Gou S M, Yin T, Xiong J X, Peng T, Li Y, Wu H S
Department of Pancreatic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
Zhonghua Wai Ke Za Zhi. 2020 May 1;58(5):326-330. doi: 10.3760/cma.j.cn112139-20200224-00123.
To explore the proper protective measures for pancreatic diseases treatment during the outbreak of 2019 coronavirus disease(COVID-19). Clinical data of four cases of patients that suffered COVID-19 from February 2(nd) to February 9(th), 2020 at Department of Pancreatic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology were reviewed induding 4 males and 1 female, aging of 50, 51, 46, 87 years old, respectively. After the first patients cuffed nosocomial infection of COVID-19, the general protective measures were updated.Only one patient was admitted to each room alone, with no more than one caregiver. The body temperature of care givers was measured twice a day.Primary protections were applied to all staff.The floor was sterilized using disinfectant with an effective chlorine concentration of 1 000 mg/L. The protective measures for interventional procedures were as follow. Primary protection was applied to the operators of central venipuncture catheter, percutaneous abdominal/pleural drainage, percutaneous retroperitoneal drainage, percutaneous transhepatic cholangial drainage and other surgical procedures with local anesthesia and epidural anesthesia. Secondary protection was applied to the operators of endoscopic retrograde cholangiopancreatography and surgical procedures with general anesthesia. There were four patients who were diagnosed as COVID-19, of which one died of COVID-19, two were cured, and one was still in hospital for COVID-19. After the update of protective measures, no more nosocomial infection of COVID-19 occurred. Two central venipuncture catheter, three percutaneous abdominal or pleural drainage, one percutaneous retroperitoneal drainage, one percuteneous transhepatic cholecyst drainage and one open surgery with general anesthesia were performed with no infection of operators. The caregivers of patients are potential infection source of COVID-19. Enhanced protective measures including the management measures of caregivers can decrease the risk of nosocomial infection of COVID-19.
探索2019冠状病毒病（COVID-19）疫情期间胰腺疾病治疗的恰当防护措施。回顾了2020年2月2日至2月9日在华中科技大学同济医学院附属协和医院胰腺外科确诊为COVID-19的4例患者的临床资料，其中男性4例，女性1例，年龄分别为50岁、51岁、46岁、87岁。首例患者发生COVID-19医院内感染后，更新了一般防护措施。每间病房仅收治1例患者，陪护人员不超过1名。对陪护人员每天测量2次体温。对所有工作人员采取一级防护。地面使用有效氯浓度为1000mg/L的消毒剂进行消毒。介入操作的防护措施如下：中心静脉穿刺置管、经皮腹腔/胸腔引流、经皮腹膜后引流、经皮经肝胆道引流以及其他局部麻醉和硬膜外麻醉的手术操作，操作人员采取一级防护；内镜逆行胰胆管造影术及全身麻醉的手术操作，操作人员采取二级防护。4例确诊为COVID-19的患者中，1例死于COVID-19，2例治愈，1例仍因COVID-19住院。防护措施更新后，未再发生COVID-19医院内感染。进行了2次中心静脉穿刺置管、3次经皮腹腔或胸腔引流、一次经皮腹膜后引流、一次经皮经肝胆囊引流以及一台全身麻醉的开放手术，操作人员均未发生感染。患者的陪护人员是COVID-19的潜在感染源。加强包括陪护人员管理措施在内的防护措施，可降低COVID-19医院内感染风险。
