重型新型冠状病毒肺炎患者临床特征及诊治分析  

Clinical features,diagnosis and treatment of patients with severe COVID-19

作　　者：涂雄文[1] 全斌[2] 程玉生[1] 杨江华[2] 陆志伟[1] TU Xiong-wen;QUAN Bin;CHENG Yu-sheng;YANG Jiang-hua;LU Zhi-wei(Department of Respiratory and Critical Medicine,Yijishan Hospital,Wannan Medical College,Wuhu 241001,China;Department of Infectious Diseases,Yijishan Hospital,Wannan Medical College)

机构地区：[1]皖南医学院弋矶山医院呼吸与危重症医学科,芜湖241001 [2]皖南医学院弋矶山医院感染性疾病科

出　　处：《热带病与寄生虫学》2020年第3期176-179,共4页Journal of Tropical Diseases and Parasitology

基　　金：芜湖市新冠病毒感染肺炎疫情防控科技攻关专项应急项目(2020dx1-3)。

摘　　要：目的总结重型新型冠状病毒肺炎(COVID-19)患者临床特征及诊治经验。方法回顾性分析2020年1月27日至2020年3月10日在我院诊治的重症COVID-19患者资料。结果5例重症COVID-19患者中,男性2例,女性3例,年龄47~65岁,3例合并基础疾病,主要临床表现为发热、咳嗽、咳痰、胸闷、乏力及腹泻等。外周血淋巴细胞绝对值与嗜酸性粒细胞均出现显著降低。胸部CT表现为外周分布、双肺多发斑片状阴影。5例重症患者均予抗病毒治疗,康复者血浆治疗1例,托珠单抗治疗1例。患者均治愈出院。结论5例重症COVID-19患者以呼吸道症状及消化道症状为主要表现,外周血淋巴细胞及嗜酸性粒细胞显著减少,影像学特点以外周分布的两肺多发斑片状阴影为主,经积极治疗预后良好。Objective To summarize the clinical features,diagnosis and treatment of patients with severe OVID-19.Methods Clinical data were reviewed in patients with severe COVID-19 diagnosed and treated in our hospital between January 27 and March 10 of 2020.Results Of the 5 patients with severe COVID-19,2 were males and 3 females,aged between 47 and 65 years.Three patients were concomitant with underlying disease.Clinical signs and symptoms were characterized by fever,cough,expectoration,chest tightness,fatigue and diarrhea,with markedly decreased absolute count of lymphocytes and total number of eosinophils.The features of chest CT were indicated by multiple patchy shadows,peripherally distributed at bilateral lung fields.Antiviral therapy was applied to the 5 patients,in whom one patient received convalescent plasma infusion,and another one was given Tocilizumab therapy.All patients were cured and discharged.Conclusion Respiratory and gastrointestinal symptoms are dominant in the 5 patients of severe COVID-19,with significantly decreased lymphocyte and eosinophil.CT images are characterized by peripheral distribution of multiple patchy shadows at both lungs,and aggressive treatment can lead to better prognosis.

关 键 词：重型新型冠状病毒肺炎 临床特征 诊断 治疗 

分 类 号：R563.1[医药卫生—呼吸系统]