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新型冠状病毒肺炎(COVID-19)是由2019年的新型冠状病毒感染引起的急性呼吸道传染病。该病毒较严重急性呼吸系统综合征冠状病毒(SARS-CoV)和中东呼吸综合征冠状病毒(MERS-CoV)更具传染性,其刺突蛋白通过结合血管紧张素转化酶2进入细胞并直接导致肺组织损伤,如病情进一步发展恶化,可导致心血管系统等多种血管紧张素转化酶2富集的肺外组织器官感染和损害,继而发生全身多系统损伤[1]。截至2021年1月底,全世界累计确诊感染例数逾1亿,确诊死亡例数逾218万。随着疫情的持续发展,2021年1月初,河北省石家庄市再次爆发小规模疫情,此次疫情具有发病多、增长快、区域集中的特点。为切断感染途径、避免交叉感染,确诊患者及无症状感染者被定点医院集中隔离及收治;同时,疫情迁延期间非定点医院也承担着大量中、高风险地区具有潜在感染风险可能的患者的诊治工作。
目前,全国多数核医学科设有体外分析实验室并承担着大量的检验工作。疫情期间非定点医院核医学科实验室除完成日常的检验工作外,不可避免地需要接触来自中高风险地区、核酸检测暂时阴性、具有潜在感染风险可能的患者的血液标本。COVID-19的传播方式以飞沫、接触、气溶胶为主,核医学检验人员是疑似血液标本的密切接触者,在相对封闭的环境中操作标本时面临高浓度气溶胶传播等易感因素,具有高暴露风险。如何做好感染控制工作、避免交叉感染、最大限度地降低操作风险,成为各级、各类实验室人员关心的课题。笔者从核医学实验室在疫情期间的实践工作出发,简单总结以下几点体会和建议以供同仁们参考。
核医学实验室对新型冠状病毒肺炎疫情中、高风险地区患者血液标本的管理探索
Exploration on management of blood samples from patients in intermediate and high risk areas of COVID-19 epidemic period in nuclear medicine laboratory
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摘要: 目前,新型冠状病毒肺炎仍是全世界感染防控的重点,在我国有效实施防控措施的情况下,总体已基本得到控制,但随着疫情的持续发展,仍存在小规模爆发事件。笔者在疫情防控期间,从工作实践角度出发,初步探讨了非定点医院核医学科体外分析实验室对中、高风险地区患者血液标本的管理,旨在为全国核医学实验室相关工作人员提供一定的参考和建议,以有效阻断病毒传播途径,避免院内交叉感染。Abstract: COVID-19 is still the focus of infection prevention and control in the world at present, and has been achieved general basic control under the effective implementation of prevention and control measures in China. However, with the continuous development of the epidemic, there are still small-scale outbreaks. From the perspective of work practice during the COVID-19 epidemic period, the authors preliminarily discussed the management of blood samples from intermediate and high-risk areas in the vitro analysis laboratory of nuclear medicine department in non-designated hospital. The aim of this study is to provide some experience and suggestions for the relevant staff of nuclear medicine laboratories in China, so as to effectively block the transmission route of virus and avoid nosocomial cross infection.
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Key words:
- COVID-19 /
- Infection control /
- Laboratory, nuclear medicine department /
- Blood samples
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