Chirurgia (Bucur). 2021 Dec;116(6):748-755. doi: 10.21614/chirurgia.116.6.748.
In the case of patients admitted with acute abdomen at the emergency department, interstitial pulmonary pathology (Covid-19 infections) represents a significant operative risk for the patients. The rate of postoperative complications is high with increased morbidity and mortality, a real challenge for the medical staff and surgical/intensive care unit teams. In emergency settings, patients were examined with targeted clinical and paraclinical parameters that assure a fast diagnosis to optimize a rapid medical and surgical treatment. We conducted a retrospective comparative study that included patients enrolled and diagnosed with an acute surgical abdomen in Surgical Clinic 1 Tg. Mures Emergency County Hospital. Patients were examined and analyzed at the emergency department UPU-SMURD. We included patients admitted over the two years (2019 and 2020) and divided them into two groups. The total number of patients admitted in the UPU-Smurd emergency department Surgical Clinic I over the two years was 1033. There was a significant reduction in total cases diagnosed with the acute surgical abdomen in the pandemic period (p=0.033). The average time from the admission to the surgical procedure was significantly higher in the pandemic period 380Ã+-2 min in comparison with 222+-3 min (p=0.001) and also with an increased average operative time 223+-3 min versus 145+-2 min (p=0.002). Average hospitalization time was higher in the pandemic period 10+-1 (p=0.031) with no significant difference between the groups regarding Intensive Care Unit (ICU) admission (p=0.122). Overall mortality has more than doubled, with 31 cases (19%) in the pandemic and 28 (9%) in the non-pandemic. (p=0.001). The COVID-19 pandemic has played an essential role in treating acute surgical abdomen cases. The high solicitation rate of the emergency department delayed the diagnosis and treatment of severe surgical cases. As the scale of this pandemic is unprecedented, standard protocols with minor changes do not provide adequate results.
在急诊科收治的急性腹痛患者中，间质性肺病理学（Covid-19 感染）对患者的手术风险很大。术后并发症发生率高，发病率和死亡率增加，这对医务人员和外科/重症监护病房团队构成了真正的挑战。在紧急情况下，患者接受了有针对性的临床和辅助检查参数检查，以确保快速诊断，从而优化快速的医疗和手术治疗。我们进行了一项回顾性比较研究，该研究包括在 Surgical Clinic 1 Tg. Mures 紧急县医院收治并诊断为急性外科腹痛的患者。患者在 UPU-SMURD 急诊部接受检查和分析。我们纳入了两年（2019 年和 2020 年）期间入院的患者，并将其分为两组。在这两年中，在 UPU-Smurd 急诊部 Surgical Clinic I 就诊的患者总数为 1033 人。在大流行期间，被诊断为急性外科腹痛的总病例数明显减少（p=0.033）。在大流行期间，从入院到手术的平均时间明显增加，为 380±2 分钟，而 222±3 分钟（p=0.001），手术时间也有所增加，为 223±3 分钟，而 145±2 分钟（p=0.002）。大流行期间的平均住院时间更高，为 10±1 天（p=0.031），但两组之间的重症监护病房（ICU）入住率没有显著差异（p=0.122）。总死亡率增加了一倍多，大流行期间有 31 例（19%），非大流行期间有 28 例（9%）（p=0.001）。Covid-19 大流行在治疗急性外科腹痛病例方面发挥了重要作用。急诊科高发病率延迟了严重外科病例的诊断和治疗。由于此次大流行规模空前，微小改动的标准方案并未提供足够的结果。
