新型冠状病毒感染暴发中病人的分诊管理  

Triaging patients in the outbreak of COVID-2019

作　　者：黄国庆[1,8] 曾维倩 王文波[3,8] 宋延民[1,8] 莫晓叶[1,8] 李佳[1,8] 伍平[1,8] 王若龙 周芳意[1,8] 吴静[5,8] 易斌[4,8] 熊曾[6,8] 周露[3,8] 汪凡祺 田阳婧 胡文宝 徐霞[3,8] 袁凯 李湘民[1,8] 邱新建[3,8] 邱健 王爱民[1,8] HUANG Guo-qing;ZENG Wei-qian;WANG Wen-bo;SONG Yan-min;MO Xiao-ye;LI Jia;WU Ping;WANG Ruo-long;ZHOU Fang-yi;WU Jing;YI Bin;XIONG Zeng;ZHOU Lu;WANG Fan-qi;TIAN Yang-jing;HU Wen-bao;XU Xia;YUAN Kai;LI Xiang-min;QIU Xin-jian;QIU Jian;WANG Ai-min(Department of Emergency,Xiangya Hospital,Central South University,Changsha 410008,China;Hunan Key Laboratory of Molecular Precision Medicine,Xiangya Hospital,Central South University,Changsha 410008,China;Institute of Integrated Traditional Chinese and Western Medicine,Xiangya Hospital,Central South University,Changsha 410008,China;Department of Laboratory Medicine,Xiangya Hospital,Central South University,Changsha,410008,China;Department of Medical Administration,Xiangya Hospital,Central South University,Changsha 410008,China;Department of Radiology,Xiangya Hospital,Central South University,Changsha 410008,China;Hunan Key Laboratory of Medical Genetics,School of Life Sciences,Central South University,Changsha 410078,China;National Clinical Research Center for Geriatric Disorders,Xiangya Hospital,Central South University,Changsha 410008,China)

机构地区：[1]中南大学湘雅医院急诊科,湖南长沙410008 [2]中南大学湘雅医院精准分子医学湖南省重点实验室,湖南长沙410008 [3]中南大学湘雅医院中西医结合科,湖南长沙410008 [4]中南大学湘雅医院检验科,湖南长沙410008 [5]中南大学湘雅医院医务部,湖南长沙410008 [6]中南大学湘雅医院放射科,湖南长沙410008 [7]中南大学生命科学学院医学遗传学湖南省重点实验室,湖南长沙410078 [8]中南大学湘雅医院国家老年疾病临床医学研究中心,湖南长沙410008

出　　处：《中国感染控制杂志》2023年第3期295-303,共9页Chinese Journal of Infection Control

基　　金：2018年度中国博士后科学基金第63批面上资助项目(2018M632995);2022年度湖南省自然科学基金(2022JJ70165);2020年度中南大学创新驱动计划团队项目(2020CX016)。

摘　　要：为控制SARS-CoV-2的传播,避免院内感染,长沙市某医院实施了基于流行病学史的分诊管理,将有流行病学史的患者分流至区域A,将无流行病学史的患者分流至区域B。本回顾性研究对分诊期间收集的数据进行分析,发现区域A中COVID-19最终确诊病例占比是区域B的7倍,而区域B接诊患者是区域A接诊患者的近3倍。在247名疑似患者中,发现了8例COVID-19患者。50%以上疑似患者接受了多轮核酸检测。在239名被诊断为病毒感染阴性的患者中,有188人复检并确定为COVID-19阴性病例。8例COVID-19患者中,有3例经多轮核酸检测最终确诊。除了合并症之外,流行病学信息的延迟获得也增加了实际诊断的复杂性。本文的分诊经验和策略将对今后传染病的控制具有一定的指导意义。In the outbreak of COVID-19,triage procedures based on epidemiology were implemented in a local hospital in Changsha to control the transmission of SARS-CoV-2 and avoid healthcare-associated infection.This re-trospective study analyzed the data collected during the triage period and found that COVID-19 patients were enriched 7 folds into the Section A designated for patients with obvious epidemiological history.On the other side,nearly triple amounts of visits were received at the Section B for patients without obvious epidemiological history.8 COVID-19 cases were spotted out of 247 suspected patients.More than 50%of the suspected patients were submi-tted to multiple rounds of nucleic acid analysis for SARS-CoV-2 infection.Of the 239 patients who were diagnosed as negative of the virus infection,188 were successfully revisited and none was reported as COVID-19 case.Of the 8 COVID-19 patients,3 were confirmed only after multiple rounds of nucleic acid analysis.Besides comorbidities,delayed sharing of epidemiological history added complexity to the diagnosis in practice.The triaging experience and strategy will be helpful for the control of infectious diseases in the future.

关 键 词：分诊 传染病 冠状病毒 COVID-19 

分 类 号：R181.32[医药卫生—流行病学] R373.1[医药卫生—公共卫生与预防医学]