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新冠疫情时代小儿外科实践中的挑战与变化

Challenges and Changes in Pediatric Surgical Practice during the COVID-19 Pandemic Era.

作者信息

Shah Nirkhi R, Ramji Jaishri, Vaghela Maheshkumar Manilal, Mehta Charul, Vohra Arif, Joshi Rakesh S

机构信息

Department of Pediatric Surgery, B. J. Medical College and Civil Hospital, Ahmedabad, Gujarat, India.

出版信息

J Indian Assoc Pediatr Surg. 2022 Jul-Aug;27(4):455-461. doi: 10.4103/jiaps.jiaps_142_21. Epub 2022 Jul 26.

Abstract

AIM

Working practices in pediatric surgery underwent enormous changes during the era of the COVID-19 pandemic. While certain surgical conditions in children can be managed temporarily with nonsurgical options, most neonates with congenital surgical malformations require emergent operations. We discuss the challenges faced; measures adopted in dealing with surgical emergencies and analyze the diagnoses and outcomes of patients with COVID-19 infection in our institute during the pandemic era.

MATERIALS AND METHODS

When the lockdown was imposed, it was mandated that all elective procedures should be put on hold. We formulated criteria for triaging procedures as emergent, urgent, and elective. A standard operating protocol was devised regarding admission, pre and postoperative management. Protocols for surgical procedures were established in a separate Covid-designated operation room including a specified sequence of donning and doffing personal protective equipment.

RESULTS

In the COVID era, from March 23, 2020 to mid-July 2021, 1282 surgeries have been done in our department, 344 emergencies and 461 planned procedures, which include 31 COVID-19 positive cases, with overall good outcomes. 103 emergency surgeries were done during the first wave (March-end to June 2020), and 103during the second wave (April to mid-June 2021). Moreover, not a single healthcare worker in the department has been infected.

CONCLUSION

Pediatric Surgeons are adapting to the new guidelines to continue to provide emergency services with safe and effective care to their patients during the COVID-19 pandemic. Simultaneously, focus on personal and staff protection is ensured to keep the healthcare workers healthy and able to discharge their duties adequately.

摘要

目的

在新冠疫情时代,小儿外科的工作方式发生了巨大变化。虽然某些儿童外科疾病可以通过非手术方法暂时处理,但大多数患有先天性外科畸形的新生儿需要紧急手术。我们讨论了面临的挑战;应对外科急症所采取的措施,并分析了疫情期间我院新冠感染患者的诊断和治疗结果。

材料与方法

实施封锁措施时,规定所有择期手术应暂停。我们制定了将手术分为急诊、 urgent和择期的分诊标准。制定了关于入院、术前和术后管理的标准操作方案。在一个单独的新冠指定手术室中建立了手术操作规范,包括穿戴和脱卸个人防护装备的特定顺序。

结果

在新冠疫情时代,从2020年3月23日至2021年7月中旬,我们科室共进行了1282例手术,其中急诊344例,计划手术461例,包括31例新冠阳性病例,总体效果良好。第一波疫情期间(2020年3月底至6月)进行了103例急诊手术,第二波疫情期间(2021年4月至6月中旬)进行了103例。此外,科室没有一名医护人员被感染。

结论

小儿外科医生正在适应新的指导方针,以便在新冠疫情期间继续为患者提供安全有效的紧急服务。同时,确保注重个人和工作人员的防护,以保持医护人员的健康并使其能够充分履行职责。

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本文引用的文献

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