国家卫健委2月19日发布《新型冠状病毒肺炎诊疗方案(试行第六版)》,在第五版诊疗方案的基础上,对传播途径、临床表现、治疗等多方面内容进行了修改细化。
The latest version of the plan abolished different epidemic-related standards inside and outside the epicenter of Hubei province, and will only identify "suspected cases" and "confirmed cases" across the country.
最新版诊断标准取消了湖北省和湖北省以外其他省份的区别,统一分为“疑似病例”和“确诊病例”两类。
国家卫健委有关专家表示,诊疗方案五次调整更新,边实践边总结边完善,将很多行之有效的治疗经验纳入指导工作当中,不断提高疾病的规范化诊疗水平。
具体来看,第六版诊疗方案将“经呼吸道飞沫和接触传播是主要的传播途径”改为“经呼吸道飞沫和密切接触传播是主要的传播途径(the main transmission route is droplet transmission and close contact transmission)。”“接触”前增加“密切”二字。增加“在相对封闭的环境中长时间暴露于高浓度气溶胶情况下存在经气溶胶传播的可能(aerosol transmission of the novel coronavirus is possible if one is exposed to a highly concentrated mixture in an enclosed area for an extended period)。”
临床表现上,重症患者严重者除了“快速进展为急性呼吸窘迫综合征(develop rapidly into Acute Respiratory Distress Syndrome)、脓毒症休克(septic shock)、难以纠正的代谢性酸中毒(difficult-to-tackle metabolic acidosis)和出凝血功能障碍(bleeding and coagulation dysfunction)”外,还可出现“多器官功能衰竭(multiple organ failure)”。
此外,在重症、危重症病例的治疗(treatment of patients displaying serious or critical symptoms)中,对康复者血浆治疗(infusions of blood plasma from recovered patients)的适用症和用法、用量进一步细化。
值得注意的是,诊疗方案还增加了“出院后注意事项”,患者出院后,因恢复期机体免疫功能低下,有感染其他病原体风险,应继续进行14天自我健康状况监测(recovered patients should monitor health conditions and continue to quarantine themselves for 14 days),佩戴口罩,有条件的居住在通风良好的单人房间,减少与家人的近距离密切接触,分餐饮食,做好手卫生,避免外出活动。建议在出院后第2周、第4周到医院随访、复诊(at the second and fourth week after being discharged, they are supposed to revisit the hospital and undergo a checkup)。
- 不漏一户、不漏一人
leave no household, no one behind - 增强收治能力
raise the hospital admission capacity - 提高救治水平
improve treatment for patients - 抗击疫情第一线
front line of the battle against the epidemic