院内感染严重急性呼吸综合征的临床特点及5年随访结果分析  

Clinical symptoms of SARS patients infected inside hospitals and results of five years of follow-up

作　　者：姜素椿[1] 张云辉[1] 周先志[2] 王二平[1] 闫亮[1] 王冶[1] 王海滨[1] 

机构地区：[1]解放军第302医院,北京100039 [2]解放军总后勤部卫生部科研训练局,北京100085

出　　处：《武警医学》2010年第12期1031-1034,共4页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的总结严重急性呼吸综合征(severe acute respiratory syndrome,SARS)院内感染病例特点,提高应对突发传染病的能力。方法总结21例院内感染SARS病例资料,结合连续5年随访资料(病情变化、影像学检查及SARS血清抗体检测等),分析院内感染SARS的特点。结果 (1)医务人员在抢救首例SARS患者过程中感染率高,暴露后潜伏期最短36 h,最长为5 d。12人均在5 d内发病。(2)病变主要侵犯肺部,X线片炎性改变主要出现在第1～4病日,发生率71.4%。(3)对于该传染病,做到早休息、早隔离、早治疗,有利于病情恢复。此21例均未发生ARDS或死亡。(4)大量长期应用糖皮质激素可导致二重感染、血糖升高及股骨头坏死。结论对新发传染病,在未确定病原及找到有效抗感染治疗药物的情况下,要求患者早休息、早隔离、早期科学合理治疗,防止滥用药物,以利于疾病预后。Objective To summarize and analyze the clinical features of SARS patients infected inside hospitals so as to improve the capability to handle emergencies. Methods The data of 21 SARS patients infected inside hospitals and the results of five - year follow - up were analyzed. Results The infection rate of SARS among medical workers in the process of rescue was high. The incubation period was 36 h to 4 d. The infection mainly affected the lung. X ray manifestations of the chest mainly occurred in 1 - 4 d af- ter infection, and the rate was 71.4%. Rest and isolation and treatment in the early stage of SARS contributed to convalescence. No death or ARDS occurred in the 21 cases. A sufficiently long medicinal use of glucocorticoids could result in superinfection, hyperglycemia and aseptic necrosis of the head of femur. Conclusions Rest, early isolation and correct medical treatment in the early stage of an emergent infectious disease in the absence of effective specific treatment are most important.

关 键 词：严重急性呼吸综合征 医务人员 院内感染 疾病特点 随访 

分 类 号：R511[医药卫生—内科学]