I recently read a news article about surgery for patients with AIDS combined with lung cancer. I had the honor to perform thoracoscopic surgery on two AIDS patients, and I would like to share my views.
First of all, I would like to talk about the diagnosis of HIV infection: When the patient is found to be HIV positive in the preoperative examination, he needs to be sent to the confirmatory test again (the difference between the two mainly lies in the detection means, the former is ELISA, the latter is Western-Blot), and after obtaining positive results again, he can be diagnosed as an HIV-infected person; if the patient also has CD4+ T cells below 200/mm3 or typical AIDS manifestations such as pneumosporidiosis, etc., then AIDS can be diagnosed.
Secondly, if the disease requiring surgical treatment in AIDS patients is not an emergency surgery, even if it is a limited duration surgery such as oncological disease, the surgery is usually not scheduled immediately.
Because the immunity of AIDS patients is in a severely depressed state, the possibility of infectious complications after surgery is relatively high. It is recommended that patients first receive anti-HIV treatment and then consider surgical disease treatment after CD4+ T-cell levels have rebounded and the patient’s other combined diseases have been controlled.
Third, the preparation of medical workers includes: 1, patients need to be relatively isolated.
2, Medical workers follow the protection level of exposure to infection during daily check-ups and when performing medical operations to avoid medical exposure.
3. During surgery, staff members are required to wear protective clothing, including the chief surgeon, assistant, and hand-washing nurse with N95 masks and eye protection and double rubber gloves. Sharps are passed through metal trays, surgical instruments are individually disinfected after use, and medical waste such as disposable surgical gowns and surgical towels are collected and encapsulated for special treatment.
Therefore, AIDS patients are specially infected patients and need to be treated accordingly in the perioperative period for patient safety and to avoid medical exposure of medical staff, and it is recommended to transfer to specialized medical institutions for consultation and treatment as much as possible.