南通海安地区5例新型冠状病毒肺炎的临床特征和诊疗体会  

Clinical Features and Clinical Experience of COVID-19 in 5 Cases from Haian Nantong

作　　者：冯剑春 王华雨 谢群 吴丛霞[2] 邵峰[2] FENG Jianchun;WANG Huayu;XIE Qun(Hai'an Hospital Affiliated to Nantong University,Jiangsu Haian 226600,China)

机构地区：[1]南通大学附属海安医院感染病科,江苏海安226600 [2]江苏省南通市第三人民医院感染病科,江苏南通226001

出　　处：《河北医学》2020年第6期892-896,共5页Hebei Medicine

基　　金：2019年度南通市市级科技计划项目,(编号:JCZ19004)。

摘　　要：目的:加强新型冠状病毒感染的肺炎(COVID-19)认识,减少误诊并为早期诊治提供参考。方法:全选2020年1月21日至3月3日在南通大学附属海安医院传染科及南通第三人民医院传染科隔离治疗的海安地区发生的COVID-19患者,回顾性分析流行病学、症状体征、实验室和影像学检查等临床特征。结果:共有5例确诊COVID-19患者纳入研究,其中男4例、女1例;年龄32~59岁,平均(43.6±5.7)岁;3例有武汉居住史或旅居史,1例与其中本地确诊患者有密切接触史,1例女性医务人员与本地确诊患者有可疑接触史;发病到确诊时间为5~10d,平均(7.8±1.5)d;普通型3例,重型1例,危重型1例;发热5例、咳嗽5例、咳痰4例、乏力5例、肌肉酸痛3例、头痛3例、气促胸闷4例、轻度腹痛腹泻1例;LYMPH下降2例,ESR加快1例,心肌酶谱异常5例,肝功能异常3例,PO 2下降3例,SO 2下降2例;hs-CRP升高2例,IL-6升高2例;5例患者核酸检测阳性。MSCT检查双侧肺病变4例,右侧肺病变1例,多为节段或亚段性磨玻璃样局限性炎性浸润。经高流量氧疗或辅助呼吸、中西医结合和支持等综合治疗后,均治愈出院;住院时间16~34d,平均(17.8±3.7)d,经随访1个月均未发现明显后遗症。结论:海安地区COVID-19以普通型病例为主,发热为首发症状;危重症和重症病例的病程较短,炎症反应和器官损害程度显著;所有病例均治愈出院。临床医师应综合流行病史和临床特征,结合核酸检测和胸部MSCT检查,提高本地区COVID-19的疾病防治水平。Objective:To enhance the understanding of novel coronavirus pneumonia(COVID-19),to prevent misdiagnosis and to provide reference for the early diagnosis and treatment.Methods:All the COVID-19 patients who were isolated and treated in the department of infectious diseases of hai'an hospital affiliated to nantong university and the infectious diseases department of the third people's hospital of nantong from January 21,2020 to March 3,2020 were selected,and their clinical characteristics including epidemiology,signs and symptoms,laboratory and imaging examinations were retrospectively analyzed.Results:A total of 5 confirmed COVID-19 patients were included in the study,including 4 males and 1 female.The age ranged from 32 to 59 years old,with an average of(43.6±5.7)years old.The time from onset to diagnosis was 5~10d,with an average of(7.8±1.5)d.Three patients had a history of residence or sojourn in wuhan,one had a history of close contact with a locally confirmed patient,and one female medical worker had a history of suspicious contact with a locally confirmed patient.There were 3 cases of normal type,1 case of heavy type and 1 case of critical type.There were 5 cases of fever,5 cases of cough,4 cases of sputum,5 cases of fatigue,3 cases of muscle soreness,3 cases of headache,4 cases of shortness of breath,4 cases of chest tightness,1 case of mild abdominal pain and diarrhea.There were 2 cases of LYMPH decline,1 case of accelerated ESR,5 cases of abnormal myocardial enzyme spectrum,3 cases of abnormal liver function,3 cases of decreased PO 2 and 2 cases of decreased SO 2.Hs-crp increased in 2 cases and il-6 increased in 2 cases.Five patients tested positive for nucleic acid.MSCT showed 4 cases of bilateral pulmonary change and 1 case of right pulmonary change,most of which were segmental or subsegmental ground-glass like localized inflammatory infiltration.After receiving high flow oxygen therapy,assisted breathing,integrated traditional Chinese and western medicine and supportive treatment,they were cured and d

关 键 词：新型冠状病毒感染的肺炎 临床特征 诊疗 预后 

分 类 号：R563.1[医药卫生—呼吸系统]