新型冠状病毒肺炎疫区创伤骨科早期手术效果分析  

Assessment of the initial effect of operation on traumatic orthopedics patients under epidemic of novel coronavirus pneumonia

作　　者：刘曦明 黄明 汪国栋 王华松 韩晶 陈家 徐峰 LIU Xi-ming;HUANG Ming;WANG Guo-dong;WANG Hua-song;HAN Jing;CHEN Jia;XU Feng(Department of Orthopaedics,General Hospital of PLA Central Theater Command,Wuhan 430070,China)

机构地区：[1]中国人民解放军中部战区总医院骨科,武汉430070

出　　处：《创伤外科杂志》2020年第7期486-489,共4页Journal of Traumatic Surgery

摘　　要：目的评估新型冠状病毒肺炎(COVID-19)疫区骨科创伤手术的早期手术效果。方法回顾性分析2020年1月21日—4月30日解放军中部战区总医院骨科收治的227例(疫情组:男性126例,女性101例;年龄13~86岁,平均38.1岁)和2019年同期803例(对照组:男性443例,女性360例;年龄3~82岁,平均40.2岁)病例资料,疫情组按安全救援、标准防护和分级防护原则进行救治。对比两组手术时间、术中出血量、患肢VAS评分(术前及术后14d),记录术后伤口感染率以及X线片评估骨折术后复位优良率,记录术中及术后并发症及参与治疗医护和患者感染COVID-19情况。结果患者均顺利完成手术。疫情组手术时间(123.5±38.1)min和术中出血量(327.5±77.2)mL多于对照组[手术时间(110.3±30.3)min,术中出血量(294.5±64.5)mL],但组间差异无统计学意义(P>0.05)。两组术后VAS评分(疫情组:1±0.5;对照组:1±0.6)均较术前(疫情组:7±0.6;对照组:7±0.7)改善(P<0.05),但组间差异无统计学意义(P>0.05)。疫情组骨折复位优良率为94.8%,对照组为96.1%,疫情组3例术后伤口感染,感染率为1.3%;对照组5例感染,感染率为0.6%。疫情组1例感染COVID-19并死亡,其余患者及参与救治医务人员均未发现感染COVID-19。结论在新型冠状病毒肺炎疫区,骨科创伤手术早期效果可靠,能在保护医护人员的同时为骨科创伤手术患者提供优质、安全的医疗服务。Objective To evaluate the initial effect of operation on orthopedic trauma patients under epidemic of novel coronavirus pneumonia.Methods A retrospective case-control study was carried out to analyze the clinical data of 227 operative cases(the epidemic group,126 males and 101 females,13-86 years,average age 38.1 years)from Jan.21 to Apr.30,2020 and 803 cases(the control group,443 males and 360 females,3-82 years,average age 40.2 years)in the same period of the last year.The epidemic group was treated according to the principle of safety rescue,standard protection and classified protection.Operation time,blood loss and VAS before operation and 14d after operation were statistically compared.The excellent rate of fracture reduction was evaluated by X-ray after operation and surgical complications were recorded.The infection of COVID-19 in patients and all the doctors and nurses who participated in the treatment were also recorded.Results All patients successfully completed the operation.The operation time[(123.5±38.1)min]and blood loss[(327.5±77.2)mL]of the epidemic group were more than those in the control group,but there was no significant difference between the two groups(P>0.05).The VAS was improved in both groups after operation(P<0.05),and there was no significant difference between the two groups(P>0.05).The excellent rate of fracture reduction in the epidemic group was 94.8%,which was 96.1%in the control group.There were 3 cases of wound infection in the epidemic group and 5 in control group.The infection rates were 1.3%and 0.6%,respectively.One patient was infected with COVID-19 and died,and the other patients were not infected with COVID-19.No COVID-19 was found among the doctors and nurses.Conclusion Under epidemic of novel coronavirus pneumonia,the initial effect of trauma surgery in department of orthopedics is reliable,we can reduce the incidence of covid-19 infection in hospital,and provide high-quality and safe medical services for orthopedic surgical patients while protecting medical staff.

关 键 词：冠状病毒感染 肺炎 创伤骨科 早期手术 

分 类 号：R563.1[医药卫生—呼吸系统]