支气管镜检查在新冠肺炎大流行期间的应用
Application of Bronchoscopy during the COVID-19 Pandemic
DOI: 10.12677/ACM.2022.125637, PDF,   
作者: 惠正相：青海大学，青海 西宁；李忠诚*：青海大学附属医院胸外科，青海 西宁
关键词: 新型冠状病毒性肺炎；支气管镜检查；防护措施；Corona Virus Disease 2019； Bronchoscopy； Preventive Measure
摘要: 由2019新型冠状病毒(SARS-CoV-2)引起的新型冠状病毒肺炎(Corona Virus Disease 2019, COVID-19) (以下简称“新冠肺炎”)是一种新的大流行性传染病，目前已给世界各地的卫生系统造成相当大的负担，因此仍然需要采取保护措施来防止病毒的传播。虽然目前咽拭子核酸检测2019新型冠状病毒已广泛普及，但由于新冠肺炎潜伏期及被检测人员的不确定性，有检测出现假阴性可能，因此医院工作人员及住院患者感染风险极大。与呼吸系统相关的科室进行的呼吸相关的检查及治疗，更是让医务工作者直接与病人直接接触，例如支气管镜检查，其可能导致患者咳嗽和气溶胶的形成，从而增加了相关工作人员和其他患者感染的风险。因此，减少气溶胶的产生，对有关人员的个人保护，以及改进支气管镜检查程序组织的措施，从而确保即使在COVID-19期间也能安全地进行内窥镜检查。
Abstract: Corona Virus Disease 2019 (COVID-19) is a new pandemic infectious disease that has placed a con-siderable burden on health systems around the world, so protective measures still need to be taken against the spread of the virus. Although the throat swab nucleic acid test novel coronavirus 2019 has been widely used, but the incubation period of COVID-19 and the uncertainty of the tested per-sonnel, may lead to false negative tests, so the risk of hospital staff and hospitalized patients infec-tion is great. Respiratory-related examination and treatment in departments related to the respir-atory system put medical workers in direct contact with patients, such as bronchoscopy, which may lead to cough and aerosols, thus increasing the risk of infection among relevant staff and other pa-tients. Therefore, reducing aerosol production, personal protection for the personnel concerned, and measures to improve the organization of bronchoscopy procedures to ensure that endoscopy is safely performed even during COVID-19.
文章引用：惠正相, 李忠诚. 支气管镜检查在新冠肺炎大流行期间的应用[J]. 临床医学进展, 2022, 12(5): 4396-4401. https://doi.org/10.12677/ACM.2022.125637

参考文献

[1] Guan, W.J., Ni, Z.Y., Hu, Y., Liang, W.H., Ou, C.Q., He, J.X., et al. (2020) Clinical Characteristics of Coronavirus Disease 2019 in China. The New England Journal of Medicine, 382, 1708-1720.
https://www.ncbi.nlm.nih.gov/pubmed/32242738
[2] Ferretti, L., Wymant, C., Kendall, M., Zhao, L., Nurtay, A., Abeler-Dörner, L., et al. (2020) Quantifying SARS-CoV-2 Transmission Suggests Epidemic Control with Digital Con-tact Tracing. Science, 31, eabb6936. [Google Scholar] [CrossRef] 
[3] Ong, S.W., Tan, Y.K., Chia, P.Y., Lee, T.H., Ng, O.T., Wong, M.S., et al. (2020) Air, Surface Environmental, and Personal Protective Equipment Contamination by Severe Acute Res-piratory Syndrome Coronavirus 2 (SARS-CoV-2) from a Symptomatic Patient. JAMA, 323, 1610-1612. [Google Scholar] [CrossRef] [PubMed]
[4] Wahidi, M.M., Shojaee, S., Lamb, C.R., et al. (2020) The Use of Bronchoscopy during the COVID‐19 Pandemic: CHEST/ AABIP Guideline and Expert Panel Report. Chest, 158, 1268‐1281. [Google Scholar] [CrossRef] [PubMed]
[5] Zou, L., Ruan, F., Huang, M., et al. (2020) SARS‐CoV‐2 Viral Load in Upper Respiratory Specimens of Infected Patients. The New England Journal of Medicine, 382, 1177‐1179. [Google Scholar] [CrossRef] 
[6] Guan, W.J., Ni, Z.Y., Hu, Y., et al. (2020) Clinical Characteristics of Coronavirus Disease 2019 in China. The New England Journal of Medicine, 382, 1708-1720.
