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重症监护病房(ICU)中的严重急性呼吸综合征(SARS):降低医护人员的风险

Severe acute respiratory syndrome (SARS) in intensive care units (ICUs): limiting the risk to healthcare workers.

作者信息

Tang J W, Chan R C W

机构信息

Royal Free and University College Medical Schools, Centre for Virology, Division of Infection and Immunity, Windeyer Building, 46 Cleveland Street, London W1T 4JF, UK.

Department of Microbiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong Special Administration Region (SAR), China.

出版信息

Curr Anaesth Crit Care. 2004 Aug;15(3):143-155. doi: 10.1016/j.cacc.2004.05.003. Epub 2004 Jun 26.

Abstract

The global epidemic of severe acute respiratory syndrome (SARS) during the first half of 2003 resulted in over 8000 cases with more than 800 deaths. Many of those who eventually died, did so in the critical (intensive) care units of various hospitals around the world, and many secondary cases of SARS arose in healthcare workers looking after such patients in these units. Research on SARS coronavirus (SARS CoV) demonstrated that this virus belongs to the same family of viruses, the that causes the common cold, with some important differences. Properties of this virus have been discovered which can be used to develop important infection control policies within hospitals to limit the number of secondary cases. These properties include environmental survival, transmissibility, viral load in various organs and fluids and periods of symptomatic illness during which infectivity is greatest. Various barrier methods were used throughout the epidemic to protect healthcare workers from SARS, with varying degrees of success. Treatment of SARS patients has mainly involved steroid therapy, with or without ribavirin, but there is no consensus on the best treatment protocol, as yet. This review focuses on the implications of SARS for healthcare workers and patients on critical care units.

摘要

2003年上半年全球严重急性呼吸综合征(SARS)疫情导致8000多例病例,800多人死亡。许多最终死亡的患者是在世界各地医院的重症监护病房去世的,而且许多SARS二代病例出现在这些病房照顾此类患者的医护人员中。对SARS冠状病毒(SARS-CoV)的研究表明,这种病毒与导致普通感冒的病毒属于同一家族,但存在一些重要差异。已发现该病毒的一些特性,可用于制定医院内重要的感染控制政策,以限制二代病例数量。这些特性包括在环境中的存活能力、传播性、在各种器官和体液中的病毒载量以及传染性最强的症状期。在整个疫情期间,采用了各种屏障方法来保护医护人员免受SARS感染,效果各异。SARS患者的治疗主要涉及使用或不使用利巴韦林的类固醇疗法,但目前对于最佳治疗方案尚无共识。本综述重点关注SARS对重症监护病房医护人员和患者造成的影响。

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