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浙江大学学报（医学版）
浙江大学学报（医学版）  2020, Vol. 49 Issue (2): 209-214    DOI: 10.3785/j.issn.1008-9292.2020.03.15
原著     
2019冠状病毒病(COVID-19)疑似患者多学科协作诊治分析
丁叔波1(),俞世安2,陈海君3,*(),张德和3,徐叶进3,朱丹4,陈琨5
1. 金华市中心医院放疗科, 浙江 金华 321000
2. 金华市中心医院肝胆外科, 浙江 金华 321000
3. 金华市中心医院感染科, 浙江 金华 321000
4. 金华市中心医院呼吸与危重症科, 浙江 金华 321000
5. 金华市中心医院重症医学科, 浙江 金华 321000
Roles of multidisciplinary team in diagnosis and treatment of suspected cases of COVID-19
DING Shubo1(),YU Shi'an2,CHEN Haijun3,*(),ZHANG Dehe3,XU Yejin3,ZHU Dan4,CHENG Kun5
1. Department of Oncology Radiotherapy, Jinhua Municipal Central Hospital, Jinhua 321000, Zhejiang Province, China
2. Department of Hepatobiliary Surgery, Jinhua Municipal Central Hospital, Jinhua 321000, Zhejiang Province, China
3. Department of Infectious Diseases, Jinhua Municipal Central Hospital, Jinhua 321000, Zhejiang Province, China
4. Department of Respiratory and Critical Care Medicine, Jinhua Municipal Central Hospital, Jinhua 321000, Zhejiang Province, China
5. Department of Critical Care Medicine, Jinhua Municipal Central Hospital, Jinhua 321000, Zhejiang Province, China
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摘要：

目的: 分析多学科协作诊疗（MDT）在2019冠状病毒病（COVID-19）疑似病例诊治中的参与情况及处置结果，总结MDT在COVID-19诊治中的作用。方法: 回顾性分析2020年1月21日至3月20日就诊于金华市中心医院的48例COVID-19疑似患者的临床资料及诊治经过，进一步分析MDT在患者处置流程和诊断中的作用。结果: 18例确诊COVID-19，30例排除COVID-19。确诊患者经MDT讨论2~12次，平均每例患者讨论（4.7±3.2）次；非COVID-19患者多学科讨论2~4次，平均每例患者讨论（2.3±0.6）次。MDT对COVID-19疑似患者诊疗流程及诊断标准进行了讨论及调整。在MDT主导下，1例危重型患者积极治疗后转省级定点医院治疗，1例COVID-19合并急性胆囊炎患者行胆囊穿刺置管引流术手术，1例高度疑似患者行肺泡灌洗液检查排除COVID-19。除1例COVID-19危重型患者转省级医院治疗外，17例COVID-19患者均治愈出院，未发现院内及疑似患者交叉感染，无死亡病例，无医务人员感染发生，非COVID-19患者及时转到相应专科治疗。结论: 在COVID-19疑似患者诊治过程中，MDT的参与提高了诊治效率，尤其对疑难复杂病例诊治有重要作用。
关键词： 2019冠状病毒病;  严重急性呼吸综合征冠状病毒2;  新型冠状病毒肺炎;  疑似病例;  多学科协作;  诊断;  治疗    
Abstract:

Objective: To analyze the roles of multidisciplinary team (MDT) in the diagnosis and treatment of suspected cases of coronavirus disease 2019 (COVID-19). Methods: The clinical data of 48 patients with suspected COVID-19 admitted in Jinhua Municipal Central Hospital from January 21, 2020 to March 20, 2020 were retrospectively analyzed. Results: In the 48 suspected cases, 18 were diagnosed with COVID-19, and 30 were excluded. Each of the confirmed cases were discussed among MDT for 2 to 12 times with an average of (4.7±3.2) times; while for non-COVID-19 patients were discussed for 2 to 4 times with an average of (2.3±0.6) times. With the guidance of MDT, one COVID-19 patient was transferred to designated provincial hospital after effective treatment; one patient complicated with acute cholecystitis underwent gallbladder puncture and drainage; and COVID-19 was excluded in a highly suspected patient after alveolar lavage fluid examination. Except one transferred patient, all 17 confirmed COVID-19 patients were cured and discharged. There was no cross-infection occurred in suspected patients during the hospitalization. There were no deaths and no medical staff infections. Conclusion: The efficiency of diagnosis and treatment for suspected COVID-19 patients can be improved with MDT, particularly for complicated cases.
Key words: Coronavirus disease 2019    Severe acute respiratory syndrome coronavirus 2    Novel coronavirus pneumonia    Suspected case    Multidisciplinary team    Diagnosis    Treatment
收稿日期: 2020-03-04 出版日期: 2020-04-10
:  R511  
通讯作者: 陈海君     E-mail: jhyyys@163.com;jhchenhaijun@126.com
作者简介: 丁叔波(1978-), 男, 硕士, 副主任医师, 主要从事肿瘤放化疗研究; E-mail:jhyyys@163.com; https://orcid.org/0000-0002-4533-4624
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引用本文:

丁叔波,俞世安,陈海君,张德和,徐叶进,朱丹,陈琨. 2019冠状病毒病(COVID-19)疑似患者多学科协作诊治分析[J]. 浙江大学学报（医学版）, 2020, 49(2): 209-214.

DING Shubo,YU Shi'an,CHEN Haijun,ZHANG Dehe,XU Yejin,ZHU Dan,CHENG Kun. Roles of multidisciplinary team in diagnosis and treatment of suspected cases of COVID-19. J Zhejiang Univ (Med Sci), 2020, 49(2): 209-214.

链接本文:

http://www.zjujournals.com/med/CN/10.3785/j.issn.1008-9292.2020.03.15    或    http://www.zjujournals.com/med/CN/Y2020/V49/I2/209

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