[7] Li, Q., Guan, X., Wu, P., et al. (2020) Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia. The New England Journal of Medicine, 382, 1199-1207.
[8] Ai, T., Yang, Z., Hou, H., et al. (2020) Cor-relation of Chest CT and RT-PCR Testing in Coronavirus Disease 2019 (COVID-19) in China: A Report of 1014 Cases. Radiology, 296, E32-E40. [Google Scholar] [CrossRef] [PubMed]
[9] Rothe, C., Schunk, M., Sothmann, P., et al. (2020) Transmission of 2019-nCoV Infection from an Asymptomatic Contact in Germany. The New England Journal of Medicine, 382, 970-971. [Google Scholar] [CrossRef] 
[10] Torrego, A., Pajares, V., Fernández-Arias, C., Vera, P. and Mancebo, J. (2020) Bronchoscopy in COVID-19 Patients with Invasive Mechanical Ventilation: A Center Experience. American Journal of Respiratory and Critical Care Medicine, 202, 284-287. [Google Scholar] [CrossRef] 
[11] Wang, W., Xu, Y., Gao, R., et al. (2020) Detection of SARS-CoV-2 in Different Types of Clinical Specimens. JAMA, 323, 1843-1844. [Google Scholar] [CrossRef] [PubMed]
[12] Deng, J., Zheng, Y., Li, C., et al. (2010) Plastic Bronchitis in Three Children Associated with 2009 Influenza A (H1N1) Virus Infection. Chest, 138, 1486-1488. [Google Scholar] [CrossRef] [PubMed]
[13] Zhang, J., Kang, X. (2015) Plastic Bronchitis Associated with Influenza Virus Infection in Children: A Report on 14 Cases. International Journal of Pediatric Otorhinolaryngology, 79, 481-486. [Google Scholar] [CrossRef] [PubMed]
[14] Serna-Gallegos, D., Mercado, F., Imai, T., et al. (2018) Effects of Time From Completed Clinical Staging to Surgery: Does It Make a Difference in Stage 1 Non-Small Cell Lung Cancer? American Association for Thoracic Surgery, San Diego.
[15] Rosenthal, D.I., Liu, L., Lee, J.H., et al. (2002) Importance of the Treatment Package Time in Surgery and Postoperative Radiation Therapy for Squamous Carcinoma of the Head and Neck. Head Neck, 24, 115-126. [Google Scholar] [CrossRef] [PubMed]
[16] Darwiche, K., Ross, B., Gesierich, W., Petermann, C., Huebner, R.H., Grah, C., Gompelmann, D., Hetzel, J., Holland, A., Eisenmann, S., Stanzel, F., Kempa, A., Conrad, K. and Eberhardt, R. (2020) Empfehlungen zur Durchführung einer Bronchoskopie in Zeiten der COVID-19-Pandemie [Recommendations for Per-forming Bronchoscopy in Times of the COVID-19 Pandemic]. Pneumologie, 74, 260-262. [Google Scholar] [CrossRef] [PubMed]
[17] Tran, K., Cimon, K., Severn, M., et al. (2012) Aerosol Generating Pro-cedures and Risk of Transmission of Acute Respiratory Infections to Healthcare Workers: A Systematic Review. PLoS ONE, 7, e35797. [Google Scholar] [CrossRef] [PubMed]
[18] 中华医学会呼吸病学分会介入呼吸病学学组. 2019新型冠状病毒感染疫情防控期间开展支气管镜诊疗指引(试行) [J]. 中华结核和呼吸杂志, 2020, 43(3): 199-202.
