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泌尿外科医生需要了解什么:2019冠状病毒病大流行期间的诊断、治疗及随访

What do urologists need to know: Diagnosis, treatment, and follow-up during COVID-19 pandemic.

作者信息

Ho Hui Ching, Hughes Thomas, Bozlu Murat, Kadıoğlu Ateş, Somani Bhaskar K

机构信息

University Hospital Southampton, Southampton, UK.

Department of Urology, Mersin University School of Medicine, Mersin, Turkey.

出版信息

Turk J Urol. 2020 Apr 14;46(3):169-177. doi: 10.5152/tud.2020.20119. Print 2020 May.

Abstract

Coronavirus disease 2019 (COVID-19) is an infectious disease which is caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). It has had unprecedented effect on healthcare systems globally with severe impact on every specialist service within the hospital including urology. While it affects the respiratory system causing symptoms ranging from fever, cough, dyspnea, diarrhea, nausea, myalgia and fatigue, it eventually causes pneumonia and respiratory distress needing oxygenation and ventilation. Laboratory diagnosis is required to confirm the diagnosis of COVID-19. Radiological changes are seen on chest XR or CT scan of patients. The surge in patients affected by the disease has led to extreme pressures on healthcare systems by the overwhelming number of critically unwell patients. This scenario has presented challenges to maintain other emergency and essential services. Reallocation of staff, wards and equipment has resulted in cancellations of many surgical procedures, requiring urologists to select only the most essential or critical procedures. The outpatient face-to-face clinics are also cancelled or changed to telephone or video consultations. In some hospitals, urologists are required to work outside of their usual scope of practice helping their respiratory and intensive care unit colleagues. The pandemic is disrupting training and education opportunities for junior medical staff. In this review we provide guidance on the diagnosis and management of COVID-19, the influence it has on urological practice and consider the long-term implications that may be of consequence for years to come.

摘要

2019冠状病毒病(COVID-19)是一种由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引起的传染病。它对全球医疗系统产生了前所未有的影响,对医院内的每个专科服务包括泌尿外科都造成了严重冲击。虽然它影响呼吸系统,导致发热、咳嗽、呼吸困难、腹泻、恶心、肌痛和疲劳等症状,但最终会导致肺炎和呼吸窘迫,需要进行氧疗和通气。需要实验室诊断来确诊COVID-19。在患者的胸部X光或CT扫描中可见放射学变化。受该疾病影响的患者激增,大量病情危急的患者给医疗系统带来了巨大压力。这种情况给维持其他急诊和基本服务带来了挑战。工作人员、病房和设备的重新调配导致许多外科手术被取消,这就要求泌尿外科医生只选择最必要或最关键的手术。门诊面对面诊所也被取消或改为电话或视频咨询。在一些医院,泌尿外科医生被要求在其通常的执业范围之外工作,以帮助呼吸科和重症监护室的同事。这场大流行正在扰乱初级医务人员的培训和教育机会。在本综述中,我们提供了关于COVID-19诊断和管理的指导,它对泌尿外科实践的影响,并考虑了可能在未来数年产生影响的长期后果。

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