新型冠状病毒肺炎疫情期间开展显微外科手术专家共识  

Experts Consensus on Performing Microsurgery during the Epidemic of COVID-19

作　　者：无 王洪刚[2] 徐雷 陈振兵[4] 康皓 喻爱喜[6] 朱庆裳 顾立强(指导)[2,7] 刘小林(指导) 张长青(指导)[8] 徐永清(指导) 无;WANG Honggang;XU Lei;CHEN Zhenhin;KANG Hao;YU Aixi;ZHU Qingtang;GU Liqiang;LIU Xiaolin;ZHANG Changqing;XU Yongqing(Chinese Microsurgery Society of Chinese Medical Association;Department of Microsurgery,Orthopedic Trauma and Hand Surgery,The First Affiliate Hospital of Sun Y at-sen University,Guangzhou 510080,China;Department of Hand Surgery,Huashan Hospital of Fudan University,Shanghai 200040,China;Department of Hand Surgery,Union Hospital of Tongji Medical College of Huazhong University of Science and Technology,Wuhan 430022,China;Department of Orthopedics,Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology,Wuhan 430030,China;Department of Orthopedics Trauma and Microsurgery,Zhongnan Hospital of Wuhan University,Wuhan 430071,China;Editorial office of Chinese Journal of Microsurgery,Guangzhou 510062,China;Department of Orthopaedics,Shanghai Sixth People's Hospital Affiliated to Shanghai Jiaotong University,Shanghai 200233,China;The 920 Hospital of PLA,Kunming 650032,China)

机构地区：[1]中华医学会显微外科学分会 [2]中山大学附属第一医院显微创伤手外科,广州510080 [3]复旦大学附属华山医院手外科,上海200040 [4]华中科技大学同济医学院附属协和医院手外科,武汉430022 [5]华中科技大学同济医学院附属同济医院骨科,武汉430030 [6]武汉大学中南医院创伤与显微骨科,武汉430071 [7]《中华显微外科杂志》编辑部,广州510062 [8]上海交通大学附属第六人民医院骨科,上海200233 [9]解放军联勤保障部队第九二O医院骨科,昆明650032

出　　处：《中华显微外科杂志》2020年第2期105-111,共3页Chinese Journal of Microsurgery

摘　　要：目前,国内新型冠状病毒肺炎(简称新冠肺炎,COVID-19)疫情防控形势持续向好,各地生产、生活秩序加速恢复.然而,复工、复产带来的人员聚集和流动可能增加疫情反复的风险,境外疫情爆发带来的病例输入压力与日俱增.在“内防反弹,外防输入”的疫情防控要求下,如何开展显微外科手术,做到既满足患者日常诊治需求,又避免疫情扩散,亟待一份专家指导意见.中华医学会显微外科学分会和《中华显微外科杂志》编辑部组织部分显微外科专家,总结、讨论在新冠肺炎疫情期间进行疫情防控及开展显微外科手术的经验,形成专家共识:①根据患者新冠病毒感染风险的级别选择治疗方案,对于高风险患者,可选择非手术治疗或延迟手术,不影响预后者应暂缓进行手术,必须实施急诊手术者,应在Ⅲ级防护下进行手术;对于低风险患者,可在Ⅰ级防护下开展各类显微外科手术.院前急救或需进行紧急手术而未完成新冠肺炎排查,未能确定风险级别者,需在Ⅱ级以上(含Ⅱ级)防护条件下进行手术.②设置过渡病房(病区),集中收治中、高风险患者.③医务人员实施分级防护,正确使用防护用品.④中、高风险患者围术期处置应统一指挥,严格遵守疫情防控指引,有序落实人员、物品及环境准备.⑤需加强医护人员新冠肺炎知识及院感培训,以及手术人员在防护条件下进行显微外科操作的培训.The prevention and control of the epidemic of coronavirus disease 2019(COVID-19)in China is currently continuing to improve and the normal lives and work are gradually restored.However,the gathering and movements of people due to the return of work may increase the risk of recurrence of COVID-19.The pressure from imported COVID-19 is increasing daily,due to the epidemic of COVID-19 abroad.Under the prevention and control portfolio to prevent the COVID-19 being broke out again from home and imported from abroad,the challenges should be addressed to meet the daily demand by the patients to perform microsurgery operations and meanwhile to avoid the spread of the COVID-19.A 5-point export consensus on performing microsurgery under the strict COVID-19 prevention and control measures during the outbreak of COVID-19 is hereby issued as the reference to colleague surgeons.This export consensus is based on the experiences summarised from the authors who had carried out microsurgical op-erations during the outbreak of COVID-19.The 5-point export consensus are put forward below:1.Surgeries should be planned according to the risk level of the patient.High risk patients:Grade III personal protection apply.Microsur-gical operations are only performed for the must surgeries.All non-urgent surgical operations should be postponed or advise the patient to seek non-surgical treatment.Low risk patients:Grade I personal protection apply.Microsurgical operations are allowed.Risk unconfirmed patients:Grade II-III personal protection apply,if make contact with pre-hospital or emergency patient who has not completed the COVID-19 exclusion check-ups.2.Establish an intermedi-ate monitoring ward/zone and keep all patients in moderate and high risks.3.All medical staff must follow the graded personal protection procedures and pay special attentions to personal protective equipment(PPE),and follow the pre-vention and control procedures.4.In the perioperative period,strict medical management procedures apply:the pa-tients in moderate or high r

关 键 词：新型冠状病毒肺炎 显微外科手术 院感防控 专家共识 

分 类 号：R5[医药卫生—内科学]