重症埃博拉病毒病患者脏器功能损害与加强支持治疗的文献分析  

Multiple organ dysfunctions and aggressive supportive therapies in patients with severe Ebola virus disease:a literature analysis

作　　者：刘毅[1,2] 李成忠[1,3] 张景熙[1,4] 陈志辉[1,3] 

机构地区：[1]中国人民解放军第二批援利医疗队 [2]第二军医大学长海医院麻醉科,上海200433 [3]第二军医大学长海医院感染科,上海200433 [4]第二军医大学长海医院呼吸内科,上海200433

出　　处：《第二军医大学学报》2015年第8期828-831,共4页Academic Journal of Second Military Medical University

摘　　要：目的通过复习相关文献分析和总结重症埃博拉病毒病患者的脏器功能损害表现以及相应的支持治疗方法。方法检索Medline和EMbase数据库,选取2014年以来收治于重症监护病房(ICU)的重症埃博拉病毒病病例,收集患者的临床表现、治疗经过以及预后等资料,结合相关文献进行分析和总结。结果共检索到7篇病例研究,报告了10例重症埃博拉病毒病患者。几乎所有患者都伴发内环境紊乱、肝损伤、血小板降低。4例患者出现呼吸衰竭,其中3例伴有肾功能衰竭。患者在ICU中接受了不同程度的加强支持治疗,包括维持内环境稳定、输注血制品、有创或无创机械通气、肾脏替代治疗、抗病毒治疗等。9例患者康复出院,1例死亡。结论重症埃博拉病毒病患者常合并多脏器功能损害,经加强支持治疗后脏器功能可恢复,存活率大大提高。Objective To analyze and summarize the characteristics of multiple organ dysfunctions and the associated supportive therapies in patients with severe Ebola virus disease（EVD）through a systematic literature review.Methods Medline and EMbase were searched since 2014 for eligible studies on severe EVD patients in ICU.The data of clinical presentations,treatment procedures as well as prognosis of these patients were summarized and analyzed.Results Ten patients from 7reports were finally enrolled in the present study.Internal environment disturbance,liver injury and thrombocytopenia occurred in almost all of the patients.Respiratory failure was found in 4patients and 3of them were also complicated with renal failure.All of the patients received aggressive supportive therapies,such as maintaining the stability of internal environment,transfusion of blood products,mechanical ventilation,renal replacement therapy,antiviral therapy,etc.Of the 10 patients,9recovered and 1died.Conclusion Severe EVD patients are always complicated with multiple organ dysfunctions and effective supportive therapies can improve the organ dysfunctions and prognosis of these patients.

关 键 词：埃博拉病毒病 重症监护病房 支持疗法 多脏器功能障碍 

分 类 号：R512.89[医药卫生—内科学]