新型冠状病毒肺炎疫情期口腔专科感染防控的应急管理

本文根据国家有关新型冠状病毒感染防控要求和突发公共卫生事件应急条例,以及口腔专科的临床诊疗特点,参考国内外口腔诊疗中感染防控相关指南和文献,结合医院疫情期口腔诊疗中感染防控的应急管理工作举措,提出应对此次新型冠状病毒肺炎疫情期医院感染防控的建议,重点聚焦疫情期医务人员防护培训及医院感染防控落实等方面,旨在为口腔专科在疫情发生期快速应对新型冠状病毒感染防控的应急管理提供参考。     

新型冠状病毒肺炎流行期降低口腔诊疗中气溶胶传播风险的策略

新型冠状病毒肺炎(COVID-19)自2019年12月爆发以来,迅速在全国蔓延。《新型冠状病毒肺炎诊疗方案(试行第六版)》明确了在相对封闭环境长时间暴露于高浓度气溶胶的情况下存在气溶胶传播COVID-19的可能。口腔诊疗操作中可产生大量气溶胶,是交叉感染的重要风险因素之一。本文根据现有国内外公开发表的相关资料,分析并总结口腔诊疗中应注意的防控措施,为口腔诊疗工作的安全开展提供参考。     

新型冠状病毒肺炎防控时期口腔颌面外科病房诊疗模式的构建与运行

自新型冠状病毒肺炎（COVID-19）疫情爆发以来,中山大学附属口腔医院口腔颌面外科病房从未间断诊疗及护理相关工作。疫情期间,口腔颌面外科医护人员认真学习并严格遵守国家及地区颁布的新型冠状病毒（2019-nCoV）感染疫情防控相关法律法规文件,制定符合疫情防控要求的口腔颌面外科病房诊疗工作模式,有效地开展口腔颌面外科疾病临床治疗及护理工作,从而为口腔颌面部创伤、恶性肿瘤等急危重症患者争取了手术治疗时机。     

新型冠状病毒感染防控时期口腔外科门诊诊疗的专家建议

随着新型冠状病毒肺炎的爆发及蔓延,口腔诊疗过程中带来的感染风险也迅速被人重视。在可择期的口腔诊治项目按照疫情防控相关要求全面暂停的当下,口腔外科医护人员仍坚守一线,担负着口腔颌面部外伤、感染及造成患者极大痛苦且无法保留的患牙拔除等必须急诊处置的工作。本文围绕口腔外科急诊处置的原则、适应证、风险评估、患者准备、医护防护等方面提出建议,以期为疫情期间开展口腔外科诊疗的医护人员提供参考。     

新型冠状病毒肺炎疫情下提高口腔种植门诊诊疗工作的安全性

新型冠状病毒肺炎(Corona Virus Disease 2019,COVID-19)的爆发和传播,成为被世界卫生组织认定的“国际关注的突发公共卫生事件”[1],对口腔种植门诊的诊疗和护理带来巨大的挑战。口腔种植门诊诊疗操作的特殊性,新型冠状病毒肺炎的流行病学特点,使口腔医务人员成为新型冠状病毒肺炎感染的高危群体,疫情存在口腔操作中爆发的危险。本文根据对新型冠状病毒防控的总体要求,结合口腔种植门诊的专业特点,制定相关护理防控措施,保证护理工作有序进行,提高诊疗工作的安全性。本文内容涉及预检分诊、不同工作场景下的防护及提高口腔种植门诊诊疗环境安全性等,提出了疫情下的口腔护理防护策略,达到保护医护人员和患者健康的目的,以期为口腔种植门诊在疫情期的护理防控工作提供参考。     

新型冠状病毒肺炎疫情期间口腔门诊管理与感染防控对策

2019年12月以来,湖北省武汉市新型冠状病毒肺炎（COVID-19,简称新冠肺炎）疫情爆发,并快速向全国各地及境外蔓延,严重威胁人民生命健康。口腔诊疗因具有医护患距离近、操作时间长,并且常规使用高速涡轮快速手机、超声波洁牙机等产生大量飞沫和气溶胶设备的特点,存在较高的院内扩散和医院感染风险。为有效地阻断医院内新型冠状病毒的传播,控制疫情的扩散,结合口腔诊疗特点,本文提出了新冠肺炎疫情期间口腔门诊管理及防控对策,并希望对后疫情期即将恢复正常诊疗活动的医院感染防控提供参考。     

