温州地区重症甲型H1N1流行性感冒的临床特征与治疗分析  

Analysis of clinical features and treatment of patients with severe type A H1N1 flu in Wenzhou

作　　者：蒋贤高[1] 施伎蝉[1] 朱海燕[1] 苏菲菲[1] 崔小亚[1] 宁洪叶[1] 杨守峰[1] 金方平[1] 

机构地区：[1]温州市第二人民医院感染科,325000

出　　处：《中华传染病杂志》2011年第2期113-115,共3页Chinese Journal of Infectious Diseases

摘　　要：目的了解温州地区住院重症甲型H1N1流行性感冒（流感）的临床特征并探索临床有效的治疗方法。方法分析住院的42例重症甲型H1N1流感病例临床资料，总结重症甲型H1N1流感的临床特点及发展规律。结果42例重症甲型H1N1流感病例均以发热、咳嗽起病，39例有咳痰，其他依次为咽痛、畏寒等；WBC正常或降低，C反应蛋白升高30例，血细胞沉降率增快30例，40例患者出现肺部影像学改变。所有患者常规予奥司他韦抗病毒治疗，并及时予有效抗菌药物治疗及对症处理，均未使用糖皮质激素。对有基础疾病者给予相应的对症治疗。3例患者予抗真菌治疗，3例妊娠患者适时终止妊娠。结论重症甲型H1N1流感病情进展快，迅速累及下呼吸道，应在出现发热症状后尽早诊断和治疗，预后良好。Objective To investigate the clinical features and effective treatment of patients with severe type A H1N1 flu in Wenzhou. Methods The clinical data of 42 hospitalized patients with severe type A H1N1 flu were analyzed and the clinical features were summarized. Results A total of 42 patients with severe type A HIN1 flu all began with fever and cough. The symptoms of expectoration, pharyngalgia, chilly accounted for 92. 9%, 90. 5% and 42. 9%, respectively. The peripheral leucocyte counts were normal or reduced. C-reactive protein and erythrocyte sedimentation rate levels both increased in 30 patients （71. 4%）. About 95. 2% （40/42） patients had changes of pulmonary imaging. All of the patients were treated with oseltamivir and effective antibiotic drugs as well as symptomatic management. No patients was treated with glucocorticoid. The patients with underlying diseases were given proper treatment. Three cases were treated with antifungat therapy and 3 pregnant patients were timely terminated of pregnancy. Conclusions Severe type A H1N1 flu progresses rapidly and the lower respiratory tract is involved soon after onset. Therefore, the patient should be diagnosed early and treated promptly after presenting fever, which will lead to good prognosis.

关 键 词：流感病毒A型 H1N1亚型 流感 人 危重病 奥司他韦 抗病毒药 

分 类 号：R511.7[医药卫生—内科学]