摘要
目的分析新型冠状病毒(COVID-19)疫情期间内镜下逆行胰胆管造影术(ERCP)诊疗病例的特点及经验,探讨特殊时期ERCP诊疗的规范性和安全性,为平时ERCP及特殊时期防护及洗消提供参考资料。方法回顾性分析2020年2月20日至3月17日经包头医学院第二附属医院消化科住院,并行ERCP诊疗的82例患者的临床资料,同时收集2019年2月20日至3月17日经包头医学院第二附属医院消化科住院,并行ERCP诊疗的43例患者的临床资料作为对照组。分析这两批患者的发病特点、流行病学史、住院管理方案、ERCP诊疗方案、ERCP操作人员防护方案、ERCP相关器械的消毒方案等。结果疫情期间ERCP诊疗82例,均无入院前14日内的流行病学史、无特殊接触史。比2019同期ERCP患者数量增加90.1%,转诊数量增加157.1%,住院急诊ERCP比例增加(61.0%vs 43.9%),行单纯鼻胆引流管置入(ENBD)比例增加(87.8%vs41.9%)。2台ERCP诊疗平均间隔时间为60.3 min,增加302%。疫情期间外地来源患者数量明显下降(28%)。疫情期间及2019年同期,我科无因胆道梗阻疾病死亡患者。疫情期间,医务人员无人出现发热、咳嗽、肺部感染状况。结论2020年疫情期间ERCP诊疗数量、急诊患者、病危患者、消毒时间均明显增加,外地患者明显减少。特殊时期,危重患者的及时诊疗是必须的,前提是医疗机构、医疗人员、患者及陪护人员必须按国家有关部门要求做好医学防护。
Objective To analyze the characteristics and experience of patients diagnosed and treated with endoscopic retrograde cholangiopancreatography(ERCP)in our hospital during the COVID-19 epidemic in 2020,to explore the standardization and safety of ERCP treatment in special periods,and to provide reference materials for daily and special period protection and decontamination of ERCP.Methods A retrospective analysis of the clinical data of 82 patients who was in hospital for ERCP diagnosis and treatmenton 20 February 2020 solstice March 17 in depatment of Gastroenterology of the Second Affiliated Hospital of Baotou Medical College and 43 patientson February 20,2019 solstice March 17 as control group.The disease characteristics,epidemiological history,inpatient management scheme,ERCP diagnosis and treatment scheme,ERCP operator protection scheme and ERCP equipment disinfection scheme of the two groups of patients were analyzed.Results During the epidemic period,82 patients were diagnosed and treated with ERCP,without any epidemiological history or special contact history within 14 days before admission.Compared with the same period,2019 patients with ERCP number increased by 90.1%,referral number increased by 157.1%,the proportion of in-hospital emergency ERCP increased(61.0%vs.43.9%),and the proportion of nasal biliary drainage tube implantation(ENBD)increased(87.8%vs.41.9%),the simple nasal biliary drainage tube placement(endoscopic nasobiliary drainage,ENBD)percentage increase(87.8%vs.41.9%),2 sets of ERCP diagnosis and treatment time average interval of 60.3 min,an increase of 302%.The number of patients of foreign origin decreased significantly(28%)during the outbreak.During the epidemic period and the same period in 2019,no patients in our department died of biliary obstruction.During the outbreak,none of the medical staff developed fever,cough or lung infection.Conclusion There were increases in the number of ERCP patients,emergency care,intensive care,and sterilization time during the epidemic breakout of the coronavirus,compared to a regular time.Of course,the number of patients from out the city dropped clearly.Special care for those endangered individuals is always necessary,as long as conforming the safety regulations.
作者
江振宇
孟宪梅
张静洁
贺静
周怡
贾冬武
党彤
Jiang Zhenyu;Meng Xianmei;Zhang Jingjie;He Jing;Zhou Yi;Jia Dongwu;Dang Tong(Depatment of Gastroenterology,The Second Affiliated Hospital of Baotou Medical College,Baotou 014030,China)
出处
《中华胃肠内镜电子杂志》
2020年第2期84-88,共5页
Chinese Journal of Gastrointestinal Endoscopy(Electronic Edition)
基金
包头医学院自然科学基金“扬帆”项目(BYJJ-YF-2018031)。
关键词
新型冠状病毒肺炎
内镜下逆行胰胆管造影术
医学防护
Corona virus disease 2019
Endoscopic retrograde cholangiopancreatography
Medical precaution
