Division of Infectious Diseases, Emory University School of Medicine, 101 Woodruff Circle, WMRB 2101, Atlanta, GA, 30322, USA.
Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, 101 Woodruff Circle, WMRB 2101, Atlanta, GA, 30322, USA.
Curr Top Microbiol Immunol. 2017;411:115-137. doi: 10.1007/82_2017_19.
Like most viral illnesses in humans, supportive care of the patient is the mainstay of clinical care for patients with Ebola virus disease (EVD). The goal is to maintain and sustain the patient until a specific immune response develops and clears the viral infection. Clearly, antiviral therapy may eventually help speed recovery, but supportive care will likely always be the centerpiece of care of the patient with EVD. While terrible in terms of human suffering and loss, the EVD outbreak of 2014-2016 provided an unheralded opportunity to advance our understanding in the care of patients (WHO 2016). Regardless of the care setting, resource-rich or resource-constrained, it is beneficial to have an established team of care providers. This team should consist of nurses and physicians who are familiar with clinical care of patients with EVD and have demonstrated competency using necessary personal protective equipment (PPE). Consideration should be given to having several physician specialties on the team, including critical care, infectious diseases, and anesthesiology. Additional individuals in other medical specialties should be identified in case needed during the course of caring for a patient. The National Ebola Training and Education Center (NETEC) has detailed guidance on preparations for developing a high-containment unit and care team (NETEC 2016).
与人类的大多数病毒性疾病一样,对埃博拉病毒病(EVD)患者的主要临床治疗方法是提供支持性护理。治疗目标是维持和支持患者,直到产生特定的免疫反应并清除病毒感染。显然,抗病毒疗法最终可能有助于加快康复,但支持性护理仍可能始终是 EVD 患者护理的核心。尽管这场疫情给人类带来了巨大的痛苦和损失,但 2014-2016 年的埃博拉疫情为我们深入了解患者护理提供了一个前所未有的机会(世界卫生组织,2016 年)。无论护理环境是资源丰富还是资源有限,建立一支由熟悉 EVD 患者临床护理且已熟练掌握必要个人防护装备(PPE)使用方法的护理提供者组成的固定团队都是有益的。应考虑让包括重症监护、传染病和麻醉学在内的多个医师专业领域的人员加入团队。还应确定其他医疗专业的其他人员,以便在照顾患者的过程中根据需要进行调配。国家埃博拉培训和教育中心(NETEC)就建立高防护病房单元和护理团队的准备工作提供了详细指导(NETEC,2016 年)。