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在 COVID-19 大流行期间接诊耳鼻喉科患者

Approaching Otolaryngology Patients During the COVID-19 Pandemic.

机构信息

ENT Institute and Otorhinolaryngology Department of the Affiliated Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology, Institutes of Biomedical Sciences, Fudan University, Shanghai, China.

NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China.

出版信息

Otolaryngol Head Neck Surg. 2020 Jul;163(1):121-131. doi: 10.1177/0194599820926144. Epub 2020 May 12.

Abstract

. To describe coronavirus disease 2019 (COVID-19) patient presentations requiring otolaryngology consultation and provide recommendations for protective measures based on the experience of ear, nose, and throat (ENT) departments in 4 Chinese hospitals during the COVID-19 pandemic. . Retrospective case series. . Multicenter. . Twenty hospitalized COVID-19 patients requiring ENT consultation from 3 designated COVID-19 hospitals in Wuhan, Shanghai, and Shenzhen were identified. Data on demographics, comorbidities, COVID-19 symptoms and severity, consult reason, treatment, and personal protective equipment (PPE) use were collected and analyzed. Infection control strategies implemented for ENT outpatients and emergency room visits at the Eye and ENT Hospital of Fudan University were reported. . Median age was 63 years, 55% were male, and 95% were in severe or critical condition. Six tracheotomies were performed. Posttracheotomy outcomes were mixed (2 deaths, 2 patients comatose, all living patients still hospitalized). Other consults included epistaxis, pharyngitis, nasal congestion, hyposmia, rhinitis, otitis externa, dizziness, and tinnitus. At all hospitals, powered air-supply filter respirators (PAPRs) were used for tracheotomy or bleeding control. PAPR or N95-equivalent masks plus full protective clothing were used for other complaints. No inpatient ENT providers were infected. After implementation of infection control strategies for outpatient clinics, emergency visits, and surgeries, no providers were infected at the Eye and ENT Hospital of Fudan University. . COVID-19 patients require ENT consultation for many reasons, including tracheotomy. Otolaryngologists play an indispensable role in the treatment of COVID-19 patients but, due to their work, are at high risk of exposure. Appropriate protective strategies can prevent infection of otolaryngologists.

摘要

描述需要耳鼻喉科咨询的 2019 年冠状病毒病(COVID-19)患者表现,并根据 COVID-19 大流行期间 4 家中国医院耳鼻喉科(ENT)部门的经验提供保护措施建议。

回顾性病例系列。

多中心。

从武汉、上海和深圳的 3 家指定 COVID-19 医院确定了 20 例需要 ENT 咨询的住院 COVID-19 患者。收集并分析了人口统计学、合并症、COVID-19 症状和严重程度、咨询原因、治疗和个人防护设备(PPE)使用的数据。报告了复旦大学眼耳鼻喉科医院对耳鼻喉科门诊和急诊的感染控制策略。

中位年龄为 63 岁,55%为男性,95%为重症或危重症。进行了 6 例气管切开术。气管切开术后结局不一(2 例死亡,2 例昏迷,所有存活患者仍住院)。其他咨询包括鼻出血、咽炎、鼻塞、嗅觉减退、鼻炎、外耳道炎、头晕和耳鸣。在所有医院,均使用动力送风过滤式呼吸防护器(PAPR)进行气管切开或出血控制。对于其他投诉,使用 PAPR 或 N95 等效口罩加全防护服。没有住院耳鼻喉科医生感染。在实施门诊、急诊和手术感染控制策略后,复旦大学眼耳鼻喉科医院没有医护人员感染。

COVID-19 患者因多种原因需要耳鼻喉科咨询,包括气管切开术。耳鼻喉科医生在 COVID-19 患者的治疗中发挥着不可或缺的作用,但由于工作性质,他们面临着高暴露风险。适当的保护策略可以防止耳鼻喉科医生感染。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/182a/7331789/725fcc955828/10.1177_0194599820926144-fig1.jpg

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