COVID-19 surveillance in department of neurosurgery, a retrospective analysis of 59 pneumonia complication cases among 112 hospitalized patients
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摘要:
目的回顾分析COVID-19疫情爆发2月内，神经外科收治的112例患者中合并有59例肺炎的情况，总结COVID-19防控措施。 方法回顾性分析2020年1月25日~3月30日神经外科急诊收治的住院患者共112人，年龄3~83岁（49.5±18.9岁）。在急诊核酸检测资源匮乏情况下，分析我科所有肺炎患者的类型及胸部CT表现，比较不同肺炎的CT影响学特征，并与COVID-19相鉴别。总结我科COVID-19高度疑似患者的处理办法，及在病人准入流程、医务人员管理、病房管理等疫情防控上的经验措施。 结果入院时有86例患者在急诊完善了胸部CT检查，明确合并肺炎患者59例（68.6%）。其中最多的为吸入性肺炎者54例（62.8%）；CT影像显示磨玻璃影的患者有8例（11.76%）；疑似患者被收入神经外科病房仅2例，后转感染科诊治并确诊为普通肺炎；所有入院患者的首次咽拭子核酸检测均为阴性，对部分可疑患者入院后复查仍为阴性。在我科的严格防控下，无新冠肺炎确诊病例。 结论神经外科病患肺炎发生率高，专科医师应加强肺炎的认识及读片能力，更好地鉴别肺炎早期胸部CT改变。实行严格的防护措施，尤其是憋气操作以及良好的通风条件，对神经外科这类非传染病专科在今后防范新的不明原因或者变异传染性肺炎的具有借鉴价值。 Abstract:ObjectiveTo review the situation of 59 cases of pneumonia in 112 patients admitted to neurosurgery and strict COVID-19 prevention and control measures within two months of the COVID-19 outbreak. MethodsA total of 112 hospitalized patients aged 3-83 years (49.5±18.9 years) in the Department of neurosurgery from January 25 to March 30, 2020 were retrospectively analyzed. In the case of lack of emergency nucleic acid detection resources, the types and chest CT manifestations of all pneumonia patients in our department were analyzed. The CT impact characteristics of different pneumonia were compared, which were distinguished from COVID- 19. We analyzed the treatment of COVID-19 highly suspected patients in our department, and summarized the experience and measures of epidemic prevention and control in our department, such as patient admission process, medical staff management, ward management and so on. Result Eighty-six patients completed chest CT examinations in the emergency department at the time of admission. Fifty-nine patients (68.6%) with pneumonia were identified. Among them, 54 patients (62.8%) had aspiration pneumonia. CT images showed 8 patients with ground glass shadow, accounting for 11.76%. Only 2 suspected patients were admitted to the neurosurgery ward, then transferred to the infection department for diagnosis and treatment. The patients were diagnosed with common pneumonia. The first throat swab nucleic acid test of all admitted patients was negative, and some suspicious patients were still negative after admission. Under the strict prevention and control of our department, there was no confirmed case of new coronary pneumonia. ConclusionThe incidence of pneumonia in neurosurgery patients is high. Specialist physicians should strengthen their understanding of pneumonia and their ability to read films, identify early chest CT changes in pneumonia. The strict protective measures, especially the suffocation operation implemented and the good ventilation conditions, are harmful to the nerves. -
Key words:
- department of neurosurgery /
- COVID-19 /
- pneumonia
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图 1 3位COVID-19确诊患者的CT影像学表现
A: 双肺下侧高密度结节影; B: 双肺多发小结节; C: 双肺病灶大面积实变灶、磨玻璃影为主.
Figure 1. CT imaging findings of 3 patients diagnosed with COVID-19.
