The First School of Clinical Medicine, Southern Medical University, Guangzhou, China.
Department of Neurosurgery, Central Theater General Hospital of PLA, Wuhan, China.
Surg Infect (Larchmt). 2021 May;22(4):450-458. doi: 10.1089/sur.2020.193. Epub 2020 Sep 23.
In December 2019, a novel coronavirus infectious disease, coronavirus disease 2019 (COVID-19), began to appear in China. Wuhan, Hubei Province, is the origin and core location of the epidemic. Neurosurgeons were faced with the challenge of balancing treatment of patients with life-threatening conditions and preventing the cross-transmission of the virus. A series of infection prevention and control strategies was adopted for the peri-operative period of emergency surgeries in our department. These strategies include protective measures for the emergency department (ED) and measures for the peri-operative period of emergency surgery. The propensity score matching (PSM) was used to match COVID-19-related patients with patients before the epidemic. Length of wait time in the ED and duration of operation were compared. From January 23, 2020 to March 18, 2020, we performed emergency surgery for 19 patients who were either COVID-19-related or COVID-19-suspected. None of the medical staff involved in the surgeries developed viral infection, and no peri-operative virus transmission occurred in our hospital. After the PSM, 32 patients were included in the epidemic group and the pre-epidemic group (16 patients in each group). The duration of wait time in the ED of the former group was longer than that of the latter group ( = -3.000; p = 0.003). During the epidemic, the duration of a craniotomy was longer than before the epidemic (z = -2.253; p = 0.024), and there was no difference in the duration of interventional surgery ( = -0.314; p = 0.753). We believe that our experience can provide a useful reference for other surgeons facing the same challenges and as a lesson for similar infectious diseases that may occur in the future.
2019 年 12 月,一种新型冠状病毒传染病,即 2019 年冠状病毒病(COVID-19)在中国出现。湖北省武汉市是疫情的起源地和核心所在地。神经外科医生面临着平衡治疗危及生命的患者和防止病毒交叉传播的挑战。我科对急诊手术围手术期采取了一系列感染防控策略。这些策略包括急诊科(ED)的防护措施和急诊手术围手术期的措施。采用倾向评分匹配(PSM)对 COVID-19 相关患者与疫情前患者进行匹配,比较 ED 等待时间和手术时间。从 2020 年 1 月 23 日至 2020 年 3 月 18 日,我们为 19 名 COVID-19 相关或疑似 COVID-19 的患者实施了急诊手术。参与手术的医护人员无一例发生病毒感染,我院未发生围手术期病毒传播。PSM 后,将 32 例患者纳入疫情组和疫情前组(每组 16 例)。前者 ED 等待时间长于后者( = -3.000;p = 0.003)。疫情期间,开颅手术时间长于疫情前(z = -2.253;p = 0.024),介入手术时间无差异( = -0.314;p = 0.753)。我们相信,我们的经验可以为其他面临同样挑战的外科医生提供有益的参考,也可以为未来可能发生的类似传染病提供借鉴。