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2019年冠状病毒病大流行期间的脊柱外科手术:还能否继续为患者提供治疗?封城首月的一项观察性研究结果

Spine Surgical Procedures during Coronavirus Disease 2019 Pandemic: Is It Still Possible to Take Care of Patients? Results of an Observational Study in the First Month of Confinement.

作者信息

Meyer Mikael, Prost Solène, Farah Kaissar, Denis Jean-Baptiste, Dufour Henry, Blondel Benjamin, Fuentes Stéphane

机构信息

Unité de Chirurgie Rachidienne, Aix-Marseille Université, APHM, CNRS, ISM, CHU Timone, Marseille, France.

出版信息

Asian Spine J. 2020 Jun;14(3):336-340. doi: 10.31616/asj.2020.0197. Epub 2020 May 8.

Abstract

STUDY DESIGN

Observational study.

PURPOSE

The actual sanitary crisis led to a massive mobilization of the sanitary system toward intensive care units and management of coronavirus disease 2019 (COVID-19) patients. However, some patients still require spinal interventions. The present study aimed to assess the impact of the COVID-19 pandemic on spine surgical in a moderate COVID-19 cluster region.

OVERVIEW OF LITERATURE

Previous studies have reported screening and management of patients with spinal conditions during the COVID-19 pandemic. However, to date, knowledge, no observational study on spine surgeries during the pandemic has not been reported.

METHODS

Between March 17, 2020 and April 17, 2020, information on spine surgical activity was prospectively collected at our institution. This surgical activity related to the first month of confinement in France was compared to the activity during the same period in 2019 to evaluate the impact of the COVID-19 pandemic on surgical activities.

RESULTS

In order to reduce the contamination rate of patients and medical staff during hospitalization, the spine department was completely reorganized. Non-urgent elective spine surgeries were cancelled. When considering the global amount of surgeries procedures during the first month of confinement, a decrease of almost 50% was observed in the number of surgical procedures. During the study period, 62 patients were eligible for spine surgery. The numbers of patients managed for tumor and infectious cases were stable, while a considerable reduction was observed in the number of trauma and degenerative cases. During the follow-up period, two patients were tested as COVID+ during the postoperative course, and no cases of medical or paramedical staff contamination were reported using polymerase chain reaction-testing.

CONCLUSIONS

During the COVID-19 pandemic, it is possible to maintain spine surgical activity. Each surgical procedure must be discussed and organized with all the caregivers involved. Indications for surgery must be in line with the scientific guidelines and adapted to each healthcare facility.

摘要

研究设计

观察性研究。

目的

实际的卫生危机导致卫生系统大规模动员,以应对重症监护病房及2019冠状病毒病(COVID-19)患者的管理。然而,仍有一些患者需要脊柱干预。本研究旨在评估COVID-19大流行对中度COVID-19聚集地区脊柱手术的影响。

文献综述

先前的研究报告了COVID-19大流行期间脊柱疾病患者的筛查和管理情况。然而,迄今为止,尚未有关于大流行期间脊柱手术的观察性研究报告。

方法

在2020年3月17日至2020年4月17日期间,前瞻性收集了我们机构的脊柱手术活动信息。将与法国首次封锁第一个月相关的该手术活动与2019年同期的活动进行比较,以评估COVID-19大流行对手术活动的影响。

结果

为降低患者和医护人员在住院期间的感染率,脊柱科室进行了全面重组。非紧急择期脊柱手术被取消。考虑到封锁第一个月的手术程序总量,手术程序数量减少了近50%。在研究期间,62例患者符合脊柱手术条件。肿瘤和感染病例的治疗患者数量稳定,而创伤和退行性病例数量显著减少。在随访期间,两名患者在术后过程中COVID检测呈阳性,且未报告使用聚合酶链反应检测出医护人员感染的病例。

结论

在COVID-19大流行期间,可以维持脊柱手术活动。每个手术程序都必须与所有参与的护理人员进行讨论和安排。手术指征必须符合科学指南,并适应每个医疗机构的情况。

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