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新型冠状病毒肺炎疫情下胸部肿瘤学面临的挑战与对策

Challenges and countermeasures of thoracic oncology in the epidemic of COVID-19.

作者信息

Guo Haoyue, Chen Xiaoxia, Su Chunxia, Liu Yu, Wang Hao, Sun Chenglong, Chen Peixin, Jiang Minlin, Xu Yi, Wu Shengyu, Jia Keyi, Zhao Sha, Li Wei, Chen Bin, Wang Lei, Yu Jia, Xiong Anwen, Gao Guanghui, Wu Fengying, Li Jiayu, Ye Lingyun, Bo Bing, Chen Shen, Ren Shengxiang, He Yayi, Zhou Caicun

机构信息

Department of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University Medical School Cancer Institute, Tongji University School of Medicine, Shanghai 200433, China.

Tongji University, Shanghai 200433, China.

出版信息

Transl Lung Cancer Res. 2020 Apr;9(2):337-347. doi: 10.21037/tlcr.2020.02.10.

Abstract

Since December, 2019, a 2019 novel coronavirus disease (COVID-19) infected by the severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) emerged in Wuhan, Hubei province, and the epidemic situation has continued to spread globally. The epidemic spread of COVID-19 has brought great challenges to the clinical practice of thoracic oncology. Outpatient clinics need to strengthen the differential diagnosis of initial symptoms, pulmonary ground-glass opacity (GGO), consolidation, interstitial and/or interlobular septal thickening, and crazy paving appearance. In the routine of oncology, the differential diagnosis of adverse events from COVID-19 is also significant, including radiation pneumonitis, checkpoint inhibitor pneumonitis (CIP), neutropenic fever, and so on. During the epidemic, indications of transbronchial biopsy (TBB) and CT-guided percutaneous thoracic biopsy are strictly controlled. For patients who are planning to undergo biopsy operation, screening to exclude the possibility of COVID-19 should be carried out. For confirmed or suspected patients, three-level protection should be performed during the operation. Disinfection and isolation measures should be strictly carried out during the operation. At last, more attention to the protection of cancer patients and give priority to the treatment of infected cancer patients.

摘要

自2019年12月以来,湖北省武汉市出现了由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染引发的2019新型冠状病毒病(COVID-19),疫情持续在全球蔓延。COVID-19的疫情传播给胸科肿瘤学的临床实践带来了巨大挑战。门诊需要加强对初始症状、肺部磨玻璃影(GGO)、实变、间质和/或小叶间隔增厚以及铺路石样表现的鉴别诊断。在肿瘤学常规工作中,对COVID-19不良事件的鉴别诊断也很重要,包括放射性肺炎、检查点抑制剂肺炎(CIP)、中性粒细胞减少性发热等。疫情期间,严格控制经支气管活检(TBB)和CT引导下经皮肺穿刺活检的适应证。对于计划进行活检手术的患者,应进行筛查以排除COVID-19的可能性。对于确诊或疑似患者,手术期间应采取三级防护。手术过程中应严格执行消毒隔离措施。最后,要更加关注癌症患者的防护,并优先治疗感染的癌症患者。

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