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在 COVID-19 时代恢复小儿择期手术。

Resuming elective paediatric surgical procedures in the era of COVID-19.

机构信息

Department of Surgery, Faculty of Medicine, The Hashemite University, Zarqa, Jordan.

出版信息

Afr J Paediatr Surg. 2021 Jan-Mar;18(1):24-27. doi: 10.4103/ajps.AJPS_96_20.

Abstract

BACKGROUND

The novel coronavirus and the disease it causes COVID-19, like other viral outbreaks, have an unpredictable timeline. Therefore, a triumph in the battle against COVID-19 could only be achieved if a health care system's capacity to support a potentially overwhelming increase in critical patient care needs is maintained, and the viral curve is flattened. Accordingly, health care bodies around the globe called upon prioritising appropriate resource allocation as it relates to elective invasive procedures and minimising the use of essential items required to care for patients. The unpredictability COVID-19 timeline in the absence of effective drug treatments and vaccination along with the restrictive health care policies implemented suggest that patients may be deprived of access to needed surgical care, likely for many months. However, the potential undue delay in delivering essential elective surgical care may have a more detrimental impact on patients' health compared to that of COVID-19 itself. This particularly applies to the paediatric population in which infection rates have been demonstrated to be considerably lower and mortalities have not been reported yet. Therefore, the need emerges for actions to be taken that allow for the resumption of essential elective surgical procedures in this population of patients.

MATERIALS AND METHODS

A comprehensive search through surgical guidance and recommendations to develop a set of evidence based recommendations that allow for the safe and timely delivery of essential paediatric surgical care during the time of COVID-19.

CONCLUSION

No compelling evidence that the paediatric population is at an increased risk of morbidity or mortality exists. Therefore, delaying essential paediatric surgical care cannot be justified as it may have a potentially negative health impact, and continuous refinements of surgical recommendations are encouraged in view of evolving circumstances.

摘要

背景

新型冠状病毒及其引发的疾病 COVID-19 与其他病毒疫情一样,其发展轨迹难以预测。因此,只有在维持医疗体系支持重症患者护理需求可能出现的大幅增长的能力,并使病毒传播曲线变平缓的情况下,才能在抗击 COVID-19 的战斗中取得胜利。因此,全球各地的医疗保健机构呼吁优先考虑与选择性侵入性手术相关的适当资源配置,并尽量减少照顾患者所需的基本物品的使用。在缺乏有效药物治疗和疫苗接种的情况下,COVID-19 发展轨迹的不可预测性以及实施的限制性医疗保健政策表明,患者可能会被剥夺获得所需手术护理的机会,这种情况可能会持续数月。然而,与 COVID-19 本身相比,延迟提供必要的选择性手术护理可能会对患者的健康产生更大的不利影响。这尤其适用于儿科人群,因为该人群的感染率明显较低,且尚未报告死亡率。因此,需要采取行动,允许在 COVID-19 期间恢复该人群的必要选择性手术。

材料和方法

通过全面搜索外科指导和建议,制定了一套循证建议,以确保在 COVID-19 期间安全、及时地提供必要的儿科外科护理。

结论

没有令人信服的证据表明儿科人群的发病率或死亡率增加。因此,不能以可能对健康产生潜在负面影响为理由,延迟必要的儿科手术护理,并且应鼓励根据不断变化的情况对手术建议进行持续改进。

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