严重急性呼吸综合征冠状病毒2流行期间儿童实体肿瘤诊治中的防控策略

自2019年12月湖北出现新型冠状病毒感染(corona virus disease 2019,COVID-19)患者以来,该病毒现已逐步扩散至全国各地及境外多个国家。国际病毒分类委员会将致病病毒命名为严重急性呼吸综合征冠状病毒2(severe acute respiratory syndrome coronavirus 2,SARS-CoV-2),人群普遍易感,包括儿童和孕产妇。恶性实体肿瘤患儿因肿瘤本身及化疗、放疗、免疫治疗等综合治疗手段的影响,免疫力较正常儿童低,可能更容易发生感染并进展为重症病例,而保障恶性实体肿瘤综合治疗计划实施的延续性和规范性是提高疗效、获得良好预后的关键之一。疫情期间,如何在做好疫情防控工作的同时保障肿瘤诊疗工作有序进行,是摆在每一个病患和医务人员面前的难题。本文结合COVID-19的传播特点以及有关部门防控COVID-19的要求,针对儿童实体肿瘤诊疗工作中的主要环节,提出疫情期间应考虑实施的措施和策略,建议制定科学的实体肿瘤门诊和病房管理制度,保障急诊手术,合理安排限期手术,适当延期择期手术,保障化疗规律进行,在保护患儿免受SARS-CoV-2感染的同时,确保儿童实体肿瘤综合诊疗工作的连续性。

Prevention and control strategies of diagnosing and treating pediatric solid tumors during the epidemic period of SARS-CoV-2

A novel coronavirus infection(corona virus disease 2019,COVID-19) occurred in Hubei Province in December 2019.It has gradually spread to various parts of China and overseas countries.Recently International Committee on Taxonomy of Viruses(ICTV) renamed the pathogenic virus as severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) and the susceptible population is made up of children and pregnant women.At one hand,children with malignant solid tumors tend to have lower immunity than normal counterparts due to the effects of tumors and such comprehensive treatments as chemoradiotherapy and immunotherapy.As a result,they may be more prone to infections and severe complications.At the other hand,the continuity and standardization of comprehensive treatments is crucial for achieving a decent prognosis.How to prevent and control the epidemic and ensure the orderly flows of cancer diagnosis and treatment at the same time have presented huge challenges for both patients and clinicians during the epidemic period.Based upon the transmission characteristics of SARS-CoV-2 and the requirements for prevention and control of COVID-19,the authors proposed some concrete measures and practical strategies of managing pediatric solid tumors during the epidemic period.The specific measures include:1、 Establishing a reasonable management system for outpatients and inpatients of solid tumors,2、Performing emergency surgery,rationally handling limited-term procedures and appropriately postponing elective surgery,3、Implementing regular chemotherapy.All the above measures are taken for protecting children from SARS-CoV-2 infection and ensuring the continuity of comprehensive treatments of pediatric solid tumors.