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中英对照:《抗击新冠肺炎疫情的中国行动》白皮书 [27]
Fighting COVID-19: China in Action [27]
发布时间:2020年06月07日
Published on Jun 07, 2020
建立专家巡查制度,定期组织专家团队对武汉市定点医院重症患者救治进行巡诊,评估患者病情和治疗方案。针对超过80%的重症患者合并严重基础性疾病情况,实行“一人一策”,建立感染、呼吸、重症、心脏、肾脏等多学科会诊制度,并制定重症、危重症护理规范,推出高流量吸氧、无创和有创机械通气、俯卧位通气等措施。严格落实疑难危重症患者会诊制度、死亡病例讨论制度等医疗质量安全核心制度,强化对治愈出院患者健康监测,确保重症患者救治质量。
The treatment strategy for severe cases was improved, and tailored treatment provided to individual patients. Inspection teams consisting of top experts were organized to regularly inspect Wuhan’s designated hospitals and evaluate patients in critical condition and their therapeutic regimen. For those with serious underlying medical conditions, who accounted for more than 80 percent of all severe cases, case-by-case treatment was prescribed after consultation with a multidisciplinary team consisting of experts on infection, respiratory diseases, heart and kidney diseases, and intensive care. In addition, a set of standards were formulated for nursing patients in severe and critical condition, and such measures as high-flow nasal cannula oxygen therapy, non-invasive and invasive mechanical ventilation, and ventilation in a prone position were adopted. Expert consultation on complex, severe and critical cases, and fatal cases, and other core medical security systems were strictly implemented. Those who have been cured and discharged from hospital have received rigorous health monitoring, and patients in severe condition have been given quality medical treatment.
开展康复者恢复期血浆采集和临床治疗工作,建立应急储备库,截至5月31日,全国共采集恢复期血浆2765人次,1689人次患者接受恢复期血浆治疗,取得较好治疗效果。
The plasma of convalescent Covid-19 patients has been collected to set up an emergency plasma reserve, and convalescent plasma therapy has been applied in clinical treatment. As of May 31, convalescent plasma had been collected from 2,765 recovered patients, and 1,689 patients had been treated with the therapy, with positive results.
对轻症患者及早干预治疗。及时收治轻症患者,及早实施医疗干预,尽量减少轻症转为重症。完善临床救治体系,全国共指定1万余家定点医院,对新冠肺炎患者实行定点集中治疗。建立全国医疗救治协作网络,通过远程会诊方式提供技术支持。
Early intervention for patients with mild symptoms. China has been quick to have patients with mild symptoms admitted to designated medical facilities for early medical intervention, and has done its best to prevent mild cases from worsening. The national clinical treatment network has been expanded to include more than 10,000 hospitals dedicated to the treatment of Covid-19 patients. A national network of medical treatment coordination has also been formed to provide technical support through online consultation.
武汉市针对患者数量急剧增长、80%左右是轻症的情况,集中力量将一批体育场馆、会展中心等改造成16家方舱医院,床位达到1.4万余张,使轻症患者应收尽收、应治尽治,减少了社区感染传播,减少了轻症向重症转化。16家方舱医院累计收治患者1.2万余人,累计治愈出院8000余人、转院3500余人,实现“零感染、零死亡、零回头”。
In Wuhan, faced with surging infections and considering that 80 percent of cases were mild, the city government mobilized resources to repurpose stadiums and exhibition centers into 16 temporary treatment centers. With some 14,000 beds, these centers were able to admit all confirmed mild cases for treatment. This helped to reduce infections and virus transmission in communities and prevent mild cases from worsening. The 16 treatment centers received a total of more than 12,000 patients; 8,000 and more were cured and discharged; and more than 3,500 were transferred to hospitals. While in service, these facilities had zero cases of infection, death, or relapse.
