北京某儿童专科医院新型冠状病毒感染疫情期间小儿外科急症病人的特点及应对  

Characteristics and response of pediatric surgical acute patients during the epidemic of COVID-19 at a Children's specialist hospital in Beijing

作　　者：王凯[1] 张丹[1] 庞文博[1] 陈巍[1] 沈秋龙[1] 王丽[1] 王增萌[1] 陈亚军[1] Wang Kai;Zhang Dan;Pang Wenbo;Chen Wei;Shen Qiulong;Wang Li;Wang Zengmeng;Chen Yajun(Department of General Surgery,Beijing Children's Hospital,Capital Medical University,National Center for Children's Health,Beijing 100045,China)

机构地区：[1]国家儿童医学中心,首都医科大学附属北京儿童医院普外科,北京市100045

出　　处：《临床小儿外科杂志》2020年第3期267-271,共5页Journal of Clinical Pediatric Surgery

摘　　要：目的初步探讨新型冠状病毒感染疫情期间北京某儿童专科医院小儿外科急症病人的疾病谱特征及应对措施。方法以2020年1月24日至2月24日期间首都医科大学附属北京儿童医院外科急诊就诊的患儿以及因急腹症于普外科住院治疗的患儿为研究对象,并与2018年、2019年1月24日至2月24日期间同条件患儿的病例资料进行纵向对比,总结归纳患儿来源、诊断等信息。结果新型冠状病毒感染疫情期间本院外科急诊病例数为1655例,较2018年、2019年减少,但北京市来源病例达1048例(63.3%),就诊病例中急腹症达440例(26.6%),占比较2018年、2019年均有所升高。外伤病例占比与2018年、2019年无显著差异,但车祸伤患儿比例显著下降,由2018年的46例(3.5%)减少至2020年的5例(0.7%)。因急腹症住院治疗83例,较前稍有增加。疫情期间无一例需住院治疗的重症外伤病例。从构成比来看,阑尾炎为本院急腹症住院治疗的主要病种,对比本院三年阑尾炎患儿病例资料,发现2020年疫情期间阑尾炎患儿病例数较2018年、2019年增加,1个月内收治病例达61例;出现症状至手术时间超过3天的患儿比例达24.6%,高于2018年、2019年;患儿阑尾穿孔比例较2018年、2019年增加,达57.4%。结论新型冠状病毒感染重大疫情启动一级响应后,北京某儿童专科医院小儿外科急诊病种结构有所改变,虽然病人总数显著减少,但需更加警惕急腹症,并注意与新型冠状病毒感染的鉴别;住院部急腹症患儿多数病史时间长、病情重,应谨慎筛查,改变病房运转模式。Objective To summarize the clinical characteristics and responses of emergency pediatric surgery during the epidemic of COVID-19.Methods Retrospective review was performed for clinical data from emergency and inpatient departments of pediatric surgery during January 24 to February 24 in 2020.And a comparison was made with similar data during 2018 and 2019.Results During the epidemic of COVID-19,the emergency department received 1655 cases and it was a sharp decrease while local patients increased.Acute abdomen cases increased while pediatric trauma decreased.However,trauma due to traffic accidents obviously decreased from 3.5%to 0.7%.Inpatient department handled 83 cases of acute abdomen and it increased.No severe trauma case was seen during the study period at the inpatient department.Appendicitis was the most frequent at 74%in 2020.And perforated appendix accounted for 57.4%.Up to 24.6%cases had symptoms longer than 3 days pre-surgery.Conclusion During the epidemic of COVID-19,the proportions at emergency department of pediatric surgery undergo some changes and total cases decline.However,physicians should stay more vigilant for pediatric emergency and differentiate diseases from COVID-19.Most children with acute abdomen at inpatient department have a longer history and a severe illness.Proper responses include careful screening and changing operating modes.

关 键 词：新型冠状病毒感染 小儿外科 急症 

分 类 号：R726[医药卫生—儿科] R473.51[医药卫生—临床医学]