[19] Munoz-Price, L.S., Bowdle, A., Johnston, B.L., et al. (2018) Infection Prevention in the Operating Room Anesthesia Work Area. Infection Control & Hospital Epidemiology, 40, 1-17. [Google Scholar] [CrossRef] [PubMed]
[20] Yang, S., Lee, G.W., Chen, C.M., et al. (2007) The Size and Concentra-tion of Droplets Generated by Coughing in Human Subjects. Journal of Aerosol Medicine, 20, 484-494. [Google Scholar] [CrossRef] [PubMed]
[21] Morawska, L. (2006) Droplet Fate in Indoor Environments, Or Can We Prevent the Spread of Infection? Indoor Air, 16, 335-347. [Google Scholar] [CrossRef] [PubMed]
[22] Neuman, B.W., Adair, B.D., Yoshioka, C., et al. (2006) Supramolecular Architecture of Severe Acute Respiratory Syndrome Coronavirus Revealed by Electron Cryomicroscopy. Journal of Virology, 80, 7918-7928. [Google Scholar] [CrossRef] 
[23] Radonovich, L.J., Simberkoff, M.S., Bessesen, M.T., et al. (2019) N95 Respirators vs Medical Masks for Preventing Influenza among Health Care Personnel: A Randomized Clinical Trial. JAMA, 322, 824-833. [Google Scholar] [CrossRef] [PubMed]
[24] Loeb, M., Dafoe, N., Mahony, J., et al. (2009) Surgical Mask vs N95 Respirator for Preventing Influenza among Health Care Workers: A Randomized Trial. JAMA, 302, 1865-1871. [Google Scholar] [CrossRef] [PubMed]
[25] Loeb, M., McGeer, A., Henry, B., et al. (2004) SARS among Critical Care Nurses, Toronto. Emerging Infectious Diseases, 10, 251-255. [Google Scholar] [CrossRef] [PubMed]
[26] Le, D.H., Bloom, S.A., Nguyen, Q.H., et al. (2004) Lack of SARS Transmission among Public Hospital Workers, Vietnam. Emerging Infectious Diseases, 10, 265-268. [Google Scholar] [CrossRef] [PubMed]
[27] Birnbach, D.J., Rosen, L.F., Fitzpatrick, M., et al. (2015) Double Gloves: A Randomized Trial to Evaluate a Simple Strategy to Reduce Con-tamination in the Operating Room. Anesthesia & Analgesia, 120, 848-852. [Google Scholar] [CrossRef] 
[28] Le, D.H., Bloom, S.A., Nguyen, Q.H., et al. (2004) Lack of SARS Transmission among Public Hospital Workers, Vietnam. Emerging Infectious Diseases, 10, 265-268. [Google Scholar] [CrossRef] [PubMed]
[29] Pandian, V., Morris, L.L., Brodsky, M.B., Lynch, J., Walsh, B., Rushton, C., Phillips, J., Rahman, A., De Rose, T., Lambe, L., Lami, L., Wu, S.P.M., Garza, F.P., Maiani, S., Zavalis, A., Okusanya, K.A., Palmieri, P.A., McGrath, B.A., Pelosi, P., Sole, M.L., Davidson, P. and Brenner, M.J. (2020) Critical Care Guidance for Tracheostomy Care during the COVID-19 Pandemic: A Global, Multidisciplinary Approach. Ameri-can Journal of Critical Care, 29, e116-e127. [Google Scholar] [CrossRef] [PubMed]
[30] van Doremalen, N., Bushmaker, T., Morris, D., et al. (2020) Aerosol and Surface Stability of HCoV-19 (SARS-CoV-2) Compared to SARS-CoV-1. The New England Journal of Medicine, 382, 1564-1567.

为你推荐