2019冠状病毒病流行期创伤骨科急诊诊治对策

Yue Yang, Aixi Yu, Wen-bing Xiao, Zhibo Sun, Feng Liu, Fei Wu
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引用次数: 3

摘要

目的探讨2019冠状病毒病(COVID-19)流行期创伤骨科急诊诊治策略。方法对2020年1月21日至2月15日武汉大学人民医院骨科收治的128例骨科创伤患者进行急诊救治。男性71例,女性57例,平均年龄48.7岁(5 ~ 88岁)。其中门诊107例,住院21例。紧急手术4例,选择性手术17例。在患者和医务人员中也记录了COVID-19感染。总结新冠肺炎疫情发生以来采取的措施和取得的经验。结果107例门诊确诊病例3例,疑似病例3例。4例急诊手术病例中,1例疑似感染新冠肺炎。在接受选择性手术的17例患者中,确诊1例,疑似2例。两名护士被确诊为轻度covid -19。1名医生和1名护士疑似感染COVID-19。由于医务人员感染病例均发生在新冠肺炎防控措施实施之前,不排除其感染可能来自社区。结论各级医疗机构在做好新冠肺炎疫情防控工作的同时,保持安全有效的日常服务尤为重要。在新冠肺炎疫情中,急诊创伤骨科一线医护人员在诊治患者的过程中面临着巨大的挑战。只要严格新入院患者筛查、住院患者分类管理、优化住院病房管理、规范围手术期预防措施、完善医疗防护制度、对患者及护理人员进行医学教育,有效控制院内感染,就能提供优质安全的医疗服务。关键词:2019冠状病毒病;骨科;伤口和伤害;围手术期处理;预防
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Strategies suggested for emergency diagnosis and treatment of traumatic orthopedicsin the epidemic periodof Corona Virus Disease 2019/ 中华创伤骨科杂志
Objective To suggest strategies for emergency diagnosis and treatment of trauma orthopedics in the epidemic period of Corona Virus Disease 2019(COVID-19). Methods In the epidemic of COVID-19 from January 21 to February 15, 2020, 128 patients with orthopaedic trauma sought emergency treatment at Department of Orthopedic Surgery, The People’s Hospital of Wuhan University. They were 71 males and 57 females with an average age of 48.7 years (from 5 to 88 years).Of them, 107 cases were treated at the outpatient department and 21 hospitalized. Emergency operations were carried out for 4 cases and selective operationsfor 17 cases. COVID-19 infections were recorded in the patients and medical staff as well. Measures taken and experiences learned were summarized since the epidemicoutbreak of COVID-19. Results Of the 107 cases treated at the outpatient department, 3 had a definite diagnosis of COVID-19 and 3 a suspected diagnosis of COVID-19. Of the 4 cases undergoing emergency surgery, one was suspected of having COVID-19. Of the 17 cases undergoing selective surgery, one was diagnosed definitely as COVID-19and 2 were suspected of COVID-19. Two nurses were diagnosed definitely as having mildCOVID-19.One doctor and one nurse were suspected of COVID-19. Since the COVID-19 infections in medical staff occurred all before the preventive and control measures for COVID-19 had been implemented,is was not ruled out that their infections might have come from communities. Conclusions It is particularly important for medical institutions of all levels to maintain safe and effective routine services while doing well in COVID-19 prevention. In the epidemic of COVID-19, front-line medical staff in emergency traumatic orthopedics is faced with great challenges in the process of diagnosing and treating patients. High-quality and safe medical services can be provided as long as nosocomial COVID-19infection is effectively controlled by rigid screening of patientsnewly admitted, classified management of inpatients, optimal management of inpatient wards, standard preventive measures in perioperative period, a perfect system for medical protection, and medical education for patients and their carers. Key words: Corona Virus Disease 2019; Orthopaedics; Wound and injuries; Perioperative period; Prevention
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