新型冠状病毒肺炎疫情防控时期主动脉急症患者诊治的建议

近期新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)疫情爆发,恰逢主动脉急症高发的冬春时节,而主动脉急症大多起病急骤,病情危重,死亡率高,需紧急处理。在国家"重大突发公共卫生事件一级响应机制"之下,疫期主动脉急症患者的诊疗需制订全新的流程。如何在这一特殊时期增强医护人员的防护和正确救治意识,既让主动脉急症患者获得及时、有效的治疗,又能避免救治期间可能发生的院内疫情传播,是急诊科、心外科、血管外科等相关学科当前面临的重大课题。本文呼吁各医疗单位在严格遵守政府和医院感控部门规章制度的基础上开展医疗实践,在"疫情防控为重,严防院内感染,确诊COVID-19患者首选保守"的前提下,提倡"择期手术适当推迟,限期手术术前隔离排查,急诊手术严格防护"的诊治原则,同时针对COVID-19疫期主动脉急症患者的急诊科接诊、病房收治、术前准备、术中防护、术后处理等方面提出了建议。

Suggestions on the Management of Aortic Emergencies in Prevention and Control Period of Coronavirus Disease 2019

The outbreak of coronavirus disease 2019(COVID-19) now coincides with high incidence of aortic emergencies, which traditionally are more often seen in the winter and spring. Aortic emergencies are characterized by sudden onset, critical illness and high mortality, thus require urgent treatment. Under the "National first-level response mechanism for major public health emergencies", the diagnosis and treatment strategies of patients with aortic emergencies need to be highlighted with a new mode. How to provide timely treatment for patients with aortic emergencies in this special period, and at the same time to enhance the awareness of medical staff to prevent the spread of the epidemic in the hospital, are major issues currently encountered by the staffs working in emergency department/cardiac surgery/vascular surgery and other related departments. This article calls on all medical units to carry out medical practice on the basis of strictly abiding by the rules and regulations of the government and the hospital’s infection control department. On the premise of "prevention and control of epidemic situation is priority, prevention of nosocomial infection is the most important, and conservative treatment is the first choice for confirmed COVID-19 patients", it advocates the diagnosis and treatment principle of "appropriate postponement of selective operation, isolation and screening of COVID-19 before deadline operation, and emergency surgery under strict protection". It also comprehensively puts forward the experts’ suggestions on the diagnosis, treatment and nursing for aortic emergency patients in pre-operative preparation, intraoperative protection and postoperative care during COVID-19 epidemic period.