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| 围术期新型冠状病毒肺炎患者感染防控相关建议解读 |
| Explanation of perioperative precautions related recommendations for novel coronavirus patients |
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| DOI：10.12089/jca.2020.02.001 |
| 中文关键词: 新型冠状病毒 新型冠状病毒肺炎 感染防控 个人防护设备 围术期管理 |
| 英文关键词: 2019-nCoV COVID-19 Infection control precaution Personal protective equipment Perioperative management |
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| 中文摘要: |
由2019新型冠状病毒(2019-nCoV)引起的新型冠状病毒肺炎(COVID-19)是一种传染性极强的感染性疾病。多数新型冠状病毒肺炎患者症状较轻,表现为发热、乏力和干咳等症状,但重症患者可迅速发展为急性呼吸窘迫综合征(ARDS)、感染性休克、严重的酸中毒和凝血功能紊乱。此类重症患者往往需要行气管插管和机械通气,且部分非重症患者也可能因急诊手术需行全身麻醉。2019-nCoV可通过飞沫、接触和气溶胶等途径在人与人之间进行传播。而气道管理过程中,医务人员可能接触病毒载量很高的呼吸道飞沫和气溶胶,所以具有极高的职业暴露风险。加强围术期医护人员和手术室的感染防控对于预防院内聚集性感染非常重要。中华医学会麻醉学分会和中国医师协会麻醉学医师分会先后制定了《新型冠状病毒肺炎危重型患者气管插管术的专家建议(10版)》和《新型冠状病毒肺炎患者围术期麻醉工作指导及感染防控建议》,对围术期和围插管期的感染防控提出了原则性的指导。本文结合这两个建议,以及《新型冠状病毒肺炎防控指南(第五版)》和《普通物体表面消毒剂的卫生要求》,对围术期新型冠状病毒肺炎患者感染防控提出详细的操作性建议,供基层医务人员参考。 |
| 英文摘要: |
Coronavirus disease 2019 (COVID-19), caused by a novel coronavirus (2019-nCoV), is a highly contagious disease. Most of the infected patients have mild symptoms including fever, fatigue and cough. But in severe cases, patients can progress rapidly and develop to acute respiratory distress syndrome (ARDS), septic shock, metabolic acidosis and coagulopathy. Most severe cases need endotracheal intubation and mechanical ventilation, and some mild cases may need emergent surgery under general anesthesia. The new coronavirus was reported to spread via droplets, contact and natural aerosols from human-to-human. Therefore, high-risk aerosol-producing procedures such as endotracheal intubation and airway suction might put the health providers into high risk of nosocomial infections. Chinese Society of Anesthesiologists and Chinese Association of Anesthesiologists have issued Expert Recommendations for Tracheal Intubation in Critically ill Patients with Noval Coronavirus Disease 2019 and Safe Medical Practice and Infection Control Precautions for Perioperative Management of Patient Infected with the Novel Coronavirus to provide principle guidelines for perioperative management and endotracheal intubation in COVID-19 patients. This article aims to develop more detailed workable recommendations for the primary anesthesiologists. All the suggestions are in accordance with the two above recommendations, as well as Infection Control Precautions for Novel Coronavirus and Hygienic Requirements for Disinfectants for Common Objects’ Surface. |
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