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[1] Kandel N, Chungong S, Omaar A, et al. Health security capacities in the context of COVID-19 outbreak: an analysis of International Health Regulations annual report data from 182 countries[J]. Lancet, 2020, 395(10229): 1047-53. doi: 10.1016/S0140-6736(20)30553-5 [2] Lai CC, Wang CY, Wang YH, et al. Global epidemiology of coronavirus disease 2019(COVID-19): disease incidence, daily cumulative index, mortality, and their association with country healthcare resources and economic status[J]. Int J Antimicrob Agents, 2020, 55(4): 105946. doi: 10.1016/j.ijantimicag.2020.105946 [3] Lai CC, Shih TP, Ko WC, et al. Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) and coronavirus disease-2019(COVID-19): The epidemic and the challenges[J]. Int J Antimicrob Agents, 2020, 55(3): 105924. doi: 10.1016/j.ijantimicag.2020.105924 [4] Cheng MP, Papenburg J, Desjardins M, et al. Diagnostic testing for severe acute respiratory syndrome-related coronavirus 2: a narrative review[J]. Ann Intern Med, 2020, 172(11): 726-34. doi: 10.7326/M20-1301 [5] Zhang T, Wu HT, Wang LH, et al. Scenario-based study of medical resource requirement rapid assessment under the COVID-19 pandemic[J]. Zhonghua Liu Xing Bing Xue Za Zhi. 2020, 41(0): E59. http://www.researchgate.net/publication/341295042_Scenario-based_study_of_medical_resource_requirement_rapid_assessment_under_the_COVID-19_pandemic [6] Huang MW, Wang J, Ni XW, et al. Neurocritical care in China: past, present, and future[J]. World Neurosurg, 2016, 95: 502-6. doi: 10.1016/j.wneu.2016.06.102 [7] Chen P, Xiong XH, Chen Y, et al. Perioperative management strategy of severe traumatic brain injury during the outbreak of COVID-19[J]. Zhonghua Chuang Shang Za Zhi, 2020, 23(4): 202-6. http://www.sciencedirect.com/science/article/pii/S1008127520301206 [8] 张伟珍, 周秀红, 郑醒云, 等. 建立在充分补液基础上的气管插管气道湿化方法效果分析[J]. 齐鲁护理杂志, 2016, 22(14): 84-5. https://www.cnki.com.cn/Article/CJFDTOTAL-QLHL201614046.htm [9] Wang X, Wang MJ, Jiang XB, et al. Letter: strategies for prevention and control of 2019 novel coronavirus infection among medical staff [J]. Neurosurgery, 2020, 87(1): E57-62. doi: 10.1093/neuros/nyaa117 [10] Kang LJ, Li Y, Hu SH, et al. The mental health of medical workers in Wuhan, China dealing with the 2019 novel coronavirus[J]. Lancet Psychiatry, 2020, 7(3): e14. doi: 10.1016/S2215-0366(20)30047-X [11] Hecht N, Wessels L, Werft FO, et al. Need for ensuring care for neuroemergencies: lessons learned from the COVID-19 pandemic[J]. Acta Neurochir, 2020, 162(8): 1795-801. doi: 10.1007/s00701-020-04437-z [12] 菡丹. 张继先疫情上报第一人[J]. 中华儿女, 2020(5): 13. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHEV202005012.htm [13] Balofsky A, George J, Papadakos P. Neuropulmonology[J]. Handb Clin Neurol, 2017, 140: 33-48. http://www.sciencedirect.com/science/article/pii/B9780444636003000039 [14] Yang WJ, Sirajuddin A, Zhang XC, et al. The role of imaging in 2019 novel coronavirus pneumonia (COVID-19[) J]. Eur Radiol, 2020, 30(9): 4874-82. doi: 10.1007/s00330-020-06827-4 [15] 南喜文, 唐光健, 彭泰松, 等. CT肺坠积效应与气道阻力关系的初步研究[J]. 中华放射学杂志, 2015, 49(3): 183-5. doi: 10.3760/cma.j.issn.1005-1201.2015.03.006 [16] Dogrul BN, Kiliccalan I, Asci ES, et al. Blunt trauma related chest wall and pulmonary injuries: an overview[J]. Zhonghua Chuang Shang Za Zhi, 2020, 23(3): 125-38. http://www.sciencedirect.com/science/article/pii/S1008127520301103?utm_source=TrendMD&utm_medium=cpc [17] Wang DW, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China[J]. JAMA, 2020, 323(11): 1061. doi: 10.1001/jama.2020.1585 [18] Mao L, Jin H, Wang M, et al. Neurologic Manifestations of hospitalized patients with coronavirus disease 2019 in wuhan, China [J]. J Am MedAssco Neurol. 2020, 77(6): 683-90. http://www.researchgate.net/publication/340564673_Neurologic_Manifestations_of_Hospitalized_Patients_With_Coronavirus_Disease_2019_in_Wuhan_China [19] Moriguchi T, Harii N, Goto J, et al. A first case of meningitis/ encephalitis associated with SARS-Coronavirus-2[J]. Int J Infect Dis, 2020, 94: 55-8. doi: 10.1016/j.ijid.2020.03.062 -
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