金华市首例新型冠状病毒肺炎确诊出院病例治疗经验分享  

Diagnosis and treatment experience sharing and analysis of 1 case of corona virus disease 2019 in Jinhua City

作　　者：王黎明[1] 陈琨[1] 徐晓[1] 彭伟[1] Wang Liming;Chen Kun;Xu Xiao;Peng Wei(Intensive Care Unit,Jinhua Central Hospital of Zhejiang Province,Jinhua 321000,Zhejiang,China)

机构地区：[1]浙江省金华市中心医院重症医学科,浙江金华321000

出　　处：《中国中西医结合急救杂志》2020年第4期407-409,共3页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：浙江省金华市新冠肺炎疫情应急防治科研攻关项目(2020XG-17)。

摘　　要：目的介绍金华市首例新型冠状病毒肺炎(简称新冠肺炎)患者的诊治经过。方法金华市中心医院收治金华市首例新冠肺炎患者,给予抗病毒及对症支持治疗后,最终救治成功,介绍临床诊治过程,分享救治体会。结果患者为25岁男性,因“咽痛、咳嗽、咳痰4 d”,于2020年1月24日收入隔离病房。①流行病学特征:患者4 d前无明显诱因出现咽痛、咳嗽、咳痰,以干咳为主;1月14日曾赴武汉旅游;既往血压偏高,平时未规律测量治疗。②临床表现:入院体温37℃,呼吸频率16次/min,脉搏101次/min,血压164/123 mmHg(1 mmHg≈0.133 kPa);意识清楚,咽红,扁桃体无肿大;双肺呼吸音粗,未闻及干湿啰音,心律齐,四肢活动可,双下肢无明显水肿。③辅助检查:2020年1月20日胸部CT平扫未见明显异常;1月21日血常规:白细胞计数(WBC)7.53×10^9/L,中性粒细胞比例62.6%,淋巴细胞比例25.0%,单核细胞比例12.2%,淋巴细胞计数1.88×10^9/L,红细胞计数(RBC)5.73×10^12/L,血红蛋白(Hb)176 g/L,血细胞比容(HCT)0.52,血小板计数(PLT)263×10^9/L,超敏C-反应蛋白(hs-CRP)1.9 mg/L。④病毒检测:1月24日市疾病控制中心回报咽拭子采样新型冠状病毒(2019-nCoV)核酸初筛阳性,诊断为新冠肺炎。⑤治疗经过:入院后予洛匹那韦/利托那韦2片(每片含洛匹那韦200 mg和利托那韦50 mg)口服,每12 h 1次;同时给予干扰素α-2b 5000 kU雾化,每12 h 1次,进行联合抗病毒治疗;为缓解咳嗽症状,给予患者孟鲁司特钠10 mg口服,每晚1次。1月24日下午,加用磷酸奥司他韦75 mg口服,每日2次,进行抗病毒治疗。2月1日停用磷酸奥司他韦。2月2日患者体温正常持续3 d以上,呼吸道症状明显缓解,肺部影像学未见明显异常,连续2次2019-nCoV核酸检测阴性,病情好转,解除隔离出院。结论本例新冠肺炎病例属于普通型,整体治疗顺利有效,病情无反复。应提高症状不典型的新冠肺炎病例的早期确诊率,采取正�Objective To introduce the diagnosis and treatment process of the first case of corona virus disease 2019(COVID-19)in Jinhua City.Methods Jinhua Central Hospital admitted the first case of COVID-19 in Jinhua.The patient was treated by antiviral and symptomatic support.The final treatment was successful.The clinical diagnosis and treatment process was introduced,and the experience of treatment was shared.Results The patient was a 25-year-old male admitted to the isolation ward on January 24,2020 due to"sore throat,cough and expectoration for 4 days".①Epidemiological characteristics:the patient developed pharyngeal pain,cough and expectoration,mainly dry cough without obvious inducement 4 days ago;on January 14,the patient went to Wuhan for tourism;the blood pressure was high in the past,without regular measurement and treatment.②Clinical manifestations:admission temperature 37℃,respiratory frequency 16 times/min,pulse 101 bpm,blood pressure 164/123 mmHg(1 mmHg≈0.133 kPa);clear consciousness,pharyngeal red,no swelling of tonsil;two lungs breathing sound thick,no dry and wet rales,rhythm neat,limb activity,no obvious edema of both legs.③Auxiliary examination:on January 20,chest CT showed no obvious abnormality;on January 21,blood routine examination:white blood cell count(WBC)7.53×10^9/L,neutrophil ratio 62.6%,lymphocyte ratio 25.0%,monocyte ratio 12.2%,lymphocyte count 1.88×10^9/L,red blood cell count(RBC)5.73×10^12/L,hemoglobin(Hb)176 g/L,hematocrit(HCT)0.52,platelet(PLT)263×10^9/L,hypersensitive C-reactive protein(hs-CRP)1.9 mg/L.④Virus detection:on January 24,the Municipal Center for Disease Control reported positive 2019 novel coronavirus(2019-nCoV)nucleic acid test by throat swab,and the patient was diagnosed as COVID-19.⑤Treatment process:after admission,the patient was given 2 tablets of lopinavir/ritonavir(each tablet contains 200 mg of lopinavir and 50 mg of ritonavir),once every 12 hours;at the same time,the patient was given 5000 kU of interferon-α2b by atomization,once every 12 hours

关 键 词：新型冠状病毒肺炎 新型冠状病毒 治疗 经验分享 

分 类 号：R47[医药卫生—护理学]