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International Journal of Clinical Research. 2021; 5: (1) ; 10.12208/j.ijcr.20210005.

Features of emergent ERCP in the treatment of elderly acute obstructive cholangitis during the outbreak of novel coronavirus pneumonia
新冠肺炎期间急诊ERCP诊治老年梗阻性胆管炎之特点

作者: 盛春,李爽,李瑜琴,金玉兰,刘婷,寇玉彬*

上海市宝山区中西医结合医院消化病研究所胰胆外科 上海

*通讯作者:寇玉彬,单位:上海市宝山区中西医结合医院消化病研究所胰胆外科 上海;

引用本文: 盛春,李爽,李瑜琴,金玉兰,刘婷,寇玉彬. 新冠肺炎期间急诊ERCP诊治老年梗阻性胆管炎之特点[J]. 国际临床研究杂志, 2021, 5(1) : 20-23.
Published: 2021-01-29

摘要

2019年12月底新冠肺炎首先在湖北武汉开始发病、扩散,乃至疫情在全球范围的快速蔓延,在党和国家领导人的全盘统筹指导下,随着对新冠病毒的认识不断加深,诊治也取得阶段性胜利。因新冠病毒系全新的病毒种,全人类普遍没有免疫性,潜伏期3-14天,感染了新冠病毒的病人是传染源,无论有无症状都可以传染人群,防治难度大。急性梗阻性胆管炎是外科急诊常见病,是普外科领域中最重要的外科急症之一,诊治不及时可以导致感染性休克,甚至死亡。目前中国已步入老龄社会,老年病人多合并其他疾患,围手术期处理棘手,再者疫情爆发的特殊时期,全国范围内切断传染源中的疫情隔离和审查,部分患者病情拖到严重时才就诊,人为造成疾病诊治困难。急性梗阻性胆管炎确诊后必须紧急处理,越早效果越好。在疫情暴发的特殊时期,详尽病史调查,排除新冠肺炎患者,急诊行十二指肠逆行性胰胆管造影检查,明确病因(胆结石或肿瘤),遵循外科快速康复理念,实施简单有效的治疗方案,充分引流胆道,减轻炎症反应综合征,在大后方发扬疫情第一线医护人员不怕困难牺牲精神,尽可能抢救患者生命。同时外、内科医生、麻醉师、护理人员必须严格遵照当地卫生行政主管部门或所在医疗机构的相关防护规定,密切协调,所有人员均应做好适当防护,避免医护人员出现不良事件。

关键词: 新冠肺炎;急性梗阻性胆管炎;急诊手术;ERCP;黄疸

Abstract

At the end of December 2019, The epidemic of the novel coronavirus (2019-nCoV)-associated pneumonia was raging in Wuhan,China. And even now the epidemic spread rapidly around the world. With the deepening of the understanding of novel coronavirus, the diagnosis and treatment also achieved a stage victory.Because novel coronavirus was a brand new virus, all mankind didn’t have immunity universally. Prevention and treatment was big challenge.Acute obstructive cholangitis was one of the most mortal surgical emergencies. Failure to diagnose and treat in time could lead to septic shock and even death. At present, the elderly patients were often combined with other diseases, which made it difficult to face in perioperative treatment. Moreover, during the special period of the outbreak of the epidemic, some patients were unwilling go to the doctor until their illness developed seriously. Acute obstructive cholangitis must be treated urgently. In the special period of outbreaks, detailed medical history investigation must eliminate COVID - 19 patients.(Encoscopic Retrograde CholangioPancreatography, ERCP) identified etiology (gallstones or tumors), drain the bile duct was done to reduce inflammatory response syndrome following the concept of fast track surgery. At the same time, physicians, anesthesiologists and nursing staff must strictly comply with the relevant protection laws or regulations and avoid adverse events.

Key words: Novel Coronavirus Pneumonia; Acute Obstructive Cholangitis; Emergent ERCP; Obstructive Icterus

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