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探讨 COVID-19 大流行对小儿外科学服务的影响。

Exploring the impact of the COVID-19 pandemic on pediatric surgical services.

机构信息

MBBS, Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan -

MBBS, Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan.

出版信息

Minerva Pediatr (Torino). 2021 Oct;73(5):460-466. doi: 10.23736/S2724-5276.21.06146-6. Epub 2021 Apr 12.

Abstract

Inevitably, along with other healthcare specializations, pediatric surgery was affected by the Coronavirus disease-19 (COVID-19) pandemic. Children were reported to manifest mild to moderate symptoms and mortality was primarily observed in patients aged <1 year and having underlying comorbidities. Most of the cases were asymptomatic in children, hence, posing a challenge for pediatric surgery centers to take drastic measures to reduce the virus transmission. Telemedicine was introduced and out-patient consultations were conducted online as out-patient clinics were closed. Elective surgeries were postponed with delayed appointments while the healthcare sector was diverted towards tackling COVID-19. Case urgency was classified and triaged, leading to limited surgeries being performed only in COVID-19 negative patients following an extensive screening process. The screening process consisted of online history taking and RT-PCR tests. Newer practices such as mouth rinse, video laryngoscopy, and anesthesia were introduced to restrict patients from crying, coughing, and sneezing, as an attempt to avoid aerosolization of viral particles and safely conduct pediatric surgeries during the pandemic. Surgical trainees were also affected as the smaller number of surgeries conducted reduced the clinical experience available to medical enthusiasts. There is still room for advanced practices to be introduced in pediatric surgery and restore all kinds of surgeries to improve the quality of life of the patient.

摘要

不可避免的是,儿科外科也受到了冠状病毒病-19(COVID-19)大流行的影响。据报道,儿童的症状从轻度到中度不等,死亡率主要发生在年龄<1 岁且有潜在合并症的患者中。大多数儿童无症状,因此,儿科外科中心采取了严格措施来减少病毒传播,这构成了挑战。引入了远程医疗,关闭了门诊诊所,通过在线方式进行了门诊咨询。择期手术被推迟,预约时间延长,而医疗保健部门则转向应对 COVID-19。对病例的紧急程度进行了分类和分诊,只有在经过广泛的筛查过程后,在 COVID-19 阴性患者中才进行有限的手术。该筛查过程包括在线病史采集和 RT-PCR 检测。引入了新的做法,如漱口、视频喉镜和麻醉,以限制患者哭泣、咳嗽和打喷嚏,试图避免病毒颗粒的气溶胶化,并在大流行期间安全地进行儿科手术。外科培训生也受到了影响,因为手术数量减少,减少了医疗爱好者的临床经验。在儿科外科中仍有引入先进实践的空间,并恢复各种手术,以提高患者的生活质量。

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