■在COVID-19大流行中进行紧急眼外伤手术会带来明显的困难,因为严格的感染控制措施对于保护患者和医务人员至关重要。尽管如此,在发展中国家,眼外伤仍然是可避免的视力丧失的重要原因.
方法:一名57岁男子出现红肿,出血,入院前9小时发生摩托车事故后左眼受伤,还有他左脸颊上的伤口.左眼的视敏度显示没有光感。各个方向的眼睛运动有限,眼睑血肿,结膜注射,前房积血,观察到组织在6至8点钟位置从角膜缘突出。患者双眼有白内障手术史(+),并被诊断为开放性眼球损伤伴II区穿透性损伤,伴随着完整的前房积血,左眼玻璃体和脉络膜脱垂,和确诊的COVID-19病例。在COVID-19大流行期间,按照眼外伤手术的基本指南进行了左眼内脏伤。对确诊的COVID-19患者,独立进行术后随访,无明显投诉。
■必须紧急手术干预以防止视力损害,遵循建议在4-72小时内进行手术的指南。眼部组织可能有助于COVID-19通过鼻泪管系统传播,给医护人员带来风险,特别是在手术期间。术前措施,包括获得COVID-19状态和提供适当的个人防护装备(PPE),是至关重要的。最小化气溶胶生成程序并采用杀病毒消毒进一步减轻了传播风险。这起案件强调了在眼外伤的即时干预与COVID-19的安全协议之间取得平衡的必要性,强调标准化的PPE和外科手术程序,以保护医疗保健专业人员。
结论:纳入COVID-19大流行期间获得的见解将加强医疗保健系统,以应对未来的大流行。特别是,它使有效的外科应急反应,同时减轻传染病风险。
UNASSIGNED: Conducting urgent eye trauma surgery amidst the COVID-19 pandemic poses distinct difficulties, as strict infection control measures are crucial to safeguard both patients and medical staff. Nonetheless, eye trauma remains a significant contributor to avoidable vision loss in developing countries.
METHODS: A 57-year-old man presented with redness, bleeding, and injury in the left eye after a motorcycle accident 9 h prior to hospital admission, along with a torn wound on his left cheek. The visual acuity in the left eye showed no light perception. Limited eye movement in all directions, eyelid hematoma, conjunctival injection, hyphema, and tissue protrusion from the limbus at 6 to 8 o\'clock positions were observed. The patient had a history of cataract surgery (+) in both eyes and was diagnosed with an open globe injury with zone II penetrating trauma, accompanied by full hyphema, vitreous and choroid prolapse in the left eye, and a confirmed case of COVID-19. Evisceration of the left eye was performed following the basic guidelines for ocular trauma surgery during the COVID-19 pandemic. Postoperative follow-up was conducted as usual by the operator in isolation for confirmed COVID-19 patients with no significant complaints.
UNASSIGNED: Urgent surgical intervention is necessary to prevent visual impairment, following guidelines recommending surgery within 4-72 h. Ocular tissue may facilitate COVID-19 transmission via the nasolacrimal system, posing risks to healthcare workers, particularly during surgery. Preoperative measures, including obtaining COVID-19 status and providing appropriate personal protective equipment (PPE), are crucial. Minimizing aerosol-generating procedures and employing virucidal disinfection further mitigates the transmission risks. This case underscores the need to balance immediate intervention for eye injuries with safety protocols for COVID-19, emphasizing standardized PPE and surgical procedures to safeguard healthcare professionals.
CONCLUSIONS: Incorporating insights gained during the COVID-19 pandemic will fortify healthcare systems against future pandemics. In particular, it enables effective surgical emergency response while mitigating infectious disease risks.