新型冠状病毒肺炎疫情下实施普通外科手术的思考和建议

由2019新型冠状病毒(2019-nCoV)引起的肺炎(简称新冠肺炎)目前正在我国肆虐。已经证实,新冠肺炎可以在人际间传播。根据最新的临床报道,由医院相关性传播导致的新冠肺炎并不少见,给外科医护人员和住院患者造成严重威胁。在此疫情之下,普通外科医生应掌握新冠肺炎的临床表现和流行病学特点,尤其是了解新冠肺炎可能引起的消化道和腹部症状,避免误诊漏诊。针对急诊手术和限期手术,应在积极排查和防控新冠肺炎的基础上,合理有序开展。为新冠肺炎患者实施紧急手术时,必须严格遵照当地卫生行政主管部门或所在医疗机构的相关防护规定,密切协调手术各方,所有人员均应做好二级或三级防护,手术必须在负压手术间进行。对于不具备上述医疗条件的单位,宜尽快将需要紧急手术的新冠肺炎患者转诊至有条件的医疗单位。

Thoughts and advice on performing procedures in general surgery during the outbreak of novel coronavirus pneumonia

The epidemic of the novel coronavirus 2019 (2019-nCoV)-associated pneumonia (abbreviated as NCP) is currently raging in China. It has been proven that 2019-nCoV can be transmitted from human-to-human. According to the latest clinical reports, hospital-associated spread of NCP is not rare, which poses great threats to both the medical staff and in-hospital patients. Under the epidemic situation, surgeons who practice general surgery should be aware of the epidemiological features and clinical manifestations of NCP, especially the digestive tract and abdominal symptoms caused by this condition, to avoid misdiagnosis and missed diagnosis. The emergent or urgent surgeries should be performed properly and timely on the basis of aggressive exclusion and prevention of NCP. During emergent surgery for patients with NCP, the prevention and control rules framed by the local health administration or local medical institution should be strictly followed, all members of the surgical team must function in a coordinated fashion, class 2 or 3 prevention measures should be provided to all personnel, and the operation should be performed in a negative-pressure operating room. If the local hospital does not have the above capability, the patients with NCP requiring urgent surgery should be transferred immediately to a hospital with appropriate services.