新型冠状病毒肺炎危重症患者的救治体会  

Treatment experience of critically ill patient with corona virus disease 2019

作　　者：杨朝辉[1] 焦汉荣 满珂 陈宇[1] Yang Zhaohui;Jiao Hanrong;Man Ke;Chen Yu(Department of Critical Medicine,the Second Hospital of Lanzhou University,Lanzhou 730030,Gansu,China)

机构地区：[1]兰州大学第二医院重症医学科,甘肃兰州730030

出　　处：《中国中西医结合急救杂志》2020年第2期213-215,共3页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

摘　　要：近期新型冠状病毒(2019-nCoV)感染肆虐,兰州大学第二医院重症医学科(ICU)收治疑似新型冠状病毒肺炎(简称新冠肺炎)重症患者1例,临床表现、实验室检查和肺部影像学符合卫生健康委员会下发诊疗方案,虽2次咽拭子2019-nCoV核酸检测均阴性,但肺泡灌洗液宏基因组测序(mNGS)2019-nCoV核酸检测阳性,最终确诊为新冠肺炎危重症.因此,对于临床表现尤其是影像学符合新冠肺炎特征的患者,即使核酸检测阴性,仍不能完全排除2019-nCoV感染的可能,必要时可采集肺泡灌洗液等深部标本行mNGS2019-nCoV核酸检测;同时,早期、积极、综合性地器官功能支持治疗对于2019-nCoV感染危重症患者有重要的救治意义.The recent outbreak of 2019 novel coronavirus(2019-nCoV)infection is rampant.One severe case of suspected corona virus disease 2019(COVID-19)was admitted in the Second Hospital Affiliated to Lanzhou University,and the clinical manifestations,laboratory examination and pulmonary imaging were in line with the diagnosis and treatment plan issued by the National Health Committee.Although the 2019-nCoV nucleic acid tests of throat swab were negative for twice,the metagenomics next generation sequencing(mNGS)2019-nCoV nucleic acid test of alveolar lavage fluid was positive,and the patient was finally diagnosed with critical COVID-19.Therefore,for the patients with clinical manifestations of COVID-19,especially with imaging features,even if the nucleic acid test is negative,the possibility of 2019-nCoV infection cannot be completely ruled out.If necessary,mNGS 2019-nCoV nucleic acid detection can be performed for deep samples of alveolar lavage fluid and so on.At the same time,early,active and comprehensive treatment of organ function support is of great significance for 2019-nCoV infected critical patients.

关 键 词：新型冠状病毒肺炎 危重症 宏基因组测序 器官功能支持 

分 类 号：R47[医药卫生—护理学]