新型冠状病毒感染疫情防控阶段口腔黏膜病诊疗的专家建议

2020年1月20日,国家卫生健康委员会公告(2020年第1号)将新型冠状病毒感染的肺炎纳入《中华人民共和国传染病防治法》规定的乙类传染病,按甲类传染病管理。各级人民政府、卫生健康行政部门高度重视,医疗卫生机构依法采取系列防控措施,共同预防控制新型冠状病毒感染的肺炎疫情的传播。在抗击疫情工作中,如何做好口腔黏膜病科医师防护规范、手部和环境的清洁消毒,对于口腔黏膜病伴发热的患者如何合理开展预检分诊,疫情防控期间口腔黏膜病患者的自我保健和自我管理等,是各级医疗机构、医务工作者和口腔黏膜病患者遇到的实际问题。针对这3个与口腔黏膜病科相关的问题,上海市口腔医学会口腔黏膜病专业委员会和上海第九人民医院集团口腔黏膜病专科联盟组织专家编写了相应的处置流程及专家建议,以满足当前口腔黏膜病医务工作者和患者更好地应对新型冠状病毒感染疫情工作的需要。本建议将根据国内疫情防控形势及新的相关诊疗方案而及时更新。     

从新型冠状病毒肺炎疫情防控看传染病流行期口腔门诊管理策略

新型冠状病毒肺炎爆发对口腔医疗机构管理和临床诊疗中的传染病防护提出了新课题。本文结合我国传染病防治法、国家卫生健康委员会颁发的相关规范标准,参考部分省份口腔医疗质量控制中心制定的口腔门、急诊医院感染控制规范和本次新型冠状病毒肺炎疫情情况,对口腔门、急诊在疫情控制期控制交叉感染和医务人员防护等方面进行了探讨,希望为疫情发生时口腔医疗机构的应对和相关的临床研究提供参考。     

Determinants of Iranian dentists' behaviour regarding infection control

Aim: To evaluate the determinants of Iranian dentists’ behaviour regarding infection control (IC). Design: A cross‐sectional questionnaire survey. Setting: Iranian general dental practitioners (GDP) participating in a national dental congress. Methods: The GDPs filled in a self‐administered questionnaire containing questions regarding their attitudes towards and their behaviour on several aspects of IC. Background factors included GDP’s year of birth, gender, and work‐related factors. Statistical evaluation employed the Chi‐square test, Cronbach alpha, and regression analysis. Results: In total, 479 GDPs returned the questionnaire. Their mean age was 38.6 years (SD = 9.4) and 53% were men. The vast majority of the GDPs had positive attitudes towards the inquired after IC criteria with no statistical difference based on the GDP’s background characteristics. Of all respondents, >70% reported that they inform the laboratory about the infection status of the sent items, disinfect impressions before sending to the laboratory, and wash patients’ mouths before working with high‐speed or ultrasonic devices. Adherence to all the studied IC criteria was reported by 10% of the respondents; more frequently by younger GDPs and those with fewer experience years (P < 0.05). Conclusion: Greater emphasis on infection control programmes in dentists’ education is called for especially in continuing education.     

加强口腔医院消毒供应中心管理控制医院感染

口腔医院消毒供应中心与医院感染的控制紧密相联,加强消毒供应中心的管理可有效控制医源性感染。根据消毒供应中心管理的行业规范和相关科学理论,分析口腔医院消毒供应中心的管理内容和工作程序,通过科学化管理,严格控制消毒供应质量,可以提升工作品质,提高消毒供应水平,控制医院感染的发生。     

新型冠状病毒肺炎防控期间综合性医院口腔科急诊739例临床分析与对策

目的:通过整理新型冠状病毒肺炎(COVID-19)防控期间口腔科急诊病例的年龄、性别、病例分类、就诊时间,整体分析综合性医院口腔科在COVID-19 防控期间的急诊规律及防治原则.方法 :收集泰州市人民医院2020年01月29日-2020年02月28日间,口腔科急诊病例739例,按年龄分为青少年(≤18岁)、青壮年(1...     

