南方医科大学学报 ›› 2020, Vol. 40 ›› Issue (04): 606-608.doi: 10.12122/j.issn.1673-4254.2020.04.25

• • 上一篇    

临床实验室检测新型冠状病毒感染防控预案的制定及疫情后时代应对策略的思考

杭建峰,孙朝晖,李林海   

  • 出版日期:2020-04-30 发布日期:2020-04-20
  • 基金资助:

Prevention and control of SARS-CoV-2 infection in clinical laboratories: implementation of contingency plan and post-pandemic response strategies

  

  • Online:2020-04-30 Published:2020-04-20

摘要: 2019年底爆发的新型冠状病毒(SARS-CoV-2)肺炎疫情在国内已经得到有效遏制,但感染已呈全球扩散之势。结合《2019 新型冠状病毒肺炎临床实验室生物安全防护指南(试行第二版)》和《2019 新型冠状病毒肺炎临床实验室生物安全防护专家共识》,我们制定了临床实验室检测新冠感染防控预案并对其执行现状和暴露出的问题进行了分析,认为在应对重大疫情时大部分临床实验室(包括临床基因扩增实验室)的设计布局不合理,不能达到相应的生物安全防护要求,无法开展相应的病原学及血清学检测;实验室人员的生物安全防护意识严重弱化;医院发热门诊检验室的检测能力不足,其功能和地位急需加强;而军队人员聚集程度高,其临床实验室设备自动化程度低,甚至没有相应的生物安全柜和足够的个人防护用品,无法满足军队遂行多样化及海外重大任务的需要。针对这些问题和现状,我们也提出相应的对策和建议供大家参考:临床实验室可以参照P2实验室的标准来规范设计布局和人员管理;而发热门诊检验室的检测能力和人员配备需要加强,有条件时可以配备单独的临床基因扩增实验室;对于不达标的临床基因扩增实验室,可按照相应的生物安全防护要求进行改建和升级;军队医疗系统的临床实验室除了加强人员的生物安全防护外,更要保证医疗物资和生物安全装备的供给充足,并尽可能常规配置生物安全柜等设备。

Abstract: The outbreak of COVID-19 has currently been under control in China, but now the disease has rapidly evolved into a global pandemic. We formulated a prevention and control plan for clinical laboratories responsible for detection of the novel coronavirus infection. We analyzed the implementation of this plan and the problems arising from its clinical practice. We found that the layout of most clinical laboratories (including gene amplification laboratories for clinical samples) was inadequate in response to a major outbreak and did not meet the requirements for biosafety protection and etiology and serology testing; and laboratory staff showed insufficiencies in their awareness regarding biosafety protection; the functions and status of the laboratory in the fever clinic need to be enhanced to increase its detection capacity; the high density of military personnel, the low level of automation of clinical laboratory equipment, and the lack of biosafety cabinets and personal protective equipment all limit the performance of diverse military operations and major overseas missions. In view of these problems, we propose the following strategies and recommendations: the clinical laboratory needs to standardize the design and staff management according to the standards of P2 laboratory; the detection capacity and staffing of fever clinic laboratory in hospitals need to be strengthened, and a separate clinical gene amplification laboratory can be optimal; for those clinical gene amplification laboratories that fail to meet these standards, reconstruction and upgrade should be made according to the requirements of biosafety protection; for the clinical laboratory in the military medical system, in addition to enforcement of biological safety protection of the staff, sufficient supply of medical materials and biological safety equipment should be ensured and biological safety cabinets should be routinely equipped if possible.