胸外科病区内交叉感染新型冠状病毒肺炎防治的临床实践

目的总结胸外科病区院内交叉性感染新型冠状病毒围手术期患者的临床特点,以指导抗击疫情期间病区内感染的防治工作。方法回顾性分析华中科技大学同济医学院附属同济医院胸外科病房2020年1月1~24日因胸部疾病在院治疗451例患者的临床资料,其中手术患者245例、非手术患者206例;并对患者出院后进行随访。结果胸外科病房内新型冠状病毒感染患者7例,感染率1.55%(7/451),其中男5例、女2例,年龄56~68岁。感染者均为手术患者,其术前影像学资料均未提及病毒性肺炎影像学改变。高龄、吸烟、手术、冠状动脉粥样硬化性心脏病、慢性肝病及肿瘤病史的患者更容易感染。从患者床位空间分布上发现感染患者之间的距离均>1 m,且未发现同病房人员交叉感染。随访中有2名家属出院后1周感染,但回溯家属在院期间的床位时空分布与感染患者均无交叉。结论本研究发现胸外科病区新型冠状病毒肺炎感染率低,可能属于机会感染,同时做好严密的消毒杀菌防控防疫工作能够减少胸外科病区交叉感染的发生。

Prevention and treatment of cross infection of novel coronavirus pneumonia in thoracic surgery ward

Objective By summarizing the clinical characteristics of perioperative patients with cross infection of novel coronavirus in thoracic surgery ward,to guide the prevention and treatment of nosocomial infection during the anti-epidemic period.Methods The clinical data of 451 patients with chest diseases in the Department of Thoracic Surgery of Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from January 1 st to 24 th,2020 were analyzed and followed up.There were 245 surgical patients and 206 non-surgical patients.Results In the department,7 patients(7/451,1.55%)were infected with the novel coronavirus and all of them were surgical patients,whose preoperative imaging data did not reveal the imaging changes of novel coronavirus.There were 5 males and 2 females,aged 56 to 68 years.The patients with old age,smoking,surgery,coronary heart disease,chronic liver disease and tumor history were more susceptible to infection.From the spatial distribution of patient beds,it was found that the distance among infected patients was greater than 1 m,and no cross infection was found in the other patients of the same ward.During follow-up,two family members of noninfected patients were found to be infected one week after discharge.However,there was no overlap of spatiotemporal distribution between the family members and the infected patients during the hospitalization period.Conclusion The novel coronavirus pneumonia rate in the department of thoracic surgery is low,which may be opportunistic infection.At the same time,a good control and prevention of epidemic disease can reduce the occurrence of cross infection in the department of thoracic surgery.