新型冠状病毒肺炎患者出院后"复发"原因分析及治疗策略  

Cause analysis and treatment strategies of"recurrence"with novel coronavirus pneumonia(COVID-19)patients after discharge from hospital

作　　者：周灵 刘馗[1] 刘辉国[1] Zhou Ling;Liu Kui;Liu Huiguo(Department of Respiratory and Critical Care Medicine,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院呼吸与危重症医学科,武汉430030

出　　处：《中华结核和呼吸杂志》2020年第4期281-284,共4页Chinese Journal of Tuberculosis and Respiratory Diseases

摘　　要：随着新型冠状病毒肺炎(COVID-19)患者大量出院,部分患者出院后出现再次发热、核酸检测阳性的现象。这可能是由于新型冠状病毒(2019-nCoV)的生物学特性所决定的,也可能与患者的基础疾病、临床状况、糖皮质激素的使用以及标本采样、处理、检测有关,甚至还与部分患者再次感染或继发其他细菌病毒感染有关。为此,我们建议针对这一现象,应在指南基础上进一步对患者出院进行分层管理,尤其是高龄、有基础疾病或重症及危重型患者可能要进行相应处理措施,对于患者住院后长期吸氧难以完全脱氧者采用个体化的处理方式和不同出院评估标准,旨在保证彻底治愈患者,防止出院后"复发"。With a large number of COVID-19 patients discharging from hospital,some had showed re-fever and positive nucleic acid test after discharge from hospital.This might be due to the biological characteristics of 2019-nCoV,and might also be related to the basic disease,clinical status,glucocorticoid using,sample sampling,processing and detecting of patients,and some even related to the re-infection or secondary bacterial virus infection.Therefore,we suggest that in view of this phenomenon,further stratified management of discharge from hospital should be carried out on the basis of guidelines,especially for patients with advanced age,underlying diseases or severe or critical pneumonia.For those patients who can′t completely deoxygenate for a long time after hospitalization,individualized treatment methods and different discharge evaluation criteria should be adopted to ensure the complete cure of patients and prevent recurrencing after discharge from hospital.

关 键 词：新型冠状病毒肺炎 出院 复发 原因分析 治疗策略 

分 类 号：R563.1[医药卫生—呼吸系统]