55例重症甲型H1N1流感流行特征及预防治疗策略  

Pandemic features of influenza A(H1N1) and preventive measures

作　　者：赵婵[1] 包云光[1] 

机构地区：[1]金华市中心医院儿二科,浙江金华321000

出　　处：《中华医院感染学杂志》2011年第15期3195-3197,共3页Chinese Journal of Nosocomiology

摘　　要：目的了解浙中西部地区甲型H1N1流感流行特征,为甲型H1N1流感防控提供科学依据。方法分析2009年11月-2010年1月收住医院55例确诊重症甲型H1N1流感病例的临床资料。结果临床主要表现为流感样症状,发热55例,占100.00%,咳嗽52例,占94.55%,涉及多系统、多脏器,少数病例病情进展迅速,出现呼吸衰竭、多脏器功能损伤甚至死亡;94.55%患者出现实验室检查异常;危重症患者病初白细胞数或(和)CRP值明显高于重症患者,差异有统计学意义(P<0.01);55例患者发现肺部炎性改变;53例用磷酸奥司他韦抗病毒治疗;54例治愈,死亡1例。结论儿童、青少年及慢性基础疾病患者和妊娠妇女是甲型H1N1流感和甲型H1N1流感重症的高危人群;发病初期血白细胞和(或)CRP明显升高、淋巴细胞下降者更易发展为危重症,且易误诊误治,应引起临床重视;磷酸奥司他韦加综合治疗,效果可靠;早发现、早治疗是救治成功的关键所在。OBJECTIVE To comprehend the pandemic features of influenza A H1N1 in the middle and west part of Zhejiang.METHODS The clinical data of the 55 diagnosed cases with seriously ill influenza A H1N1 in this hospital from Nov 2009 to Jan 2010 were analyzed.RESULTS The patients range from eight month baby to 72 years old people with an average age of 20 were included;there were 26 male patients and 29 female patients（1∶1.1）;20 cases are from urban city,while 35 rural（1∶1.75）.The clinical manifestations are flu symptoms： 55 cases with fever（100.0%） and 52 patient with coughing（94.55%）,with multisystem symptoms where a few cases progress seriously with multi-organ damage and death;majority of the patients present laboratory examination exception（94.55%）;The white blood cell or/and CRP of critical ill patients were apparently higher than that of severely ill patients,and the difference is of evident statistical significance（P0.01）;lung phlogistic transform was found in 55 cases（100.0%）;Osletamirvir Phosphate antiviral therapy was applied for 53 cases;54 cases were healed with one death case.CONCLUSION Children,teenagers,patients with chronic underlying disease,and pregnant women are high risk group of H1N1.At the initial stage,patients with apparent rise in white blood cell and/or CRP and drop in lymphocyte are much easier to become critically ill.Misdiagnose and therapeutic errors are quite possible,therefore,clinical importance should be attached to such cases.Osletamirvir Phosphate antiviral comprehensive therapy is quite reliable.The key of successful treatment is early detection and treatment.

关 键 词：甲型H1N1流感 流行特征 预防治疗 策略 

分 类 号：R181.32[医药卫生—流行病学]