大流行时代的择期骨科手术会增加感染新冠病毒的风险吗？印度尼西亚雅加达西托·芒古库苏莫医院的回顾性和前瞻性研究联合分析。
Does elective orthopaedic surgery in pandemic era increase risk of developing COVID-19? A combined analysis of retrospective and prospective study at Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
作者信息
Kamal A F, Widodo W, Kuncoro M W, Karda I W A M, Prabowo Y, Singh G, Liastuti L D, Hutagalung E U, Saleh I, Tobing S D A L, Gunawan B, Dilogo I H, Lubis A M T, Kurniawan A, Rahyussalim A J, Oesman I, Ifran N N P P S, Latief W, Wijaya M T, Ivansyah M D, Primaputra M R A, Reksoprodjo A Y, Hendriarto A, Novriandi K M A, Alaztha Z, Canintika A F, Sitanggang A H R
机构信息
Department of Orthopaedics and Traumatology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
出版信息
Ann Med Surg (Lond). 2020 Dec;60:87-91. doi: 10.1016/j.amsu.2020.10.015. Epub 2020 Oct 15.
BACKGROUND
To date, no recommendations have been published on when and how to start again carrying out elective, non-urgent surgery on COVID-19-negative patients after the epidemic peak has been reached in a given country or region and the pressure on healthcare facilities, healthcare workers and resources has been released by so far that elective surgery procedures can be safely and ethically programmed again. This study aims to investigate whether elective orthopaedic surgery will increase the risk of developing COVID-19.
MATERIALS AND METHODS
This was a combined retrospective and prospective studies performed at a national tertiary hospital in Jakarta, Indonesia. Subjects were patients who underwent elective orthopaedic surgeries at our institution from April to May 2020. Those who were previously infected with COVID-19 from polymerase chain reaction (PCR) reverse transcriptase (RT) examination obtained via nasopharynx and oropharynx swab, as well as those who were reluctant to participate were excluded from the study.
RESULTS
A total of 35 subjects (mean age 32.89 ± 17.42) were recruited. Fifteen (42.9%) subjects were male, and 20 subjects (57.1%) were female. Mean duration of surgery was 240 min with the longest and shortest duration of 690 and 40 min, respectively. General anaesthesia was performed in the majority of cases in 18 surgeries (51.4%) with local anaesthesia as the least in 2 surgeries (5.7%). Length of stay of our study was 6 days of average. None of the patients developed symptoms suggestive of COVID-19 infection.
CONCLUSION
We found that elective orthopaedic surgery may not be associated with increased cases of COVID-19 cases. However, our study was limited by short duration of follow-up. Further studies are required in order to investigate the affect of undergoing elective surgery and the number of COVID-19 cases.
背景
迄今为止，尚未发布关于在特定国家或地区疫情高峰过后，以及医疗设施、医护人员和资源的压力已得到缓解，从而可以再次安全且符合伦理地安排择期手术时，应何时以及如何重新开始对新冠病毒检测呈阴性的患者进行择期非紧急手术的建议。本研究旨在调查择期骨科手术是否会增加感染新冠病毒的风险。
材料与方法
这是一项在印度尼西亚雅加达的一家国家级三级医院进行的回顾性和前瞻性相结合的研究。研究对象为2020年4月至5月在我们机构接受择期骨科手术的患者。那些通过鼻咽和口咽拭子进行聚合酶链反应（PCR）逆转录酶（RT）检测先前感染过新冠病毒的患者，以及那些不愿参与的患者被排除在研究之外。
结果
共招募了35名受试者（平均年龄32.89±17.42岁）。15名（42.9%）受试者为男性，20名（57.1%）受试者为女性。平均手术时长为240分钟，最长和最短时长分别为690分钟和40分钟。大多数病例（18例，51.4%）采用全身麻醉，最少的2例（5.7%）采用局部麻醉。我们研究中的住院时间平均为6天。没有患者出现提示新冠病毒感染的症状。
结论
我们发现择期骨科手术可能与新冠病毒感染病例增加无关。然而，我们的研究受到随访时间短的限制。需要进一步研究以调查接受择期手术的影响以及新冠病毒感染病例数。
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