病毒性肺炎合并急性呼吸窘迫综合征的临床观察  

Clinical observation of viral pneumonia complicated with acute respiratory distress syndrome

作　　者：晏蕾 李玉茜[1] 高占成[1] YAN Lei;LI Yu-qian;GAO Zhan-cheng(Department of Respiratory and Critical Care Medicine,Peking University People’s Hospital,Beijing 100044,China)

机构地区：[1]北京大学人民医院呼吸与危重症医学科

出　　处：《中国医刊》2019年第9期958-961,共4页Chinese Journal of Medicine

摘　　要：目的 探讨呼吸与危重症监护病房病毒性肺炎合并急性呼吸窘迫综合征患者的临床特点。方法 回顾性分析2008年4月至2016年5月入住北京大学人民医院呼吸与危重症监护病房的32例病毒性肺炎合并急性呼吸窘迫综合征患者的临床资料。根据住院期间是否死亡将患者分为死亡组(27例)和存活组(5例),对其临床特点及影响预后的因素进行统计学分析。结果 32例患者的临床症状主要表现为发热、咳嗽、呼吸困难。其中29例影像学表现为片状磨玻璃密度影及斑点片状高密度影,余2例表现为双肺纹理增多,透亮度稍低,1例为实变影。17例合并细菌感染(53.1%),9例合并真菌感染(28.1%),其中3例同时合并细菌及真菌感染(0.1%)。存活组与死亡组患者在氧分压、氧合指数等方面差异有显著性(P<0.05)。结论 病毒性肺炎合并急性呼吸窘迫综合征死亡率极高,临床表现及影像学具有一定特征,病情呈进行性加重趋势,氧分压及氧合指数可能是影响患者预后的因素。Objective To investigate the clinical characteristics of viral pneumonia complicated with acute respiratory distress syndrome(ARDS).Method Thirty-two patients with viral pneumonia complicated with acute respiratory distress syndrome(ARDS)hospitalized in the Respiratory Intensive Care Unit(RICU)of Beijing University People’s Hospital between April 2008 and May 2016 were included in the study.According to whether hospitalization death divided the patients into death and survival groups,the clinical features and factors affecting the prognosis were statistically analyzed.Result In 32 patients the main clinical manifestations were fever、cough and difficulty in breathing.29 patients with the imaging findings as patchy ground glass opacities and spotty high-density plot area.with 17 cases concurrent bacteria infection(53.1%),9 cases concurrent fungal infections(28.1%),including 3 cases concurrent both bacterial and fungal infection at the same time(0.1%).Compared Survival group and death group patients in the oxygen partial pressure,oxygenation index has statistical significance(P<0.05).Conclusion Viral pneumonia complicated with acute repiratory distress syndrome has a extremely high mortality rate,the clinical manifestations and imaging has certain characteristics,the disease has a progressive trend,oxygen partial pressure and oxygenation index may be the factors affecting the prognosis of patients.

关 键 词：病毒性肺炎 急性呼吸窘迫综合征 临床特点 预后 

分 类 号：R563.1[医药卫生—呼吸系统] R563.8[医药卫生—内科学]