Precaution of 2019 novel coronavirus infection in department of oral and maxillofacial surgery

The epidemic of the 2019 novel coronavirus (2019-nCoV) infection has presented as a critical period. Until February 23^rd 2020, more than 77 000 cases of 2019-nCoV infection have been confirmed in China, which has a great impact on economy and society. It has also interferred with ordinary medical practice of oral and maxillofacial surgery seriously. In order to protect the oral and maxillofacial surgery medical staff from 2019-nCoV infection during the outbreak period, this paper suggests the necessary medical protective measures for oral and maxillofacial surgery outpatients and wards.     

Impacts of lockdown during the SARS-CoV-2 pandemic on patients presenting with cervicofacial infection of odontogenic origin: a comparative study

The SARS-CoV-2 pandemic caused unprecedented disruption to primary and secondary healthcare services. Our aim was to explore whether the pandemic had had any impact on patients presenting with cervicofacial infections (CFI) of odontogenic origin to secondary care and management. Comparative analysis was carried out evaluating prospective and retrospective consecutively admitted patients with a diagnosis of CFI of odontogenic origin in the COVID-19 lockdown period from 15 March to 15 June 2020 and pre-COVID-19 during the same period of the previous year. Data included patients’ demographics, comorbidities, systemic inflammatory response syndrome (SIRS) status on admission, clinical features, prior treatment in primary care, source of referral, SARS-COV-2 antigen status, treatment received in secondary care, intraoperative findings, and whether escalation of the level of care was required. Across both cohorts there were one hundred and twenty-five (125) patients admitted with CFI of odontogenic origin, with a 33% reduction (n=75 (2019) vs n=50 (2020)) in number of patients admitted during COVID-19 lockdown. There was no difference between the cohorts in terms of age (p=0.192), gender (p=0.609) or major comorbidities (p=0.654). Proportionally more patients in the COVID-19 group presented with SIRS (p=0.004). This group of patients persisted with symptoms for longer before presenting to secondary care (p=0.003), more delay from hospital admission to surgical intervention (p<0.005) and had longer hospital stays (p=0.001). More patients required extraoral surgical drainage during COVID-19 (p=0.056). This study suggests that the COVID-19 lockdown has had adverse effects on the presentation of CFI of odontogenic origin and its management within a Regional Acute Maxillofacial Service. Commissioners and clinicians should endeavour to plan for adequate primary and secondary care provision during any future local lockdowns to ensure that patient care is optimised.     

Role of respirators in controlling the spread of novel coronavirus (COVID-19) amongst dental healthcare providers: a review

During the ongoing COVID-19 pandemic, healthcare professionals are at the forefront of managing the highly infectious coronavirus. As the most common route of transmission is via aerosols and droplet inhalation, it is critical for healthcare workers to have the correct personal protective equipment (PPE) including gowns, masks and goggles. Surgical masks are not effective in preventing the influenza and SARS, so they are unlikely to be able to resist contaminated aerosols from entering the respiratory system. Therefore, it is vital to use respirators which have been proven to offer better protection against droplets, aerosols and fluid penetration and which form a tight seal around the mouth and nose. Various types of respirators are used in healthcare settings, such as half-mask filtering facepiece respirators (FFRs) and powered air-purifying respirators (PAPRs). The most commonly used FFR is the N95 disposable respirator, which is tight fitting and has a 95% or above particle filtering efficiency for a median particle size of 0.3 µm. This review discusses respirators, their purpose, types, clinical efficiency and proper donning and doffing techniques.     

新型冠状病毒肺炎疫情期间口腔颌面创伤门急诊护理策略

新型冠状病毒肺炎（COVID-19）疫情目前仍然处于严峻阶段。由于口腔颌面创伤处理的特殊性及紧迫性,门急诊创伤工作医务人员承担着潜在的感染风险,切实有效落实防控措施尤为重要。护理工作在整个口腔颌面创伤的诊救过程中扮演着相当重要的角色。如何协同团队,在积极应对急症的情况下,正确落实各项防控措施,阻断疫情扩散,从而降低感染发生的风险,是目前护理工作需要面临的重要问题。本文以上海交通大学医学院附属第九人民医院口腔颌面门急诊创伤护理工作经验为例,初步讨论了口腔颌面门急诊创伤护理策略,旨在为临床开展工作提供参考。