国家卫生健康委解读:第七版新冠肺炎诊疗方案做了哪些调整?

2020-09-15 佚名 国家卫生健康委

对新冠肺炎认识的不断加深,也在促进着《新型冠状病毒肺炎诊疗方案》不断调整和完善。

新冠肺炎认识的不断加深,也在促进着《新型冠状病毒肺炎诊疗方案》不断调整和完善。

9月15日,国务院应对新型冠状病毒肺炎疫情联防联控机制综合组发布《新型冠状病毒肺炎诊疗方案(第七版)》,在原有诊疗方案的基础上,对传播途径、疫情监测、流行病学调查等多方面内容进行了修改细化。

《方案》在标本采集和实验室检测部分增加基因测序内容,要求各地发生的首例和感染来源不明的病例以及环境监测发现的阳性标本,应当开展基因测序等溯源工作。

主要修订内容如下:

1.总体要求

明确坚持预防为主、防治结合、依法科学防治的原则,按照及时发现、快速处置、精准管控、有效救治的工作要求,落实“四早”措施,坚决防范境外疫情输入和境内疫情反弹。

2.病原学和流行病学特征

强调主要传播途径仍为经呼吸道飞沫和密切接触传播,但是特定条件下接触病毒污染的物品和暴露于病毒污染的环境可造成接触传播或气溶胶传播。

3.疫情监测

一是根据国内外疫情流行变化,病例流行病学史强调报告病例或无症状感染者社区的旅行史或居住史、病例或无症状感染者接触史等,更加精准科学。

二是强调无症状感染者为呼吸道等标本新型冠状病毒病原学检测呈阳性,无相关临床表现,如发热、干咳、咽痛等可自我感知或可临床识别的症状与体征,且CT影像学无新冠肺炎影像学特征者。

三是增加多渠道监测预警,要求按照点与面结合、传染病监测系统与其他部门监测系统结合、常规监测与强化监测结合的原则,针对人群和环境开展监测工作。

四是完善聚集性疫情定义,根据分区分级标准,将聚集性疫情从“2例及以上病例”修改为“5例及以上病例”。

检测.jpg4.流行病学调查

增加境外输入病例、输入继发病例、密切接触者的密切接触者(简称密接的密接)等定义,强调做好个案调查,密接判定、病例主动搜索、聚集性疫情调查及调查信息报告,做好感染来源、污染范围、传播特征和传播链分析。

5.密切接触者和密接的密接管理

一是增加密接的密接管理要求,包括管理方式、管理流程、管理要求、信息报告4方面内容。

二是增加集中隔离医学观察期间核酸检测要求,要求对密切接触者和密接的密接集中隔离医学观察期间分别进行3次和1次核酸检测。

三是细化集中隔离和居家医学观察要求,制定集中隔离和居家医学观察指南,指导各地科学开展相关工作。

6.疫情处置

一是针对低、中、高不同风险地区,进一步细化防控措施,低风险地区落实常态化防控工作,加强疫情监测和应对准备。

二是中风险地区科学划定防控区域范围至最小单元(如学校以班级、楼房以单元、工厂以工作间、工作场所以办公室、农村以户为最小单元),启动强化监测、实施终末消毒。根据疫情防控需要和感染风险,确定核酸检测人群范围和优先次序。

三是高风险地区以学校、楼房、工厂、工作场所、自然村为最小单元划定防控区域,开展入户全面排查、限制人群聚集性活动、区域管控等措施,启动应急响应。

7.标本采集和实验室检测

增加基因测序内容,要求各地发生的首例和感染来源不明的病例以及环境监测发现的阳性标本,应当开展基因测序等溯源工作。

8.境外疫情输入防控

调整“7+7”“2+1”集中隔离医学观察措施。入境人员在入境口岸接受海关核酸检测后,在入境地集中隔离7天并自费进行核酸检测(原则上在进入集中隔离医学观察点的第5天),检测结果阴性者可转居家隔离7天,并于隔离期满14天后自愿自费进行1次核酸检测。

9.重点环节防控

增加冷链食品加工和交易场所的防控要求,降低冷链环节传播疫情风险。

10.社会健康管理和服务

加强社区防控与服务、爱国卫生运动、宣传教育与风险沟通、个人卫生与防护、心理健康服务等措施。

11.隔离场所设置

在保持隔离场所设置其他要求基本不变的前提下,将选址要求修改为“应相对独立,与人口密集居住与活动区域保持一定防护距离”,有利于在保证隔离安全和避免疫情传播的基础上,提升城市总体隔离能力。

防控方案要求各地进一步压实属地、部门、单位和个人“四方”责任,强化联防联控、加强能力建设,定期对本辖区内疫情形势进行研判和风险评估,组织开展防控技能培训和实战演练,加强对重点地区、重点场所、重点人群防控工作的指导检查,督促各项防控措施落地落实。

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    2020-09-16 14818eb4m67暂无昵称

    学习

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    2020-09-16 公卫新人

    新冠肺炎,疫情何时才能消失

    0

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