方舱医院是阻击重大传染病的重大创新,使“应收尽收”“床位等人”成为现实,有力扭转了防控形势。英国《柳叶刀》社论认为,“中国建造的方舱庇护医院对于缓解医疗卫生系统所承受的巨大压力有着至关重要的作用”。(注2)
Temporary treatment centers, or Fangcang shelter hospitals, are a major innovative solution that provided enough beds to admit all confirmed cases, thus turning the tide in the battle against Covid-19. An article in The Lancet wrote, “To relieve the huge pressure on the healthcare system, Fangcang shelter hospitals have also been crucial.”2
及时总结推广行之有效的诊疗方案。坚持边实践、边研究、边探索、边总结、边完善,在基于科学认知和证据积累的基础上,将行之有效的诊疗技术和科技研究成果纳入诊疗方案。先后制修订7版新冠肺炎诊疗方案,3版重型、危重型病例诊疗方案,2版轻型、普通型管理规范,2版康复者恢复期血浆治疗方案,1版新冠肺炎出院患者主要功能障碍康复治疗方案,提高了医疗救治工作的科学性和规范性。
Reviewing diagnostic and therapeutic plans and applying effective ones on a broad scale. China’s diagnostic and therapeutic plans for Covid-19 have been developed and improved through clinical practice, medical research, experimentation and regular reviews. Based on scientific knowledge and accumulated evidence, R&D results and the diagnostic and therapeutic regimens that proved effective were incorporated in the national diagnosis and treatment plans. These include seven versions of the diagnosis and treatment protocol, three editions of the protocol for severe and critical cases, two editions of the manual for mild case management, two editions of convalescent plasma therapy treatment protocol, and one rehabilitation treatment program for patients discharged from hospitals. All these protocols and plans have contributed to science-based treatment of patients and the establishment of standards for medical treatment.
最新的第7版新冠肺炎诊疗方案增加病理改变内容,增补和调整临床表现、诊断标准、治疗方法和出院标准等,并纳入无症状感染者可能具有感染性、康复者恢复期血浆治疗等新发现。目前,第7版诊疗方案已被多个国家借鉴和采用。
In Diagnosis and Treatment Protocol for Covid-19 (Trial Version 7), information on pathological changes, clinical symptoms, criteria for diagnosis, therapies, and criteria for patient discharge was added or updated. The protocol states that asymptomatic cases may be contagious. It also notes that plasma from convalescent cases may work in treating the infected. This edition has been adopted or used for reference in a number of countries.
强化治愈出院患者隔离管理和健康监测,加强复诊复检和康复,实现治疗、康复和健康监测一体化全方位医疗服务。注重孕产妇、儿童等患者差异性诊疗策略,实现不同人群诊疗方案的全覆盖。
Concerning discharged patients, quarantining, monitoring of their health and rehabilitation, and reexamination and re-testing have all been strengthened. Integrated medical services covering treatment, rehabilitation and health monitoring have been put in place. Differentiated treatment approaches have been adopted for children and pregnant women, among other groups.
充分发挥中医药特色优势。坚持中西医结合、中西药并用,发挥中医药治未病、辨证施治、多靶点干预的独特优势,全程参与深度介入疫情防控,从中医角度研究确定病因病基、治则治法,形成了覆盖医学观察期、轻型、普通型、重型、危重型、恢复期发病全过程的中医诊疗规范和技术方案,在全国范围内全面推广使用。
Leveraging the unique strength of traditional Chinese medicine (TCM). Both TCM and Western medicine were used and traditional Chinese and Western drugs administered. China has leveraged the unique strength of TCM in preemptive prevention, differentiated medication, and multi-targeted intervention, and at every step of Covid-19 treatment and control. The etiology and pathogen of the disease were analyzed and confirmed through TCM methodology, as were the principles and methods of treatment. A set of TCM diagnosis and treatment protocols were developed to cover the entire process of medical observation, treatment of mild, moderate, severe, and critical cases, and recovery, and they have been applied nationwide.
中医医院、中医团队参与救治,中医医疗队整建制接管定点医院若干重症病区和方舱医院,其他方舱医院派驻中医专家。中医药早期介入、全程参与、分类救治,对轻症患者实施中医药早介入早使用;对重症和危重症患者实行中西医结合;对医学观察发热病人和密切接触者服用中药提高免疫力;对出院患者实施中医康复方案,建立全国新冠肺炎康复协作网络,提供康复指导。
TCM hospitals were used in the treatment of Covid-19 patients, and TCM teams took charge of and ran some wards for patients in severe condition at designated hospitals and some treatment centers. All the other shelter hospitals had resident TCM experts. TCM has played its part in the entire process of Covid-19 response, from early intervention to administering case-specific treatment. TCM drugs and treatment methods were used for early intervention and treatment of patients with mild symptoms; for patients with severe symptoms they were used in combination with Western medicine; for those under medical observation for fever and those who had been in close contact with confirmed cases they served to improve immunity; they helped to strengthen the constitution of those who had recovered. A national TCM coordination network was formed to offer guidance to patients recovering from the disease.
注:为确保中英对照准确,“热词译”网站可能对中英文重新分段。