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术前检测 2019 年冠状病毒病——感染患者安全的手术结局。

Testing for coronarvirus disease 2019 before cardiac surgery-safe outcome of infected patients.

机构信息

Department of Cardiothoracic Surgery, Karolinska University Hospital, Eugeniavägen 23, C12:28, 171 76, Stockholm, Sweden.

Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.

出版信息

J Cardiothorac Surg. 2022 Aug 24;17(1):201. doi: 10.1186/s13019-022-01960-1.

Abstract

BACKGROUND

The aim was to analyze routine preoperative testing for coronavirus disease 2019 (COVID-19) performed to avoid infected cardiac surgical patients transmitting virus during the pandemic.

METHODS

Every patient scheduled to undergo cardiac surgery from March 2020 through December 2021 had preoperative polymerase-chain-reaction (PCR) test for COVID-19 by nasopharynx swabs. Any history of COVID-19 was recorded.

RESULTS

In 15 of 1870 patients (0.8%) with minimal or no airway symptoms unexpected positive PCR tests were detected, and surgery was deferred for two weeks. Totally 38 patients with negative tests had recovered without sequelae from previous COVID-19 a mean of 5 months before the operation. Sixteen patients (0.8%) developed airway symptoms within six weeks after the operation and had positive COVID-19 tests. Body Mass Index was higher and female gender, diabetes mellitus, chronic obstructive pulmonary disease and reduced left ventricular ejection fraction were more common in patients with than in those without COVID-19. Early postoperative outcomes did not differ significantly in patients with versus without COVID-19.

CONCLUSIONS

An unexpected preoperative positive COVID-19 test was detected in less than one percent of patients admitted for cardiac surgery during the pandemic. These operations were deferred to avoid transmission of virus in the hospital. Additionally, one percent of patients were diagnosed with positive COVID-19 tests within six weeks after the operation. There was no outbreak of COVID-19 among hospital staff or patients. All patients with COVID-19 before the operation were operated on safely and postoperative outcomes did not differ significantly compared with COVID-19 negative patients.

摘要

背景

本研究旨在分析 2019 年冠状病毒病(COVID-19)大流行期间为避免感染性心外科患者传播病毒而进行的常规术前检测。

方法

2020 年 3 月至 2021 年 12 月期间,所有拟行心脏手术的患者均接受鼻咽拭子聚合酶链反应(PCR)检测 COVID-19。记录任何 COVID-19 病史。

结果

在 1870 例有或无轻微气道症状的患者中,有 15 例(0.8%)意外检测到阳性 PCR 结果,手术推迟两周。共有 38 例阴性检测结果的患者在手术前 5 个月从先前 COVID-19 中康复,无后遗症。16 例(0.8%)患者在术后 6 周内出现气道症状,COVID-19 检测阳性。与无 COVID-19 患者相比,BMI 更高,女性、糖尿病、慢性阻塞性肺疾病和左心室射血分数降低更为常见。有 COVID-19 与无 COVID-19 的患者术后早期结局无显著差异。

结论

在大流行期间,接受心脏手术的患者中,不到 1%的患者术前意外检测出 COVID-19 阳性。这些手术被推迟以避免在医院内传播病毒。此外,1%的患者在术后 6 周内被诊断出 COVID-19 阳性。医院工作人员或患者中未发生 COVID-19 爆发。所有在手术前患有 COVID-19 的患者均安全接受了手术,术后结局与 COVID-19 阴性患者无显著差异。

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