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江苏卫生事业管理:2020,Vol.>>Issue(8):991-993
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新冠肺炎疫情下急诊科的保障与防护措施△
王 蕾,朱保锋*,陈建荣,沈君华,张 毅,任玉琴,龚振华,朱 锦,贾寒雨
(南通大学附属第二医院急诊科;医务科;科教科;烧伤科)
Protection and response measures of emergency department in the case of COVID-19△
WANG Lei,ZHU Baofeng*,CHEN Jianrong,SHEN Junhua,ZHANG Yi,REN Yuqin,GONG Zhenhua,ZHU Jin,JIA Hanyu
(Department of Emergency center,Second Affiliated Hospital of Nantong University;Department of Medical Department;Department of Science and Education;Department of Burn and Plastic Surgery)
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中文摘要: 目的:分析及比较新型冠状病毒肺炎(COVID-19)的流行病学及临床特征,为制定急诊科疫情分级诊疗策略和应对措施提供科学依据。方法:通过参考相关文献,针对新冠病毒肺炎疫情下南通大学附属第二医院急诊科分级分诊进行相关探讨。结果:(1)发热、乏力和咳嗽是冠状病毒所致疾病的共同症状,COVID-19在早期症状可不典型;(2)动态观察白细胞计数、中性粒细胞计数、中性粒细胞计数/淋巴细胞计数(N/L)、C反应蛋白(CRP)/平均血小板体积、CRP和血沉,N/L比值是重症患者的独立危险因素;(3)关注胸膜下磨玻璃影的影像学征象,警惕早期肺肿瘤可能;(4)COVID-19核酸检测可与影像学结果不一致,做好实验室质控;(5)急诊预检分诊不应过分关注发热症状,有效的分级分层防控管理,尽快减少人员聚集。结论:急诊科的疫情防护不容懈怠,早期识别非发热新型冠状病毒肺炎患者,降低漏诊及误诊病例。
Abstract:Objective:To analyze and compare the epidemiological and clinical characteristics of COVID-19,and to provide scientific basis for the development of emergency diagnosis and treatment strategies and response measures for emergency department. Methods:By referring to relevant literatures,the clinical characteristics and special inspections of COVID-19 were summarized and analyzed,and the classification and triage of the emergency department of the Second Affiliated Hospital of Nantong University under the epidemic of new crown virus pneumonia were discussed. Results:(1)Fever,fatigue,and cough are common symptoms of coronavirus-induced diseases. COVID-19 may be atypical in early symptoms;(2)focus on white blood cell count,neutrophil count,neutrophil count / lymphocyte Changes in the index,C-reactive protein / mean platelet volume,CRP and erythrocyte sedimentation rate,and N/L count ratio are independent risk factors for critically ill patients;(3)pay attention to the imaging changes of gound-glass opacity differentiation from early lung tumors;(4)Coronavirus pneumonia nucleic acid detection may be inconsistent with imaging results,Pay attention to laboratory quality control work;(5)Emergency pre-trial triage should not focus too much on fever symptoms,and carry out effective grading and stratification Prevention and control management to effectively prevent personnel gathering. Conclusion:The emergency department’s protection should not be lazy,early identification of patients with non-fever new coronavirus pneumonia can reduce missed diagnosis and misdiagnosis.
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基金项目:南京医科大学教育研究课题(2019ZC044、2019ZC045、2019ZC043);江苏省“六大人才高峰”高层次人才项目(2019-WSW-199);南京医科大学康达学院教育研究课题(KD2018JYYJYB04) 南京医科大学教育研究课题(2019ZC044、2019ZC045、2019ZC043);江苏省“六大人才高峰”高层次人才项目(2019-WSW-199);南京医科大学康达学院教育研究课题(KD2018JYYJYB04)
引用文本:
王 蕾,朱保锋*,陈建荣,沈君华,张 毅,任玉琴,龚振华,朱 锦,贾寒雨.新冠肺炎疫情下急诊科的保障与防护措施△[J].江苏卫生事业管理,2020,31(8):991-993.
WANG Lei,ZHU Baofeng*,CHEN Jianrong,SHEN Junhua,ZHANG Yi,REN Yuqin,GONG Zhenhua,ZHU Jin,JIA Hanyu.Protection and response measures of emergency department in the case of COVID-19△[J].Jiangsu Health System Management,2020,31(8):991-993.

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