新型冠状病毒肺炎患者实施气管插管术的感控建议:基于SARS患者气道管理的文献回顾  

Suggestions on infection control for performing endotracheal intubation in patients with coronavirus disease 2019:based on literature review of airway management in patients with SARS

作　　者：薄禄龙 万小健 卞金俊 邓小明 Bo Lulong;Wan Xiaojian;Bian Jinjun;Deng Xiaoming(Faculty of Anesthesiology,Changhai Hospital,Naval Medical University,Shanghai 200433,China)

机构地区：[1]海军军医大学长海医院麻醉学部,上海200433

出　　处：《中华麻醉学杂志》2020年第2期131-135,共5页Chinese Journal of Anesthesiology

摘　　要：为有效防止疑似或确诊新型冠状病毒肺炎患者实施气管插管术过程中导致医护人员感染或病毒传染,保证实施气管插管术人员的安全,通过文献回顾分析2003年国内外针对SARS患者气道管理的经验,结合国家卫健委相关文件与诊疗方案、相关学会指南及最新进展,就疑似或确诊新型冠状病毒肺炎患者实施气管插管术提供感控建议。应充分认识新型冠状病毒的传染风险,加强相关人员的感控培训。建议适当放宽气管插管的指征,提前预警并做好准备。实施气管插管术时,原则上应由最具气道管理经验的医师,采用最熟练掌握的气管插管工具完成该操作,建议实施快速顺序诱导气管插管术。In order to effectively prevent infection or severe acute respiratory syndrome coronavirus 2 transmission among medical staff during tracheal intubation in patients with suspected or confirmed coronavirus disease 2019(COVID-19),and to ensure the safety of personnel who will perform the endotracheal intubation,we made a literature review to analyze the airway management for SARS patients from China and abroad in 2003.Relevant documents,consensus of diagnosis and therapy for patients with COVID-19 from the National Health Commission,and guidelines of relevant academic societies were also reviewed.Thus,we provide suggestions on infection control for performing endotracheal intubation in patients with COVID-19 mainly as follows.Medical staff should fully understand the infection risk of COVID-19 and strengthen the training before the procedure.It is suggested that the indication of endotracheal intubation should be properly defined,and the need for intubation as emergent or elective should be evaluated early with preparation made in advance.During the implementation of endotracheal intubation,the procedure should be completed by the most experienced personnel in airway management using the tools they master best,and a rapid sequential induction of endotracheal intubation is recommended.

关 键 词：插管法 气管内 新型冠状病毒肺炎 严重急性呼吸综合征 气道管理 

分 类 号：R563.1[医药卫生—呼吸系统]