新型冠状病毒肺炎阴影下急诊血管手术的诊断与合理方法

J. Bai, L. Qu, Jie Jin, Jianjin Wu
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摘要

目的探讨新冠肺炎(2019冠状病毒病)保障区血管外科突发事件的安全、有效、快速救援方法和管理要点。方法在新冠肺炎诊疗指南指导下,对我科2020年2月1日至2月10日收治的4例血管外科急诊患者进行新冠肺炎筛查,并给予急诊血管外科治疗。结果2例患者为急性胸主动脉夹层,1例患者为感染性急性左脚溃疡,1例为严重颈动脉狭窄和频繁短暂性脑缺血发作。根据三级分诊流程,所有患者都得到了快速诊断。血管内修复术(TEVAR)2例,颈动脉支架置入术1例,左脚截肢术1例。两名术后发热低于38℃的患者被安全排除在新冠肺炎之外并治愈。没有其他重大疾病,也没有死亡。结论在新冠肺炎防控指南指导下,建立一套全面的病医结合管理防控体系,有助于血管外科急诊手术的实施。关键词:冠状病毒感染;血管外科手术;应急处理
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Diagnosis and rational approach to emergency vascular surgery in the shadow of novel coronavirus pneumonia/ 中华普通外科杂志
Objective To explore a safe, effective and rapid rescue method and key points for the management of vascular surgical emergencies in an area under guaranting Covid-19 (corona virus disease 2019) . Methods Under the guidance of COVID-19 diagnosis and treatment guidelines , 4 cases of vascular surgical emergency patients admitted to our department from Feb 1 to Feb 10, 2020 were screened for COVID-19 and given emergency vascular surgical treatment. Results Two patients had acute thoracic aortic dissection, one patient had acute left foot ulcer with infection, one patient had severe carotid artery stenosis and frequent TIA. All patients were diagnosed quickly according to the three-level triage process. Endovascular repair (TEVAR) was performed in 2 cases, carotid stenting in 1 case, and left foot amputation in 1 case. Two patients running postoperative fever below 38℃ were safely excluded COVID-19 and cured. There were no other major morbidities nor mortality. Conclusions Under the COVID-19 prevention and control guidelines, the establishing of a comprehensive prevention and control system of patient-medicine-care-management helps to perform confine operation on vascular surgical emergency. Key words: Coronavirus Infection; Vascular surgical procedures; Emergency treatment
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