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新冠疫情时代寻求泌尿外科护理患者的管理

Management of Patients Who Seek Urologic Care in Covid-19 Pandemic Era.

作者信息

Tonyali Senol, Haberal Hakan Bahadir, Ergul Rifat, Dursun Murat

机构信息

Istanbul University, Istanbul School of Medicine, Department of Urology, Istanbul.

University of Health Sciences, Kecioren Training and Research Hospital, Ankara.

出版信息

Urol J. 2020 Aug 18;17(5):548-554. doi: 10.22037/uj.v16i7.6285.

Abstract

INTRODUCTION

Novel coronavirus Disease (Covid-19) has emerged in Wuhan, China in December 2019 and became a pandemic in a few weeks. In this review, we aimed to summarize the current urologic practice trends worldwide to help urologist in decision making in disasters particularly in Covid-19 pandemic.

MATERIAL AND METHOD

We have performed a PubMed and Internet search by using the keywords: 'Covid', 'new coronavirus', 'coronavirus urology, 'covid urology' without a date restriction.  Results: All elective surgeries for benign urological conditions such as urinary tract stone disease that not caused complicated obstruction, benign prostate enlargement, infertility, incontinence and genitourinary prolapse, erectile dysfunction undescendent testis, vesico-ureteral reflux   should be postponed till the lasting of Covid-19 outbreak. In obstructing ureteral stone both nephrostomy tube and double-J stent insertion are valid management options. However, one must consider that these procedures must be performed under local anesthesia when possible to spare a ventilator. When deferring urooncological operations and treatments oncological outcomes must be considered. Aggressive cessation or reducing the dosage of immunosuppressant therapy might be an option in renal transplanted patients with severe pneumonia or acute respiratory distress syndrome.

摘要

引言

新型冠状病毒病(Covid-19)于2019年12月在中国武汉出现,并在几周内成为大流行病。在本综述中,我们旨在总结全球目前的泌尿外科实践趋势,以帮助泌尿外科医生在灾难情况下,特别是在Covid-19大流行期间做出决策。

材料与方法

我们使用关键词“Covid”、“新型冠状病毒”、“冠状病毒泌尿外科”、“Covid泌尿外科”在PubMed和互联网上进行了不限日期的搜索。结果:所有择期手术,如未引起复杂梗阻的尿路结石病、良性前列腺增生、不育症、尿失禁和泌尿生殖器官脱垂、勃起功能障碍、隐睾、膀胱输尿管反流等良性泌尿外科疾病,均应推迟至Covid-19疫情结束。对于梗阻性输尿管结石,置入肾造瘘管和双J支架都是有效的治疗选择。然而,必须考虑到,这些操作应尽可能在局部麻醉下进行,以节省呼吸机。在推迟泌尿肿瘤手术和治疗时,必须考虑肿瘤学结果。对于患有严重肺炎或急性呼吸窘迫综合征的肾移植患者,积极停止或减少免疫抑制治疗剂量可能是一种选择。

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