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新冠疫情期间冠状动脉旁路移植术后患者的管理策略

Management Strategies for Patients After CABG Surgery in the Outbreak of the COVID-19 Pandemic.

作者信息

Wang Xiaogang, Zhou Yangzhao, Zhang Xia, Li Jianming, Zhou Xinmin, Zhang ZhiWei

机构信息

Department of Cardiovascular Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, People's Republic of China.

Department of Medicine, University of California San Diego, La Jolla, CA 92093, USA.

出版信息

Risk Manag Healthc Policy. 2020 Sep 21;13:1655-1659. doi: 10.2147/RMHP.S271133. eCollection 2020.

Abstract

BACKGROUND

The novel coronavirus 2019 pandemic (COVID-19) has quickly spread over the world and affected over 100 countries so far. Patients with pre-existing cardiovascular disease may have a higher risk of infection of COVID-19 and worse outcomes than others. To improve the outcome during the pandemic, management strategies for the patients recovering from coronary artery bypass graft (CABG) surgery need to be reconsidered.

METHODS

Some precaution advices including self-protection, blood glucose and blood pressure controlling are recommended for the patients recovering from CABG during the pandemic. They are encouraged to communicate with doctors by telephone or Internet when COVID-19 related symptoms such as cough, fever and dyspnea occur. As a follow-up strategy for patients after CABG surgery, cardiac biomarkers and CTA could also be helpful to the diagnosis of COVID-19. Some medications being investigated for COVID-19 therapy may have side effects relevant to cardiovascular disease. Appropriate personal protection equipment (PPE) is necessary for cardiovascular health-care workers operating in clinical settings.

RESULTS

There was zero out of over 300 follow-up patients after CABG surgery confirmed to be infected with COVID-19 from January to June 2020. No cardiovascular health-care workers were reported to be infected neither in the Second Xiangya Hospital during the pandemic.

CONCLUSION

The management strategy here we proposed could improve the outcome of patients after CABG during the pandemic and benefit both cardiovascular patients and health-care workers.

摘要

背景

2019年新型冠状病毒大流行(COVID-19)已迅速蔓延至全球,迄今为止已影响100多个国家。患有心血管疾病的患者感染COVID-19的风险可能更高,且预后比其他人更差。为改善大流行期间的预后,需要重新考虑冠状动脉旁路移植术(CABG)术后康复患者的管理策略。

方法

建议对大流行期间CABG术后康复患者采取一些预防建议,包括自我保护、控制血糖和血压。当出现咳嗽、发热和呼吸困难等与COVID-19相关的症状时,鼓励他们通过电话或互联网与医生沟通。作为CABG术后患者的随访策略,心脏生物标志物和CTA也有助于COVID-19的诊断。一些正在研究用于COVID-19治疗的药物可能有与心血管疾病相关的副作用。在临床环境中工作的心血管医护人员需要适当的个人防护装备(PPE)。

结果

2020年1月至6月,300多名CABG术后随访患者中确诊感染COVID-19的为零。在大流行期间,中南大学湘雅二医院也没有心血管医护人员被报告感染。

结论

我们在此提出的管理策略可改善大流行期间CABG术后患者的预后,对心血管患者和医护人员均有益。

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Perioperative planning for cardiovascular operations in the COVID-19 pandemic.2019冠状病毒病大流行期间心血管手术的围手术期规划
Turk Gogus Kalp Damar Cerrahisi Derg. 2020 Apr 3;28(2):236-243. doi: 10.5606/tgkdc.dergisi.2020.09294. eCollection 2019 Jun.
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A novel coronavirus outbreak of global health concern.一场引发全球卫生关注的新型冠状病毒疫情。
Lancet. 2020 Feb 15;395(10223):470-473. doi: 10.1016/S0140-6736(20)30185-9. Epub 2020 Jan 24.

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