COVID-19流行区域外科收治全流程防护决策对骨科创伤患者处置能力影响探讨

目的 提出一种在新型冠状病毒肺炎(COVID-19)流行区域对疑似及确诊病例合并骨创伤患者的外科流程化分区收治处置对策,研究在COVID-19疫情中心区域实施相应诊疗行动对骨科住院择期及限期手术患者的影响。方法 回顾性分析本院2020年1月20日至2020年3月15日收治的湖北省武汉市COVID-19疫情中心区域骨科择期及限期手术患者共计40例,按门急诊处理及分流、医院综合缓冲病区隔离筛查、专科病房及手术处置3个阶段分区诊疗处理决策进行救治。记录平均院前待床时间、住院后平均手术前准备时间、术后平均住院时间,与2019年度同期收治患者进行比较分析。同时进行治疗优良度的临床评估。结果 COVID-19疫情下手术患者平均手术前准备时间和2019年同期相比存在较大幅度增长,术后平均住院时间及总住院时间则有所缩短。因平均院前待床时间延长,陈旧性骨折发生率有所升高,但手术优良率在评估时未见明显下降。结论 COVID-19流行区域采用外科流程化分区收治诊疗处理可以有效对骨科患者进行快速处置,在控制院内感染风险的基础上,维持医院周转能力。

Effect of surgical admission process protection decision in the COVID-19 pandemic area on the treatment capacity of orthopedic trauma patients

Objective A surgical divisional hospitalization process strategy for suspected and confirmed cases with bone trauma in COVID-19 pandemic area, to research impact of diagnosis and treatment on orthopedic hospitalized patients in the central region of the new coronavirus pandemic. Methods A retrospective study of a total of 40 patients undergoing elective or limited time orthopedic surgery in the area of COVID-19 pandemic center in Wuhan, Hubei, from January 20, 2020 to March 15, 2020. Treatment according to the three-stage hierarchical diagnosis and treatment decision, divided into outpatient emergency treatment and triage, hospital comprehensive buffer ward isolation screening, specialist ward and surgical treatment. Recording the average pre-hospital bed-waiting time, the average pre-surgery preparation time, and the post-surgery average hospitalization time and compared and analyzed with same period of last year. At the same time, conducted a preliminary clinical evaluation of treatment. Results Under the pandemic situation, the average pre-surgery preparation time before surgery have increased significantly compared with the same period of the previous year, the post-surgery average hospitalization time has been significantly reduced. Increasing incidence of old fractures due to prolonged bed-waiting time, but the rate of excellent surgery did not decrease significantly when evaluated compared with the same period. Conclusion COVID-19 pandemic area adopts a divisional hospitalization process strategy to effectively treat patients with bone trauma. Based on monitoring the risk of nosocomial infections of suspected and confirmed cases, maintain the turnover capability of hospital.