新型冠状病毒肺炎疫区胸腰椎骨折诊疗的防控措施及方案  

Prevention and control measures for COVID-19 in diagnosis and treatment of thoracolumbar fractures

作　　者：徐峰 黄亮亮 熊承杰 康辉 马俊 伍博宇 黄景辉 罗卓荆[2] XUFeng;HUANG Liang-liang;XIONG Cheng-jie;KANG Hui;MA Jun;WU Bo-yu;HUANG Jing-hui;LUO Zhuo-jing(Department of Orthopaedics,General Hospital of PLA Central Theater Command,Wuhan 430070,China;Department of Orthopae dics,Xijing Hospital,PLA Air Force Military Medical University,Xi'an 710032,China)

机构地区：[1]中国人民解放军中部战区总医院骨科,湖北武汉430070 [2]中国人民解放军空军军医大学西京医院骨科,陕西西安710032

出　　处：《中国矫形外科杂志》2020年第6期481-485,共5页Orthopedic Journal of China

基　　金：全军医学科技青年培育计划项目(编号:18QNP054);湖北省卫生和计划生育委员会科研项目(编号:WJ2017H0033)。

摘　　要：新型冠状病毒肺炎(COVID-19)传染性强,湖北为疫情爆发最严重的地区,尤其武汉处于疫情的中心,疫情防控不到位,极易引起COVID-19扩散,甚至导致医护感染。胸腰椎骨折(thoracolumbar fracture,TLF)是一种常见急性严重的脊柱损伤,如果不能够及时规范救治,往往会遗留肌力、感觉及大小便等功能障碍,甚至截瘫。在这种疫情与病情混杂的局面,如何解决疫情防控和TLF及时规范救治是一个巨大挑战。本院处于COVID-19的中心疫区,为武汉市COVID-19定点医院,同时也为武汉市非COVID-19特殊患者医疗救治单位,收治了一批合并COV ID-19的TLF患者及非COVID-19的TLF患者。本文作者从脊柱外科医师的角度出发,总结疫情爆发以来对TLF相关诊疗经验体会,归纳TLF的诊疗流程,为骨科一线医务人员在接诊、治疗和防护等方面提供参考,以期在疫情期间减少医患COVID-19感染风险,提高TLF治愈率,降低并发症与后遗症。Coronavirus disease 2019(COVID-19)is highly contagious,which firstly outbreak seriously in Hubei with epi demic center in Wuhan.The carelessness of prevention and control of COVID-19 might result in the spread of COVID-19,even cause medical staff infection.Thoracolumbar fractures(TLF)are common server injuries,usually accompanied with severe spinal cord injury.If not treated on time,the dysfunctions of motion and sensation,even paraplegia might turn to be permanent impairment.Under COVID-19 epidemic,combination of prevention of COVID-19 infection and treatment of TLF without delay remains a huge challenge.As our hospital located in the epidemic center of COVID-19,and designated as the hospital for COV ID-19 and non-COVID-19 patients in Wuhan,a number of TLF patients with or without COVID-19 were treated.Based on views of spinal surgeons,the experiences on strategy of TLF diagnosis and treatment since the COVID-19 outbreak were sum marized in this paper,which would provide a reference for orthopedic staff who will deal with this specific scenario that TLF treatment and COVID-19 protection conducted simultaneously.We hope that it is helpful to decrease the risk of COVID-19 in fection,meanwhile improve the TLF treatment and reduce complications and sequelae.

关 键 词：新型冠状病毒肺炎 胸腰椎骨折 TLICS 评分 手术指征 手术时机 

分 类 号：R683.2[医药卫生—骨科学]