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《当下新冠疫情中的头颈医学实践:快速系统评价》

Head and Neck Practice in the COVID-19 Pandemics Today: A Rapid Systematic Review.

作者信息

Hojaij Flavio Carneiro, Chinelatto Lucas Albuquerque, Boog Gustavo Henrique Pereira, Kasmirski Júlia Adriana, Lopes João Vitor Ziroldo, Medeiros Vitor Macedo Brito

机构信息

Department of Surgery, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil.

Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil.

出版信息

Int Arch Otorhinolaryngol. 2020 Oct;24(4):e518-e526. doi: 10.1055/s-0040-1715506. Epub 2020 Sep 30.

Abstract

Head and neck specialists and otorhinolaryngologists are greatly exposed to coronavirus disease 2019 (COVID-19) transmission in their everyday praxis. Many articles are being published regarding medical staff protection and patient management during the pandemic.  To provide an easy access to and a trustful review of the main aspects that have changed in the head and neck surgery and otorhinolaryngology practice due to the COVID-19 pandemic.  The search terms used were: ( or or or ) AND ( [ or or ). The results were limited to the year of 2020. Articles were read in English, Portuguese, French, German, and Spanish or translated from Chinese. All included articles were read by at least two authors. Thirty-five articles were included. Most articles suggest postponing elective surgeries, with exception to cancer surgeries, which should be evaluated separately. Twenty-five articles recommended some kind of screening prior to surgery, using polymerase chain reaction (PCR) tests and epidemiological data. Extra precautions, such as use of personal protective equipment (PPE), are suggested for both tracheostomies and endoscopies. Fifteen articles give recommendation on how to use telemedicine.  The use of PPE (N95 or powered air-purifying respirator [PAPR]) during procedures should be mandatory. Patients should be evaluated about their COVID-19 status before hospital admission. Cancer should be treated. Tracheostomy tube cuff should be inflated inside the tracheal incision. All COVID-19 precautions should be kept until there is a validated antiviral treatment or an available vaccine.

摘要

头颈专科医生和耳鼻喉科医生在日常工作中极易接触到2019冠状病毒病(COVID-19)。关于疫情期间医护人员防护和患者管理的文章大量发表。

为方便获取并可靠回顾因COVID-19大流行而导致头颈外科和耳鼻喉科实践中发生变化的主要方面。

使用的检索词为

( 或 或 或 ) AND ( [ 或 或 )。检索结果限于2020年。文章阅读语言为英语、葡萄牙语、法语、德语和西班牙语,或从中文翻译而来。所有纳入文章至少由两位作者阅读。共纳入35篇文章。大多数文章建议推迟择期手术,但癌症手术除外,癌症手术应单独评估。25篇文章推荐在手术前进行某种筛查,采用聚合酶链反应(PCR)检测和流行病学数据。对于气管切开术和内镜检查,建议采取额外预防措施,如使用个人防护装备(PPE)。15篇文章就如何使用远程医疗给出了建议。

手术过程中应强制使用PPE(N95或动力空气净化呼吸器[PAPR])。患者入院前应评估其COVID-19状态。癌症应予以治疗。气管切开套管的气囊应在气管切口内充气。在有经过验证的抗病毒治疗或可用疫苗之前,应始终保持所有COVID-19预防措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/50b2/7575400/86d957933a2f/10-1055-s-0040-1715506-i200175-1.jpg

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