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COVID-19 期间的胸外科手术:1 级创伤中心的经验。

Thoracic Surgery during Coronavirus Disease 2019 (COVID-19): The Experience of a Level 1 Trauma Center.

机构信息

Department of Thoracic Surgery, St. George's University Hospitals NHS Foundation Trust, London, United Kingdom.

出版信息

Thorac Cardiovasc Surg. 2021 Apr;69(3):252-258. doi: 10.1055/s-0040-1718938. Epub 2020 Nov 20.

Abstract

BACKGROUND

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel coronavirus primarily affecting the respiratory system, was initially diagnosed in Wuhan, China, in late 2019. Identified as coronavirus disease 2019 (COVID-19) by the World Health Organization, the virus rapidly became a global pandemic. The effects on health care worldwide were unprecedented as countries adapted services to treat masses of critically ill patients.The aim of this study is to analyze the effect that the COVID-19 pandemic had on thoracic surgery at a major trauma center during peak prevalence.

METHODS

Prospective unit data were collected for all patients who underwent thoracic surgery during March 2020 until May 2020 inclusive. Retrospective data were collected from an earlier comparable time period as a comparison.

RESULTS

In the aforementioned time frame, 117 thoracic surgical operations were performed under the care of four thoracic surgeons. Six operations were performed on three patients who were being treated for SARS-CoV-2. One operation was performed on a patient who had recovered from SARS-CoV-2. There were no deaths due to SARS-CoV-2 in any patient undergoing thoracic surgery.

CONCLUSION

This study demonstrates that during the first surge of SARS-CoV-2, it was possible to adapt a thoracic oncology and trauma service without increase in mortality due to COVID-19. This was only possible due to a significant reduction in trauma referrals, cessation of benign and elective work, and the more stringent reprioritization of cancer surgery. This information is vital to learn from our experience and prepare for the predicted second surge and any similar future pandemics we might face.

摘要

背景

严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)是一种主要影响呼吸系统的新型冠状病毒,最初于 2019 年底在中国武汉确诊。世界卫生组织将其命名为 2019 年冠状病毒病(COVID-19),该病毒迅速成为全球大流行。由于各国调整服务以治疗大量重症患者,对全球医疗保健的影响是前所未有的。本研究旨在分析 COVID-19 大流行对一家主要创伤中心高峰期胸外科的影响。

方法

前瞻性收集 2020 年 3 月至 2020 年 5 月期间所有接受胸外科手术的患者的单位数据。回顾性收集了早些时候的可比时间段的数据作为对照。

结果

在上述时间段内,由四名胸外科医生为 117 例胸外科手术提供护理。有 6 例手术是为正在接受 SARS-CoV-2 治疗的 3 名患者进行的。有 1 例手术是为已从 SARS-CoV-2 中康复的患者进行的。没有 SARS-CoV-2 患者在接受胸外科手术时死亡。

结论

本研究表明,在 SARS-CoV-2 的第一波高峰期间,有可能在不增加 COVID-19 死亡率的情况下,调整胸外科肿瘤和创伤服务。这仅仅是由于创伤性转诊显著减少、良性和选择性手术停止以及癌症手术更严格的重新优先化。从我们的经验中吸取这些信息并为预计的第二波疫情以及我们可能面临的任何类似未来大流行做好准备是至关重要的。

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