Chinese General Practice ›› 2024, Vol. 27 ›› Issue (17): 2045-2063.DOI: 10.12114/j.issn.1007-9572.2023.0874
Special Issue: 指南/共识最新文章合集
• Guidelines·Consensus • Next Articles
Received:
2024-01-02
Revised:
2024-02-28
Published:
2024-06-15
Online:
2024-03-22
基金资助:
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URL: https://www.chinagp.net/EN/10.12114/j.issn.1007-9572.2023.0874
亚型 | 主要特征 | 主要病理生理学机制 |
---|---|---|
NSC-MOS | 新型冠状病毒感染通过各种机制对呼吸系统、心血管系统、神经系统、消化系统、泌尿生殖系统等组织器官产生损害,导致亚临床功能障碍 | 多个系统器官的组织损伤或全系统失调 |
PFS | 因新型冠状病毒感染和/或因新型冠状病毒感染而接受有创机械通气所导致的肺纤维化 | 以肺部为突出的广泛组织损伤 |
ME/CFS | 持续至少6个月的严重疲劳(休息后无法缓解)、劳累后不适、未充分休息的睡眠、认知障碍及直立不耐受 | 免疫和神经系统功能障碍 |
POTS | 直立不耐受,即维持直立时自主神经反应异常而引发一系列症状 | 自主神经系统功能障碍 |
PICS | 因新型冠状病毒感染入住ICU的患者受到危重症疾病、生命支持治疗、ICU特定环境等因素影响,出现不同程度新发或恶化的生理、心理和认知功能障碍 | 危重症难以完全康复 |
MCS | 新型冠状病毒感染损害慢性病患者或有慢性病风险者的健康;新型冠状病毒感染大流行导致慢性病的疾病管理中断;新型冠状病毒感染后病症可能导致慢性病患者发生其他慢性病或形成新的慢性病患者群体 | 健康恶化;慢性病急性加重 |
Table 1 The subtype of post-COVID-19 condition
亚型 | 主要特征 | 主要病理生理学机制 |
---|---|---|
NSC-MOS | 新型冠状病毒感染通过各种机制对呼吸系统、心血管系统、神经系统、消化系统、泌尿生殖系统等组织器官产生损害,导致亚临床功能障碍 | 多个系统器官的组织损伤或全系统失调 |
PFS | 因新型冠状病毒感染和/或因新型冠状病毒感染而接受有创机械通气所导致的肺纤维化 | 以肺部为突出的广泛组织损伤 |
ME/CFS | 持续至少6个月的严重疲劳(休息后无法缓解)、劳累后不适、未充分休息的睡眠、认知障碍及直立不耐受 | 免疫和神经系统功能障碍 |
POTS | 直立不耐受,即维持直立时自主神经反应异常而引发一系列症状 | 自主神经系统功能障碍 |
PICS | 因新型冠状病毒感染入住ICU的患者受到危重症疾病、生命支持治疗、ICU特定环境等因素影响,出现不同程度新发或恶化的生理、心理和认知功能障碍 | 危重症难以完全康复 |
MCS | 新型冠状病毒感染损害慢性病患者或有慢性病风险者的健康;新型冠状病毒感染大流行导致慢性病的疾病管理中断;新型冠状病毒感染后病症可能导致慢性病患者发生其他慢性病或形成新的慢性病患者群体 | 健康恶化;慢性病急性加重 |
筛查工具 | 目标人群 | 适用环境 | 优点 | 缺点 |
---|---|---|---|---|
MUST | ≥18岁 | 医院;社区卫生服务中心 | 简单快速,适用性较高 | 无法获得准确体质量的患者不能使用,有效性有待验证 |
NRS2002 | 18~90岁 | 医院 | 循证医学认证 | 住院需1 d以上,次日8:00前未行手术,意识清醒者 |
MNA-SF | ≥65岁 | 医院;社区卫生服务中心 | 简单快速,无创,多考虑慢性病及相关因素,考虑到体质量不详患者的评估 | 主观性较强 |
Table 2 Applicability criteria of common nutritional screening tools
筛查工具 | 目标人群 | 适用环境 | 优点 | 缺点 |
---|---|---|---|---|
MUST | ≥18岁 | 医院;社区卫生服务中心 | 简单快速,适用性较高 | 无法获得准确体质量的患者不能使用,有效性有待验证 |
NRS2002 | 18~90岁 | 医院 | 循证医学认证 | 住院需1 d以上,次日8:00前未行手术,意识清醒者 |
MNA-SF | ≥65岁 | 医院;社区卫生服务中心 | 简单快速,无创,多考虑慢性病及相关因素,考虑到体质量不详患者的评估 | 主观性较强 |
亚型 | 可能的干预措施 |
---|---|
NSC-MOS | 个性化、多学科康复计划 |
PFS | 肺康复;高压氧;药物治疗(尼达尼布,吡非尼酮);中医验方(扶正化瘀方,安络化纤丸);间充质干细胞 |
ME/CFS | 认知行为疗法(有争议);分级运动疗法(有争议);针灸及推拿;药物治疗(止痛药,助眠药,抗抑郁药,辅酶Q10) |
POTS | 增加液体和盐摄入量;紧身衣/弹力袜;非直立运动;药物治疗(米多君,普萘洛尔,氟氢可的松,抗组胺药,甲基多巴) |
PICS | 他汀类药物;达比加群;血管紧张素转换酶抑制剂(心血管和肾脏系统的调节药);SGLT-2抑制剂;二甲双胍;β受体阻滞剂;神经肌肉电刺激;虚拟现实疗法;康复计划 |
MCS | 相关的临床指南 |
Table 3 Intervention measures for subtypes of post-COVID-19 condition
亚型 | 可能的干预措施 |
---|---|
NSC-MOS | 个性化、多学科康复计划 |
PFS | 肺康复;高压氧;药物治疗(尼达尼布,吡非尼酮);中医验方(扶正化瘀方,安络化纤丸);间充质干细胞 |
ME/CFS | 认知行为疗法(有争议);分级运动疗法(有争议);针灸及推拿;药物治疗(止痛药,助眠药,抗抑郁药,辅酶Q10) |
POTS | 增加液体和盐摄入量;紧身衣/弹力袜;非直立运动;药物治疗(米多君,普萘洛尔,氟氢可的松,抗组胺药,甲基多巴) |
PICS | 他汀类药物;达比加群;血管紧张素转换酶抑制剂(心血管和肾脏系统的调节药);SGLT-2抑制剂;二甲双胍;β受体阻滞剂;神经肌肉电刺激;虚拟现实疗法;康复计划 |
MCS | 相关的临床指南 |
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