状病毒疾病（新冠肺炎）爆发后，武汉重症病例急剧增加，远远超过ICU的负荷。因此，隔离病房成了治疗重症病例的地方。由于麻醉师的重要作用，华中科技大学同济医学院附属协和医院的20多名麻醉师被派往8个重症患者隔离病房。他们参与了800多名新冠肺炎重症患者的治疗，其中包括300多例危重病例，120多例康复情况较好。他们的工作包括气管插管、中心静脉插管、动脉插管和血气分析、床边心肺超声检查，更重要的是，他们在气管插管后的呼吸管理、心血管事件的治疗和精确的液体治疗中发挥了重要作用。在这些工作中，麻醉师通过与其他专家的合作，提高了自己的专业技能，包括病历和处方的标准书写技能、适当的传染病防护、呼吸系统疾病的标准药物和氧气治疗，以及持续管理危重病例的能力。关键词：麻醉师；医院，隔离；重症监护；新冠肺炎

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引用次数: 0

Infection control in a department of anesthesiology during the epidemic period of COVID-19: experience of Wuhan Union Hospital 新冠肺炎疫情期间麻醉科感染控制——武汉协和医院的经验

Q4 Medicine

中华麻醉学杂志

Pub Date : 2020-03-08 DOI: 10.3760/CMA.J.ISSN.0254-1416.2020.0010

X. Lan, Lei Yang, Jing Wu, Zhouyang Wu, Ken Ling, Cuicui Sun, Xiangdong Chen

During the prevention and control of coronavirus disease 2019 (COVID-19) epidemic, our hospital was a designated hospital for the treatment of COVID-19, and established the infection control system in the department of anesthesiology according to the clinical practice The relevant staff of our hospital strictly followed the rules and procedures for operation, and no staff members were found to be infected by emergency surgical anesthesia performed in COVID-19 patients The experience is summarized as follows: timely establishment and unified command of the emergency infection control management team in the department of anesthesiology;scientific formulation and dynamic improvement in comprehensive, systematic and feasible infection control strategies, norms and procedures;clear division of responsibilities and adequate management and supervision of infection control management team members;carrying out strict training of infection control, establishing a good awareness of infection control in the operating room, and implementing standard infection control procedures from the medical staff of the department to the cleaning staff © 2020 Chinese Medical Association

在2019冠状病毒病(COVID-19)疫情防控过程中，我院作为COVID-19定点救治医院，根据临床实践建立了麻醉科感染控制制度，我院相关工作人员严格按照操作规则和程序进行操作，无工作人员因新冠肺炎患者急诊手术麻醉感染。总结如下:及时建立并统一指挥麻醉科突发感染控制管理团队，科学制定并动态完善全面、系统、可行的感染控制策略、规范和程序，明确责任分工，对感染控制管理团队成员进行充分的管理和监督，严格开展感染控制培训;树立良好的手术室感染控制意识，从科室医务人员到保洁人员执行标准的感染控制程序©2020中华医学会

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引用次数: 0

Details of anesthesia-related infection control: inspiration from COVID-19 epidemic 麻醉相关感染控制的细节：新冠肺炎疫情的启示

Q4 Medicine

中华麻醉学杂志

Pub Date : 2020-03-05 DOI: 10.3760/CMA.J.ISSN.0254-1416.2020.0009

Yingjie Du, Hao Cheng, Jun Li, Guyan Wang

引用次数: 1

Recommendations for anesthesia management and infection control in elderly patients with COVID-19 老年COVID-19患者麻醉管理和感染控制建议

Q4 Medicine

中华麻醉学杂志

Pub Date : 2020-03-05 DOI: 10.3760/CMA.J.ISSN.0254-1416.2020.00.101

Tianlong Wang, Yuguang Huang, Xiangdong Chen, A. Luo, Z. Xia, Zongze Zhang, Dongxin Wang, W. Ouyang, Min Yan, W. Mei, Min Li, Qian Li, Wei Xiao, Xiaoming Deng, Lize Xiong

During the epidemic of coronavirus disease 2019 (COVID-19), the infection of the elderly population will bring great challenges to clinical diagnosis and treatment, outcome and management Combined with the characteristics of anesthesia and the pathophysiological characteristics of COVID-19 on lung function impairment in elderly patients, Chinese Society of Anesthesiology formulated the " Recommendations for anesthesia management and infection control in elderly patients with COVID-19″ This recommendation expounds preoperative visit and infection control, anesthesia management protocol, anesthesia monitoring, anesthesia induction/endotracheal intubation, anesthesia maintenance and infection control, intraoperative lung protection strategy, anti-stress and anti-inflammatory management, hemodynamic optimization, infection control during emergence from anesthesia, and postoperative analgesia in elderly patients with COVID-19, and provides the reference for the safe and effective implementation of anesthesia management in elderly patients during the prevention and control of COVID-19 epidemic © 2020 Chinese Medical Association

在2019冠状病毒病(COVID-19)流行期间，老年人群的感染将给临床诊疗、结局和管理带来巨大挑战，结合麻醉的特点和COVID-19的病理生理特点对老年患者肺功能损害的影响，中国麻醉学会制定了《老年COVID-19患者麻醉管理和感染控制建议″》，该建议阐述了术前访诊和感染控制、麻醉管理方案、麻醉监测、麻醉诱导/气管插管、麻醉维持和感染控制、术中肺保护策略、抗应激和抗炎管理、血流动力学优化、为老年患者在新冠肺炎疫情防控过程中安全有效地实施麻醉管理提供参考©2020中华医学会

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引用次数: 0

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