22例传染性非典型肺炎临床分析  

A Retrospective Study of Severe Acute Respiratory Syndrom in 22 Patients

作　　者：张卓彦[1] 赵爱斌[1] 王利花[1] 郑哲[1] 毕惠君 张裕君[1] 罗宏[1] 

机构地区：[1]太原市第四人民医院,山西太原030053

出　　处：《山西职工医学院学报》2005年第1期21-24,共4页Journal of Shanxi Medical College for Continuing Education

摘　　要：目的 :分析传染性非典型肺炎 (严重急性呼吸综合征 ,SARS)患者的临床特点 ,并对其诊断和治疗方法进行探讨。方法 :对太原市第四人民医院从 2 0 0 3年 3月 10日至 2 0 0 3年 6月 2 5日收治的 2 2例有明确传染病接触史患者的临床、实验室检查、影像学资料进行回顾性分析。结果 :2 2例SARS患者 ,其中 ,男性 10例 ,女性 12例 ,年龄 17岁～ 5 8岁 ,平均年龄 (37.6± 13.0 )岁 ,医护人员 3例 (14 % )。临床症状包括 :发热 (10.0 % )、咳嗽 (6 8% )、气促 (82 % )、乏力 (72 % )、心悸 (14 % )、肌肉酸痛 (9% )、腹泻 (14 % )。血常规 :WBC小于 4.0× 10.9/L 3例 (14 % ) ,WBC为 (4 0～ 10.0 )× 10.9/L 18例 (82 % ) ,WBC大于 10 0× 10 9/L 1例 (4% ) ,WBC平均为 (5.9± 1.9)× 10 9/L ,中性粒细胞比例 (75.3± 10.0 ) % ,淋巴细胞绝对值 (1.1± 0.5 )× 10.9/L。胸部X线示肺部斑片状阴影或气管炎性改变 ,部分短期内病灶增多 ,累及单侧 11例 (5 0 % ) ,双侧 11例 (5 0 % )。分析该病的传染途径 ,进一步提示本病具有较强的飞沫距离传染性。出现急性肺损伤者 7例 (32 % ) ,急性呼吸窘迫综合症 (ARDS)者 2例。 3例死亡患者中 1例为ARDS合并肺部继发感染 ,多脏器功能衰竭 ,1例发展为肺广泛纤维化呼吸衰竭死亡 。Objective:To analyse the clinical features of severe acute respiratory syndrom(SARS) and dignosis and treatment of the disease.Methods:22 patients with SARS admitted into our hospital from March 10th,2003 to June 25th,2003 were studied retrospectively.Every patient had definite infectious disease contact history(belonging to one of infectious links).A retrospective study was made of the data of clinical manifestations,laboratory investigation and roentgenology.Results:The patients consisted of 10 men and 12 women aged 17～58 (mean 37.6±13.0),including 3 infected health-care professionals,clinical symptoms of those patients were fever (100%),coughing (68%),and dyspnea(82%).Routine blood test revealed WBCs were less than 4.0×10~9/L in 3 patients (14%),((4.0～)10.0)×10~9/L in 18 patients (82%) and over 10.0×10~9/L in 1 patient (4%),average ((5.9±)1.9)×10~9/L.The level of neutrophilic granulocyte was (0.75±)0.10,absolute value of lymphcyte was ((1.1±)0.5)×10~9/L.Chest X-ray revealed changes related to pneumonia or bronchitis.The analysis showed further that the transmission of the disease was probably via close contact with contagious droplets,7 patients with acute lung injury (ALI) and 2 with ARDS(2 of the 7 patients).2 patients developed ARDS,1 with MODS died,1 patient with severe lung infection died.Conclusions:A history of close contagious contact,fever,X-ray signs of pneumonia or bronchitis and normal or lowed WBC counts are favorable for the diagnosis of SARS.Oxygen treatment,face mask mechanical ventilation,rational utilization of hormone could lower the death rate.

关 键 词：传染性非典型肺炎 诊断 治疗 

分 类 号：R563.1[医药卫生—呼吸系统]