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新型冠状病毒肺炎疫情期间胃肠内镜感染控制策略:来自中国一家三级甲等医院的经验。

Gastrointestinal endoscopy infection control strategy during COVID-19 pandemic: Experience from a tertiary medical center in China.

机构信息

Department of Gastroenterology, Peking Union Medical College Hospital, Beijing, China.

Medical Affairs Department, Peking Union Medical College Hospital, Beijing, China.

出版信息

Dig Endosc. 2021 May;33(4):577-586. doi: 10.1111/den.13783. Epub 2020 Aug 24.

Abstract

OBJECTIVES

Coronavirus disease 2019 (COVID-19) has spread globally and become a pandemic. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) not only infects the gastrointestinal (GI) tract and causes GI symptoms, but also increases nosocomial transmission risk during endoscopic procedures for aerosol generation. We hereby share our infection control strategies aiming to minimize COVID-19 transmission in the endoscopy center.

METHODS

We established our infection control strategies based on the guidance of Chinese Society of Digestive Endoscopy and inputs from hospital infection control experts: admission control through the procedure and patient triage, environmental control to reduce possible virus exposure, proper usage of personal protective equipment (PPE), and scope disinfection and room decontamination. All endoscopic procedures accomplished during COVID-19 outbreak and progress of stepwise resumption of elective endoscopy procedures were retrospectively reviewed.

RESULTS

Only urgent or semi-urgent procedures were performed during COVID-19 outbreak. After no local new-onset COVID-19 case in Beijing for four weeks, we reopened the endoscopy center for elective procedures and monitored the outbreak continuously while maintaining a sustainable endoscopy service.

CONCLUSIONS

It is imperative that all endoscopy centers should establish standard infection control strategies in order to fight COVID-19 pandemic based on national guidance and academic society guidelines and tailor them to individual resources. These measures and setup can also be reserved for future pandemics.

摘要

目的

2019 年冠状病毒病(COVID-19)已在全球范围内传播,并已成为大流行疾病。严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)不仅感染胃肠道(GI)并引起 GI 症状,而且在产生气溶胶的内镜操作过程中还会增加医院内传播的风险。我们在此分享旨在最大程度减少内镜中心 COVID-19 传播的感染控制策略。

方法

我们根据中国消化内镜学会的指南和医院感染控制专家的建议制定了感染控制策略:通过程序和患者分诊进行入院控制,控制环境以减少可能的病毒暴露,正确使用个人防护设备(PPE),以及对内镜进行消毒和对房间进行消毒。回顾了 COVID-19 爆发期间完成的所有内镜操作以及逐步恢复择期内镜操作的进展情况。

结果

在 COVID-19 爆发期间仅进行紧急或半紧急程序。在北京连续四周没有本地新增 COVID-19 病例后,我们重新开放了内镜中心进行择期手术,并在持续提供可持续内镜服务的同时持续监测疫情。

结论

所有内镜中心都必须根据国家指南和学术学会指南制定标准的感染控制策略,以应对 COVID-19 大流行,并根据自身资源进行调整。这些措施和设置也可以为未来的大流行做好准备。

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