新型冠状病毒防控期间医疗队员鼻出血的原因分析及干预措施

Causes and preventive measures of epistaxisin in members of medical team during the prevention and control of novel coronavirus

摘要:

摘要：目的根据新型冠状病毒防控期间部分援鄂医疗队员出现鼻出血的情况，探讨鼻出血原因，制定相应的干预措施以减少鼻出血的发生。方法纳入陆军军医大学第一批援鄂队员共64例作为研究对象，其中鼻出血12例。自行设计调查问卷，发放调查问卷64份，分析援鄂医疗队员鼻出血原因。并结合武汉疫情具体情况及临床经验、文献指南，制定干预措施，具体措施包括增加环境湿度、预防使用药物、减少局部压迫、轻柔擦拭鼻腔、合理膳食营养及注意饮水休息，并对比干预前后的疗效。结果问卷有效回收64份，有效回收率100%，调查显示，回答空气干燥是鼻出血的主要原因的有39例，占60.9%。随访30d，无新增鼻出血队员，11例队员鼻出血停止，仅有1例队员仍有少量血丝，嘱其适当休息、加强营养、注意防护。干预前后鼻出血人数经比较差异具有统计学意义（χ2=85.063, P＜0.01）。结论肺炎疫情爆发期间，医护人员冲在最前线，也最容易和病毒接触。鼻出血是威胁援鄂医疗队员健康的一个重要因素，有效的干预措施能够减少援鄂医疗队员鼻出血的发生，减少创面暴露，降低医护人员感染风险。

Abstract:

ObjectiveTo investigate the causes of epistaxis in some medical team members of Hubei province during the period of prevention and control of novel coronavirus,the causes of epistaxis were discussed and formulated the corresponding preventive measures to reduce the occurrence of epistaxis. MethodsA total of 64 members were included in the study from the first batch of the medical team of Army Military Medical University assisting Hubei, twelve members of who suffered from epistaxis. The questionnaire was designed and 64 questionnaires were issued to analyze the causes of epistaxis in the medical team members. Combined with the specific situation of Wuhan epidemic situation, clinical experience and literature guidelines, the measures of intervention were formulated. The specific measures included increasing environmental humidity, the apply of preventing drugs, reducing local pressure,gently wiping the nasal cavity, reasonable diet nutrition and taking attention to water and rest. The efficacy of preintervention was compared to postintervention by taking the preventive measure.ResultsSixtyfour copies of the questionnaire(100%) were withdrawn effectively. The results showed that 39 members(60.9%) answered the main cause of epistaxis for air drying. There were 11 members of the epistaxis without epistaxis and no new members with epistaxis after followed up for 30 days.Only 1 team member still had a small amount of blood,who was asked to take proper rest, strengthen nutrition and pay attention to protection.The number of medical members with epistaxis before and after intervention was statistically significant (χ2=85.063, P<0.01). ConclusionsDuring the novel coronavirus outbreak, medical staff rushed to the antivirus front line, but also mostly contacted some patients with the virus. Nasal hemorrhage is an important factor threatening the health of medical team members assisting Hubei Province. Effective intervention can reduce the probability of epistaxis of the medical team members,and reduce a wound exposure with the less risk of infection of medical staff.