新型冠状病毒肺炎潜伏期患者全髋关节置换术麻醉处理1例  

Anesthetic management of a patient with COVID-19 in incubation period undergoing total hip arthroplasty

作　　者：陈璟莉 马璞 刘畅 严虹[1] Chen Jingli;Ma Pu;Liu Chang;Yan Hong(Department of Anaesthesiology,the Central Hospital of Wuhan,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430014,China)

机构地区：[1]华中科技大学同济医学院附属武汉市中心医院麻醉科,430014

出　　处：《中华麻醉学杂志》2020年第3期302-304,共3页Chinese Journal of Anesthesiology

摘　　要：新型冠状病毒肺炎(COVID-19)流行病学的特点之一是无症状感染者也是传染源。本例患者术前无发热和/或呼吸道症状,血常规化验显示淋巴细胞计数和淋巴细胞百分比降低,院内未开展新型冠状病毒病原体检测,未能进行该项检测,胸部影像学检查未见明显磨玻璃影,因此不考虑病毒性肺炎。参与手术的医护人员均采用规范的二级医疗防护措施。患者术后第5天新型冠状病毒核酸检测阳性,为COVID-19确诊病例。流行病学调查分析该患者术前处于COVID-19潜伏期,然而所有参与手术麻醉的医护人员和连台的下例手术患者都没有因此被传染,其原因得益于笔者医院对全体职工在感染控制方面的严格培训,手术麻醉医护人员均熟练掌握了相关的基础知识及操作技能,对手术室内的感染控制具有良好意识,且能规范实施。该病例还提示,要重视术前单纯淋巴细胞水平下降明显的患者,采取措施以早期识别无症状感染者。One of the characteristics of coronavirus disease 2019(COVID-19)epidemiology is that asymptomatic infection is also a source of infection.There was no fever and/or respiratory symptoms in this patient before the operation,and the results of routine blood test showed decreased lymphocyte count and lymphocyte percentage,and novel coronavirus pathogen detection was not carried out in the hospital,and the detection was not performed,chest imaging examination showed no obvious ground glass shadow,so viral pneumonia was not considered.The medical staff involved in the operation all adopted standard secondary medical protection measures.Five days after the operation,the patient was tested positive for novel coronavirus nucleic acid,which was a confirmed case of COVID-19.The results of epidemiological investigation and analysis showed that the patient was in the incubation period of COVID-19 before operation,however,none of the medical staff involved in surgical anesthesia and none of the patients in the next operation were infected.The reason is that the author′s hospital has strict training for all staff in infection control,and surgical anesthesiology medical staff have mastered the relevant basic knowledge and operation skills,have a good sense of infection control in the operating room,and can standardize the implementation.This case also suggested that attention should be paid to the patients with significant preoperative simple lymphocyte level decline,and measures should be taken to identify asymptomatic infection early.

关 键 词：新型冠状病毒肺炎 传染病潜伏期 麻醉 

分 类 号：R614[医药卫生—麻醉学]