“全球疫情会诊室”：中国医生与美非等地同行交流经验

5月11日晚，中央广播电视总台中国国际电视台（CGTN）邀请首都医科大学宣武医院援鄂医护人员与来自美国、加纳、肯尼亚和新加坡的同行、病毒学专家交流新冠肺炎防控和治疗方面的经验。

两位中方医护人员1月27日奔赴武汉参与医疗救援时，在武汉战斗了整整65天。在此期间，他们与武汉华中科技大学同济医院附属协和医院的医生们一起，负责危重患者的救治工作，有着丰富的一线战疫经验。

据约翰斯·霍普金斯大学（Johns Hopkins University）统计数据显示，美国确诊人数已经超过134万，死亡人数超过8万。新加坡、肯尼亚、加纳确诊人数分别达到23,822例、700例和4700例。

北京演播室，邹韵主持“全球疫情会诊室”直播交流节目

Seventeen years ago, Dr. Li Quanrui and head nurse Sun Xuelian from Beijing's Xuanwu Hospital Capital Medical University fought against SARS on the frontline in Beijing. This year, they combated COVID-19 epidemic at China's once hardest hit city Wuhan, spending 65 days there treating critically ill patients. 

In the latest episode of CGTN's live program "COVID-19 Frontline," they shared their firsthand experience with experts and medics from the U.S., Singapore, Kenya, and Ghana.

As of Monday, the U.S. has reported over 1,340,000 confirmed cases, while the number reached 23,822 in Singapore, 700 in Kenya and 4,700 in Ghana.

老年患者需要什么特殊护理？

How to provide care and treatment to elderly patients?  

纽约大学罗里·迈尔斯护理学院（Rory Meyers College of Nursing, NYU）全球卫生系教授吴蓓在交流中提到，面对新冠肺炎疫情，老年人属于易感人群，并且感染者容易发生并发症，她问中方医生老年患者护理中需要注意什么问题。

宣武医院感染疾病科主任李全瑞说，高龄人群由于免疫功能相对较差，基础疾病较多，容易受到新冠病毒的攻击，因此需要注意病情发展，采取提前预警措施。他说，可以从临床指标方面多加关注，例如，外周血淋巴细胞计数是否进行性下降；细胞因子的炎症指标是否升高，比如C反应蛋白、白介素6等；血乳酸测定是否进行性升高；必要的时候，还需要关注影像学方面的进展。在护理方面，需要关注患者的呼吸状况，例如呼吸频率是否大于等于30次/分；静息状态下，血氧饱和度是否小于等于93%，氧合指数是否小于等于300等。

Wu Bei, Dean's Professor in Global Health of Rory Meyers College of Nursing at New York University, asked how to properly take care of elderly COVID-19 patients in hospitals, which they find quite challenging in the U.S.

Dr. Li Quanrui, Chief Physician of Infectious Diseases Department at Xuanwu Hospital Capital Medical University, said that elderly people are more vulnerable to the attack of the coronavirus due to their weaker immune systems and more underlying diseases. They also tend to develop various co-morbidities.  Therefore, special attention should be paid to some key clinical indicators so as to take precaution measures timely when there is abnormality. The indicators include the levels of peripheral blood Lymphocytes, cytokines such as C-reaction protein and Interlurk-6, blood lactate, respiratory ratio, blood oxygen saturation and medical imaging results when necessary. 

Sun Xuelian, Head Nurse of the Emergency Department at Xuanwu Hospital Capital Medical University, said that more than 60 percent of their patients in Wuhan were elderly, and the majority of them were in severe conditions. As the disease is contagious, the patients' family members were not allowed to keep them company, so the nurses needed to offer comprehensive daily care to the patients, which included medication, feeding, cleaning and mental support.

李全瑞医生和同事在武汉新冠肺炎病房中工作

急诊科流水组护士长孙雪莲介绍，在武汉支援期间，60%以上的患者为老年人，且重症患者居多。但由于传染病房的特殊性，家属无法陪护，因此护士必须兼顾生活护理和基础护理。在武汉，通常两到三名确诊患者住在同一间病房，医院按责任制对护士进行分组，护士会负责包括用药、饮食、皮肤清洁、陪伴等方面的照顾和护理，以缓解病人的焦虑情绪，保持相对稳定的心理状态。

新加坡专家分享防疫经验

COVID-19 containment in Singapore

在交流中，李全瑞医生也向新加坡国际科研人员协会执行委员、专注冠状病毒和流行病研究工作的陈广博士了解新加坡的防疫经验。

陈博士说，新加坡目前采取的是常态化和精细化的应对措施，将患者进行细分，包括轻症观察患者；潜在高危人群，如外来劳工，外国人；重症治疗患者；重症ICU患者等。其中，轻症观察患者居住在隔离酒店，重症治疗患者在医院里接受治疗，危重症患者则需要在ICU接受治疗。目前新加坡ICU病房中约有20名左右的患者。

