改良粪便排泄物引流装置在COVID-19危重症患者救治中预防医护人员职业暴露感染的应用

doi:10.13481/j.1671-587x.20200331

吉林大学学报(医学版) ›› 2020, Vol. 46 ›› Issue (03): 625-629.doi: 10.13481/j.1671-587x.20200331

• 临床医学 • 上一篇

改良粪便排泄物引流装置在COVID-19危重症患者救治中预防医护人员职业暴露感染的应用

张胜男¹, 余欣², 李倩³, 麻海春⁴, 连鑫¹, 庞磊⁴

1. 吉林大学第一医院泌尿系统诊疗中心, 吉林长春 130021;
2. 吉林大学第一医院手外科, 吉林长春 130021;
3. 吉林大学第一医院眼科, 吉林长春 130021;
4. 吉林大学第一医院麻醉科, 吉林长春 130021

收稿日期:2020-03-16 发布日期:2020-06-11
通讯作者: 庞磊,副主任医师,硕士研究生导师(Tel:0431-88783337,E-mail:panglei@jlu.edu.cn);连鑫,主治医师(Tel:0431-81875832,E-mail:lianxin6216163@163.com) E-mail:panglei@jlu.edu.cn;lianxin6216163@163.com
作者简介:张胜男(1985-),女,吉林省长春市人,医学硕士,主要从事泌尿系统疾病诊疗方面的研究。
基金资助:
国家自然科学基金资助课题（81970228）；吉林省科技厅自然科学基金资助课题（20190201061JC）；吉林省教育厅"十三五"科技项目资助课题（JJKH20201085KJ，JJKH20201047KJ）

Application of modified fecal drainage device in prevention of occupational exposure infection of medical staffs in treatment of critical COVID-19 patient

ZHANG Shengnan¹, YU Xin², LI Qian³, MA Haichun⁴, LIAN Xin¹, PANG Lei⁴

1. Department of Urology, First Hospital, Jilin University, Changchun 130021, China;
2. Department of Hand Surgery, First Hospital, Jilin University, Changchun 130021, China;
3. Department of Ophthalmology, First Hospital, Jilin University, Changchun 130021, China;
4. Department of Anesthesiology, First Hospital, Jilin University, Changchun 130021, China

Received:2020-03-16 Published:2020-06-11

摘要/Abstract

摘要： 目的：探讨采用改良粪便排泄物引流装置避免新型冠状病毒肺炎（COVID-19）治疗中医护人员职业暴露感染的效果，为临床治疗COVID-19和避免医护人员职业暴露感染提供参考。方法：收集1例以腹泻为主要症状的COVID-19危重症患者的临床资料。采用F18号硅胶胃管连接一次性负压引流器的改良粪便排泄物引流装置处理患者的粪便排泄物。参与治疗的医护人员64人，其中医生16人，护士48人。收集医护团队所有人员的一般资料，每2周检测1次COVID-19血清学抗体和咽拭子。结果：患者，女性，78岁，以"腹泻、咳嗽、咳痰15 d，胸闷、气短10 d，发热1 d"入院。COVID-19咽拭子核酸检测结果呈阳性。治疗中应用改良粪便排泄物引流装置收集粪便排泄物，医护人员平均操作时间由原来的20 min减少为10 min，患者肛周皮肤潮红消退，未发生失禁性皮炎（IAD）。患者治愈，但因其他基础性疾病仍留院治疗。医护人员64人的COVID-19血清学抗体和咽拭子核酸检测结果均呈阴性，医护人员无感染。结论：改良粪便排泄物引流装置的稳定性更好，可有效预防IAD以及COVID-19的传播，降低医护人员职业暴露感染的风险，适于临床推广应用。

关键词: 新型冠状病毒肺炎, 职业暴露, 粪便排泄物, 引流, 感染

Abstract: Objective: To investigate the effect of modified fecal drainage device on avoiding the occupational exposure infection of the medical staffs in the treatment of corona virus disease 2019(COVID-19), and to provide the reference for the clinical treatment of COVID-19 and avoiding the occupational exposure infection of the medical staffs. Methods: The clinical data of a critical COVID-19 patient with diarrhea as the main symptom were collected.The modified fecal drainage device of F18 silicone gastric tube connected with disposable negative pressure drainage device was uesd to treat the fecal excrement of the patient.The general data of the medical staffs,contaning 16 doctors and 48 nurses,were collected.The COVID-19 serological antibodies and pharyngeal swabs of the medical staffs were tested every 2 weeks. Results: The 78-year-old woman patient was admitted to hospital due to diarrhea, cough and expectoration for 15 d, chest distress and shortness of breath for 10 d,and fever for 1 d.The test result of COVID-19 pharyngeal swabs of the patient was positive.After the feces were collected with the modified fecal drainage device, the average operation time of medical staffs was reduced from 20 min to 10 min, the patient's perianal skin flushing subsided, and no incontinence-associated dermatitis(IAD)occurred. The patient was cured but remained in hospital for the other underlying diseases. The test results of COVID-19 serological antibodies and pharyngeal swabs of 64 medical staffs were all negative, all the medical staffs had no infection. Conclusion: The modified fecal drainage device has better stability, which can effectively prevent IAD and the spread of COVID-19 and reduce the risk of occupational exposure infection of medical staffs, and it is suitable for clinical promotion application.

Key words: corona virus disease 2019, occupational exposure, faecal excrement, drainage, infection

中图分类号:

R563.1

张胜男, 余欣, 李倩, 麻海春, 连鑫, 庞磊. 改良粪便排泄物引流装置在COVID-19危重症患者救治中预防医护人员职业暴露感染的应用[J]. 吉林大学学报(医学版), 2020, 46(03): 625-629.

ZHANG Shengnan, YU Xin, LI Qian, MA Haichun, LIAN Xin, PANG Lei. Application of modified fecal drainage device in prevention of occupational exposure infection of medical staffs in treatment of critical COVID-19 patient[J]. Journal of Jilin University(Medicine Edition), 2020, 46(03): 625-629.

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改良粪便排泄物引流装置在COVID-19危重症患者救治中预防医护人员职业暴露感染的应用

Application of modified fecal drainage device in prevention of occupational exposure infection of medical staffs in treatment of critical COVID-19 patient

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