A 49-year-old male patient with compartment syndrome of the right leg caused by acute carbon monoxide poisoning was admitted on December 30, 2019. The patient had a 10-year history of chronic nephritis and began dialysis treatment due to renal failure 1 month ago. Emergency surgical decompression for compartment syndrome was performed after admission. Two weeks later, the patient was diagnosed as the novel coronavirus pneumonia caused by 2019 novel coronavirus (2019-nCoV) infection. Then, the patient was transferred to the isolation ward, where he was given anti-infection, anti-virus, expectorant, heat-clearing and detoxifying drugs, bedside dialysis, and nutrition support symptomatic treatment. After 2 weeks of treatment, the patient is getting better, with no fever, cough, wheezing, and other discomfort. Meanwhile, the sensory and motor functions of right lower limb recovered gradually. This case is rare, severe, and difficult to diagnose and treat. It is the first reported case of novel coronavirus pneumonia after orthopedic surgery.
ObjectiveTo summarize the clinical experience in the prevention and treatment of novel coronavirus (2019-nCoV, SARS-CoV-2) disease (COVID-19) in the department of thoracic surgery of large grade A tertiary hospitals in Wuhan, and to provide feasible clinical practice strategies.MethodsThe clinical data of 41 COVID-19 patients in the department of thoracic surgery of 7 large grade A tertiary hospitals in Wuhan from December 15, 2019 to February 15, 2020 were analyzed retrospectively. There were 20 surgical patients (10 males and 10 females at an average age of 54.35±10.80 years) and 21 medical personnel (7 males and 14 females at an average age of 30.38±6.23 years).ResultsThe main clinical manifestations of COVID-19 patients were fever (70.73%) and cough (53.66%). Normal or reduced peripheral white blood cells and reduced lymphocyte counts were found in the COVID-19 patients, and some patients may have increased C-reactive protein. COVID-19 patients showed limited ground-glass opacities in early chest CT, which was evident in the edge band of lung. The disease could further develop into multiple pulmonary infiltrations, and pulmonary consolidation was found in severe cases. At the time of confirmed diagnosis, most of the medical personnel were ground-glass shadows and unilateral lesions, and even no obvious abnormalities were found in the lungs. The diagnosed COVID-19 patients were transferred to the isolation ward immediately and treated according to the "Diagnosis and Treatment Program of Novel Coronavirus Pneumonia", which was released by the National Health Commission of the People's Republic of China. At the end of follow-up on February 20, 2020, seven surgical patients (35.00%) were discharged and seven (35.00%) were dead, 13 (61.90%) medical personnel were discharged and no death was found.ConclusionsOf all COVID-19 patients in the department of thoracic surgery of hospitals in Wuhan, the proportion of severe degree and mortality in surgical patients are significantly higher than that of the general population, and medical personnel are prone to nosocomial infections. Early oxygen therapy and respiratory support may improve prognosis. During the epidemic period of COVID-19, elective or limited surgery is suggested to be postponed and the indications for emergency operation should be strictly controlled. Emergency operation is suggested to be treated in accordance with tertiary prevention. On the consideration of specialty in the department of thoracic surgery, all people of the ward should be carefully investigated for infection once one case is confirmed with COVID-19. Early detection, isolation, diagnosis, and treatment are the best preventive measures to improve the prognosis of COVID-19.
ObjectiveTo investigate the strategy adjustment of breast cancer surgery management process during the outbreak of novel coronavirus pneumonia (NCP), and to summarize the experience.MethodsBased on "Pneumonitis Diagnosis and Treatment Plan for Novel Coronavirus Infection (Fifth Trial Version)" and "Surgery Work System During the Prevention and Control of Novel Coronavirus Infection in Mianyang Central Hospital (Second Edition)", the breast surgery department adjusted strategies and plans for breast cancer surgery during the epidemic.ResultsFrom January 25, 2020 to February 11, 2020, 8 cases of breast cancer surgery were performed in our hospital. They were all females, with an average age of 45 years. Five patients underwent modified radical mastectomy, 2 patients underwent breast-conserving surgery plus sentinel lymph nodes biopsy, and 1 case underwent breast-conserving surgery plus axillary lymph node dissection. All 8 patients were diagnosed as invasive ductal carcinoma of breast by hollow needle biopsy. All patients recovered smoothly after surgery, no complications occurred, and they were discharged as planned. No patients or medical staff showed NCP exposure and infection.ConclusionDuring the NCP epidemic, breast cancer surgery can be performed and the epidemic can be effectively prevented and controlled by adjusting the work flow and strategy.
To prevent and control 2019 novel coronavirus pneumonia diseases (COVID-19), hundreds of medical teams and tens of thousands of medical professionals throughout the nation were transferred to Hubei to assist COVID-19 control efforts. Medical professionals were at high risk of novel coronavirus pneumonia infections. To ensure the prevention and control of infection in medical teams and prevent cross-infection among medical staff at the medical station, this management standard includes routine management standards, resident disinfection, personnel entry and exit process, and logistics support management, so as to provide reference for medical teams combating COVID-19 in the future.