新型冠状病毒肺炎疫情期间ERCP在胆道外科中的临床实践  

Clinical practice of ERCP treatment in biliary tract surgery during the epidemic situation of novel coronavirus pneumonia

作　　者：胡洪生[1] 冯秋实[2] 边大鹏[2] 孙少华[1] 沈丰[1] 吴红伟[1] 胡伟[1] 魏广民[1] 刘军[1] 周文波[1] HU Hong-sheng;FENG Qiu-shi;BIAN Da-peng;SUN Shao-hua;SHEN Feng;WU Hong-wei;HU Wei;WEI Guang-min;LIU Jun;ZHOU Wen-bo(Department of Hepatopancreatobiliary Surgery,Sinopharm Dongfeng General Hospital,Hubei University of Medicine,Shiyan 442008,China;Department of General Surgery,Peking University First Hospital,Beijing 100034,China)

机构地区：[1]湖北医药学院附属国药东风总医院肝胆胰外科,湖北十堰442008 [2]北京大学第一医院普通外科,北京100034

出　　处：《中国现代普通外科进展》2021年第9期711-715,720,共6页Chinese Journal of Current Advances in General Surgery

摘　　要：目的:探讨在新型冠状病毒肺炎(简称新冠肺炎;WHO定名COVID-19)疫情下,如何正确规范处理中重度胆道感染、梗阻性黄疸。方法:分析新冠肺炎疫情期间(2020年2月1日—2020年4月30日),湖北医药学院附属东风医院ERCP治疗的8例胆总管结石伴中重度胆道感染及2例中重度梗阻性黄疸患者的资料,评估疫情期间内镜逆行胰胆管造影术(ERCP)在胆道外科中的安全性和防护流程的有效性。在进行ERCP治疗时采集内镜镜身拭子进行新型冠状病毒核酸检测,对比术前咽拭子新型冠状病毒核酸检测。结果:10例ERCP治疗过程顺利,患者恢复良好,医护人员无感染病例发生。内镜镜身拭子检测新型冠状病毒核酸与常规咽拭子检测无显著差异。制定的防护操作流程达到预期效果。结论:在新型冠状病毒肺炎疫情期间,在严格遵循防护规范基础上ERCP在胆道外科中的治疗是安全的,医护人员感染风险可有效控制。在进行ERCP治疗时采集内镜镜身拭子的方法可行。Objective:To explore how to properly regulated the treatment of moderate and severe biliary tract infection and obstructive jaundice in the epidemic of new coronavirus pneumonia(abbreviation:new coronary pneumonia;WHO designation:COVID-19).Methods:The analysis of 8 cases of common bile duct stones with moderate and severe biliary tract infections and 2 cases of moderate and severe obstructive jaundice treated by ERCP during the outbreak of new coronavirus pneumonia,to evaluate the safety and protective procedures of ERCP in biliary surgery.Through ERCP treatment,endoscopic swabs was used for the detection of new coronavirus nucleic acid,compared with the detection of new coronavirus nucleic acid in pharyngeal swab before surgery.Results:Ten cases of ERCP treatment were smooth,the patients recovered well,and there was no cases of infection among medical staff.The detection of new coronavirus nucleic acid by endoscopic body swab show no significantly difference between conventional pharyngeal swab detection.The established protective operation process was achieved the expected results.Conclusion:During the epidemic of new coronavirus pneumonia,ERCP treatment in biliary tract surgery was safe on the basis of strictly followed the protection of regulations,and the risk of infection by medical staff can be effectively controlled.The method of collecting endoscopic body swabs during ERCP treatment is feasible.

关 键 词：新型冠状病毒(2019-nCoV)肺炎 胆道感染 急性胆管炎 梗阻性黄疸 ERCP 

分 类 号：R657.43[医药卫生—外科学]