新加坡国际科研人员协会执行委员陈广博士分享新加坡防疫经验

另外，恢复期人群在私立医院和社区医院等接受观察。陈博士说，这种分类方式最大限度地减轻了医院的负担，也可以尽可能保证民众生活。

Dr. Chen Guang, a scientist focused on coronaviruses and epidemic control at Singapore Research Club, also shared Singapore's strategy to control the COVID-19 epidemic at the moment, which he summarized as "normalized" and "refined" countermeasures. 

Similar to China, Singapore has divided patients into several categories: mild patients, severe patients, critically ill patients, and potential carriers of the virus such as foreigners working in the country. Different groups have been observed and treated in different places. For example, mild patients stay in designated hotels for medical observations, and severe patients are treated in hospitals. He said there are now some 20 critically ill patients in ICUs in Singapore. 

医护人员防护如何分级？

Different levels of PPE for medical staff at different positions

来自加纳的中加友好医院感染预防和培训协调员护士波林·海耶（Pauline Hayeh）问了医院不同病区医护人员防护如何分级的问题。同时，她在交流中提到，由于新冠肺炎时期医院工作量陡然提升，医护人员长期处于较大心理压力中，她希望了解中方在医护人员排班方面的经验，如何尽可能减轻他们的工作压力。

孙雪莲护士长介绍，根据职位和负责病区的不同，医护人员的防护设备级别也不同。传染病病房和发热门诊的医护人员通常启用三级防护，即要求佩戴包括一次性工作帽、医用防护口罩（N95）、护目镜或防护面屏、防护服、一次性防渗隔离衣、双层一次性乳胶手套、手术室用胶底工作鞋或胶靴，以及防水靴套等。在进行包括气管插管等高风险操作时，还需要佩戴头部正压面罩。

中外专家在“全球疫情会诊室”通过视频连线进行交流

Pauline Hayeh, a training coordinator of infection prevention and control at China-Ghana Friendly Hospital, asked whether different levels of PPE (personal protective equipment) should be used for medical staff working at different departments of a hospital.

Sun said that there have been three levels of protection in Wuhan, which is based on the different infection risk levels. At the departments of infectious disease and fever, where the risk is the highest, medical staff have been required to use Level-3 PPE (personal protective equipment). That includes a hat to cover the hair, an N95 mask, a goggle or a facial shield, a protective gown, double-layered rubber gloves, and rubber boots with waterproof cover for each person. When perform risky operations like intubation, they should also wear a positive pressure mask, she added.

而在普通的急诊科等区域，医护人员需要佩戴KN95口罩和一次性医用外科口罩，穿普通的工作服、工作鞋，戴一层一次性外科手套或乳胶手套。

在班次方面，孙护士长说，初到武汉时，医院曾经尝试过污染区连续6小时排班，但由于对医护人员体能挑战太大，调整为4小时一个班次。她特别指出，由于长时间佩戴防护设备，一部分护士曾出现过职业性皮炎，因此建议在穿戴防护服之前均匀涂抹润肤剂和保湿霜，最大可能保护医护人员。

For medical staff working in other departments, they should wear N95 mask or surgical mask, regular working clothes and shoes, and one layer surgical gloves or rubber gloves, she added.

Hayeh also asked how to manage the working shifts of the nurses so as to ease their burden. Sun said that when they first arrived in Wuhan, they tried six-hour shifts for the nurses, which proved too physically challenging. Therefore, one shift has been shortened to four hours.

在直播过程中，中外医护人员还回答了网友们的提问，例如：使用何种洗手液更安全。孙护士长说，正规商店购买的香皂、洗手液都可以用，只要用流动的水洗手，就可以有效地阻止病毒传播。同时，她建议尽量避免去人员众多、空气不流通的封闭场所，如果不得不去，回家需要及时洗手洗澡，做好清洁。

双方的交流持续了近90分钟，期间，上述中外专家和肯尼亚肯雅塔大学医学微生物学和寄生虫学系主任奥古图（James Ogutu）还就患者心理状态、无症状感染、康复患者复阳等广受关注的问题进行了交流讨论。

截至目前，CGTN新媒体编辑部的“全球疫情会诊室”节目共举行了53场直播，在全球范围内获得2.08亿阅读量，视频观看总量达到6734万，其中海外平台阅读量1.67亿，互动量83.8万次。

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