一例老年银屑病患者感染COVID-19后的救治和应急处置报告  

Emergency response report of a positive COVID-19 nucleic test elderly inpatient

作　　者：槐鹏程 李珍[1] 李晶辉[1] 马衍鹏 杨宝琦[1] 刘静[1] 孙勇虎[1] 于功奇[1] 刘亭亭 孙远航 王猛 李紫阁 刘军[1] 张兆升 赵伟[1] 李聪聪 刘红[1] 张福仁[1] HUAI Pengcheng;LI Zhen;LI Jinghui;MA Yanpeng;YANG Baoqi;LIU Jing;SUN Yonghu;YU Gongqi;LIU Tingting;SUN Yuanhang;WANG Meng;LI Zige;LIU Jun;ZHANG Zhaosheng;ZHAO Wei;LI Congcong;LIU Hong;ZHANG Furen(Shandong Provincial Hospital for Skin Diseases&Shandong Provincial Institute of Dermatology and Venereology,Shandong First Medical University&Shandong Academy of Medical Sciences,Jinan 250022,China)

机构地区：[1]山东第一医科大学附属皮肤病医院(山东省皮肤病医院),山东省皮肤病性病防治研究所,济南250022

出　　处：《中国麻风皮肤病杂志》2023年第6期393-396,共4页China Journal of Leprosy and Skin Diseases

摘　　要：目的:2022年11月19日晚,笔者所在医院一位老年银屑病住院患者新冠核酸检测呈阳性,患者高龄、高热、高血压、高细胞因子水平且有冠心病病史,为迅速救治患者、控制疫情传播,特开展本次应急处置。方法:参照第九版新冠防控、诊疗方案及本院《新型冠状病毒肺炎应急处置预案(第十一版)》,进行信息报告、区域封锁、核酸单检、患者救治、密接判定、环境消杀、病例转运、风险评估等应急处置工作。对老年阳性患者给予IL-6受体拮抗剂和人免疫球蛋白静滴等治疗。结果:经紧急救治,老年患者未出现呼吸困难等重症表现,血压、体温恢复正常,随访1个月,无不适。共判定密接者12人,其中患者陪人及本院1名护士在隔离观察期间检出新冠病毒核酸阳性,对症治疗后痊愈。经连夜处置,疫情风险得到控制,未影响到住院患者的正常诊疗和医院门诊的正常开诊。结论:本文联合IL-6受体拮抗剂和人免疫球蛋白成功救治了一位伴基础疾病的老年新冠感染者,有效化解了患者转为重症的风险,为老年新冠感染者的救治提供了新的思路。Objective:November 19,2022,an elderly inpatient with psoriasis in our hospital tested positive for COVID-19,the elder patient had high fever,hypertension,high cytokine levels,and a history of coronary heart disease,we conducted this emergency response to quickly treat the patient and control the spread of COVID-19 in our hospital.Methods:According to the National COVID-19 Control and treatment Protocol(9th edition),and the Emergency Response Plan for COVID-19 in our hospital(11th edition),information reporting,hospital blockading,COVID-19 nucleic acid test for single person,inpatient treatment,close contact screening,environmental disinfecting,case transport to designated hospital,and risk assessment were carried.The elderly patient was treated with IL-6 receptor antagonist and human immunoglobulin et al.Results:After treatment,the patient did not develop severe symptoms such as dyspnea,blood pressure and body temperature returned to normal,and there was no discomfort during 1 month follow-up.A total of 12 close contacts were determined.Among them,the patient's daughter and a nurse in our hospital tested positive for COVID-19 during quarantine observation and recovered after symptomatic treatment.After overnight response,the risk of COVID-19 spread was under control,without affecting the treatment of inpatients and outpatients.Conclusion:The treatment of combination of IL-6 receptor antagonist and human immunoglobulin successfully treated an elderly COVID-19 positive patient with psoriasis and coronary heart disease,avoiding the patient becoming severe,and providing a new idea for the treatment of elderly COVID-19 patients.

关 键 词：新型冠状病毒感染 老年患者 救治 

分 类 号：R758.63[医药卫生—皮肤病学与性病学] R511[医药卫生—临床医学]