重症和危重症甲型H1N1流感患者临床特点分析与护理  

Clinical Characteristics and Care of Severe and Critical Patients with H1N1 Influenza

作　　者：杨淑玲[1] 朱顺芳[2] 李园[1] 张彩丽[1] 谢红燕[1] 刘定立[1] 周元平[1] 

机构地区：[1]南方医科大学南方医院感染内科 [2]南方医科大学南方医院呼吸内科,广东广州510515

出　　处：《护理学报》2010年第13期25-27,共3页Journal of Nursing（China）

基　　金：国家自然科学基金(30771899)

摘　　要：分析2009年10—12月间收治的15例重症和危重症甲型H1N1流感患者的临床特点，并探讨有效护理措施。临床特点分析：患者年龄18～63（34．9±17．1）岁，男9例，女6例，其中危重症6例。本组患者均为社区获得性感染。10例患者原有各种基础疾病。全部患者均有发热和咳嗽。肌肉痛（9例）、呼吸困难（9例）、咽痛（8例）、肺炎（9例）等是患者常见的症状和体征：少数患者出现严重消化道症状（1例）、意识改变（2例）、肾功能损害（2例）等。6例危重症患者中合并有其他器质性疾病者5例．热程7-18（10．4±6．2）d。护理对策：做好心理护理并加强宣教，编写甲型H1N1流感患者宣教手册；针对重症和危重症甲型H1N1流感的疾病特点做好高热、咳嗽、咳痰等对症护理；对于进展为成人呼吸窘迫综合征并施行有创正压通气治疗的3例危重症甲型H1N1流感患者做好呼吸机参数的调节和血流动力学监测等。本组15例患者中10例痊愈出院，5例危重症患者死亡，其中4例与基础疾病相关，单纯死于甲型H1N1流感者1例，无院内感染。This paper is aimed at analyzing clinical characteristics of 15 severe and critical H1N1 Influenza patients admitted from October to December 2009, and put forward effective caring methods. Patients aged from 18 to 63（34.9±17.1）, with 9 males and 6 females, and altogether 6 critical cases among them. All patients belonged to acquired infection and were with fever and coughing while 10 patients were with various basis diseases. Myalgia, dyspnea, pharyngalgia and pneumonia were frequently seen in patients. A few of them were with severe digestive symptoms, altered mental status and kidney damage. Other organic diseases were observed among 6 critical patients. Nursing methods were applied as the following. Psychological nursing was applied and some specific nursing methods oriented on the characteristics of severe and critical H1N1 Influenza were applied as well. Regulation of respirator and hemodynamic monitoring were employed for those progressed with ARDS and IPPV. 10 patients in this group recovered while 5 critical patients died, 4 of which died of basic diseases, only 1 patient died of H1N1. No nosocomial infection occurred.

关 键 词：甲型H1N1流感 重症 危重症 临床特点 护理 

分 类 号：R511.6[医药卫生—内科学]