复旦大学附属中山医院在新型冠状病毒肺炎疫情期间 急诊消化内镜的诊治经验

Zhongshan experience on emergency digestive endoscopic procedures during COVID-19 pandemic

摘要:

新型冠状病毒肺炎目前正在我国肆虐。虽然消化内镜学并不是此次抗击疫情的一线学科，但新型冠状病毒经呼吸道飞沫、密切接触传播，在相对封闭的环境中长时间暴露于高浓度气溶胶情况下存在经气溶胶传播的可能，而且一些医院也出现了明显的院内感染现象，内镜检查过程中患者呼吸道和消化道分泌物暴露风险使得消化内镜诊疗在疫情期间成为“高危”操作。如何在保护医患的情况下开展必要的消化内镜诊疗，是目前消化内镜医师面临的问题。本文结合复旦大学附属中山医院和本内镜中心的实际工作情况，总结了新型冠状病毒肺炎疫情防控形势下如何开展急诊胃肠镜临床工作，重点介绍需要开展的内镜诊疗项目、适应证的选择、患者的就诊接诊流程、操作过程中的注意事项，以及我中心在内镜清洗消毒、医护人员自身防护方面的特殊措施，希望能对同道提供帮助和指导。

Abstract:

Novel coronavirus (SARS-Cov-2) pneumonia (NCP, COVID-19) is currently in a pandemic in China. SARS-Cov-2 virus is highly contagious. The transmission routes include respiratory droplets, close contact, and also possible aerosol propagation when exposed with high concentration of aerosols for a long time in a relatively airtight environment. More importantly, nosocomial infection has occurred in some hospitals. The situations above have made endoscopic diagnosis and treatment "high-risk" procedures during this pandemic, even though endoscopists are not in the battle front in fighting against COVID-19. Therefore, how to carry out necessary endoscopic procedures with doctors and patients well protected is a question of high priority at present.