浙江省首例甲型H1N1流感危重症病例的成功救治  

Successful rescue of the first critical case of influenza A （ H1 N1 ） in Zhejiang Province

作　　者：楼莲青[1] 丁国强[1] 严建平[6] 斯小水[2] 何建新[2] 洪小飞[3] 贾维[4] 周旭玲[5] 朱林林[5] 浦其斌[7] 石恒[7] 倪红英[8] 曾俊 

机构地区：[1]义乌市中心医院感染科,322000 [2]义乌市中心医院监护室,322000 [3]义乌市中心医院消化内科,322000 [4]义乌市中心医院呼吸内科,322000 [5]义乌市中心医院护理部,322000 [6]浙江省人民医院呼吸科 [7]浙江大学医学院附属第一医院监护室 [8]金华市中心医院监护室 [9]金华市广福医院监护室

出　　处：《中华临床感染病杂志》2010年第1期13-18,共6页Chinese Journal of Clinical Infectious Diseases

摘　　要：目的探讨和总结成功救治甲型H1N1流感危重症病例的关键和主要治疗措施。方法回顾性分析2009年9月5日义乌市中心医院收治的浙江省首例甲型H1N1流感危重症病例的诊疗资料。结果患者病情发展迅速，并发重症细菌性肺炎、急性呼吸窘迫综合征（ARDS）、感染性休克和Ⅰ型呼吸衰竭，同时还出现心功能不全、肾功能损害、骨髓抑制和消化道出血等症状。经积极的抗病毒、抗感染、抗休克及对症支持治疗后病情好转并于10月9日出院。结论及时诊断、早期积极的抗病毒治疗，以及有效处理各种并发症是成功救治甲型H1N1流感危重症病例的关键。Objective To provide experiences for the management of critical case of influenza A （H1N1）. Methods A female influenza A （ H1N1 ） patient aged 41 was admitted to Yiwu Central Hospital with critical condition on September 5 2009 and was successfully treated. The clinical data of the patient were retrospectively reviewed. Results Patient was quickly progressed to severe bacterial pneumonia, acute respiratory distress syndrome （ARDS）, septic shock, type I respiratory failure, and cardiac dysfunction, renal dysfunction, bone marrow inhibition and gastrointestinal hemorrhage were observed. With antiviral, anti-infective, anti-shock and symptomatic and supportive therapy, the palient was improved and discharged from the hospital on October 9. Conclusion Early diagnosis and active antiviral treatment, together with management of complications are key measures for the successful treatment of critical illness due to influenza A （H1N1）.

关 键 词：流感 人 流感病毒A型 H1N1亚型 危重症 治疗 

分 类 号：R51[医药卫生—内科学]