2019冠状病毒病(COVID-19)疑似患者多学科协作诊治分析

目的: 分析多学科协作诊疗（MDT）在2019冠状病毒病（COVID-19）疑似病例诊治中的参与情况及处置结果，总结MDT在COVID-19诊治中的作用。方法: 回顾性分析2020年1月21日至3月20日就诊于金华市中心医院的48例COVID-19疑似患者的临床资料及诊治经过，进一步分析MDT在患者处置流程和诊断中的作用。结果: 18例确诊COVID-19，30例排除COVID-19。确诊患者经MDT讨论2~12次，平均每例患者讨论（4.7±3.2）次；非COVID-19患者多学科讨论2~4次，平均每例患者讨论（2.3±0.6）次。MDT对COVID-19疑似患者诊疗流程及诊断标准进行了讨论及调整。在MDT主导下，1例危重型患者积极治疗后转省级定点医院治疗，1例COVID-19合并急性胆囊炎患者行胆囊穿刺置管引流术手术，1例高度疑似患者行肺泡灌洗液检查排除COVID-19。除1例COVID-19危重型患者转省级医院治疗外，17例COVID-19患者均治愈出院，未发现院内及疑似患者交叉感染，无死亡病例，无医务人员感染发生，非COVID-19患者及时转到相应专科治疗。结论: 在COVID-19疑似患者诊治过程中，MDT的参与提高了诊治效率，尤其对疑难复杂病例诊治有重要作用。

Roles of multidisciplinary team in diagnosis and treatment of suspected cases of COVID-19

Objective: To analyze the roles of multidisciplinary team (MDT) in the diagnosis and treatment of suspected cases of coronavirus disease 2019 (COVID-19). Methods: The clinical data of 48 patients with suspected COVID-19 admitted in Jinhua Municipal Central Hospital from January 21, 2020 to March 20, 2020 were retrospectively analyzed. Results: In the 48 suspected cases, 18 were diagnosed with COVID-19, and 30 were excluded. Each of the confirmed cases were discussed among MDT for 2 to 12 times with an average of (4.7±3.2) times; while for non-COVID-19 patients were discussed for 2 to 4 times with an average of (2.3±0.6) times. With the guidance of MDT, one COVID-19 patient was transferred to designated provincial hospital after effective treatment; one patient complicated with acute cholecystitis underwent gallbladder puncture and drainage; and COVID-19 was excluded in a highly suspected patient after alveolar lavage fluid examination. Except one transferred patient, all 17 confirmed COVID-19 patients were cured and discharged. There was no cross-infection occurred in suspected patients during the hospitalization. There were no deaths and no medical staff infections. Conclusion: The efficiency of diagnosis and treatment for suspected COVID-19 patients can be improved with MDT, particularly for complicated cases.