北京市某三甲医院发热门诊新型冠状病毒肺炎疑似病例临床资料回顾性分析  

Retrospective analysis for clinical data of suspected COVID-19 cases in fever clinic of a third-class hospital in Beijing

作　　者：程洋[1] 孙成栋[2] 赵斌[3] 李笠[4] 陈辉[5] 郑婷婷[6] Cheng Yang;Sun Cheng-dong;Zhao Bin;Li Li;Chen Hui;Zheng Ting-ting(Department of Respiratory and Critical Care Medicine,Beijing Jishuitan Hospital,Bejing 100035,China)

机构地区：[1]北京积水潭医院呼吸与危重症医学科,北京100035 [2]北京积水潭医院感染疾病科 [3]北京积水潭医院急诊科 [4]北京积水潭医院医务部 [5]北京积水潭医院院感处 [6]北京积水潭医院药剂科

出　　处：《中国急救医学》2020年第8期749-752,共4页Chinese Journal of Critical Care Medicine

摘　　要：目的对北京市某三甲医院自2020年1月22日至3月29日发热门诊39例初诊为新型冠状病毒肺炎(COVID-19)疑似病例的临床资料进行回顾性分析,总结临床特征,为北京市医院发热门诊的COVID-19筛查工作提供依据.方法按照国家卫生健康委员会颁布的最新版新型冠状病毒肺炎诊疗方案,确定COVID-19疑似病例、确诊病例、排除疑似病例诊断及开展规范诊疗工作,进行诊后电话随访,修正最终诊断,对临床资料进行分析.结果对39例初诊为COVID-19疑似病例的人口学资料、流行病学史、临床表现、实验室检查、胸部影像学进行分析;根据咽拭子新冠病毒核酸检测结果及诊后电话随访,修正最终诊断,4例诊断为确诊病例(10.3%),35例排除疑似病例(89.7%);4例确诊病例中,3例有确诊患者接触史,1例有境外旅居史.结论发热门诊患者初诊时,应综合考虑流行病学史、临床表现及实验室检查,判断是否为COVID-19疑似病例,防止漏诊、误诊的发生;严格进行流行病学史的调查,对北京市COVID-19疑似病例的最终诊断有很大价值.Objective The first-visiting cases of 39 suspected coronavirus disease 2019(COVID-19)in fever clinic of a third-class hospital in Beijing from January 22,2020 to March 29,2020 were analyzed retrospectively.The clinical characteristics were described to provide the reference for screening COVID-19 in fever clinic in Beijing.Methods The diagnosis of suspected case,confirmed case or eliminated case and treatment were ruled with the official standards,Diagnosis and Treatment Protocol for COVID-19(the latest version)from National Health Commission&Administration of Traditional Chinese Medicine.Then telephone follow-up after diagnosis was conducted to correct the final diagnosis and clinical data were analyzed.Results The demographic data,epidemiological characteristics,clinical manifestations,laboratory tests and chest imaging of 39 suspected COVID-19 cases were collcted and analyzed.The final diagnosis was revised according to the polymerase chain reaction for COVID-19 test results of pharyngeal swab specimen and telephone follow-up.4 cases(10.3%)were finally confirmed to be infected,35 cases(89.7%)were eliminated.In 4 confirmed cases,3 cases had a history of contact with confirmed patients and 1 case had a history of sojourn abroad.Conclusion In the first visiting of the suspected COVID-19 cases in fever clinic,epidemiological history,clinical symptoms and laboratory tests should be studied comprehensively to avoid missed diagnosis or misdiagnosis.And rigorous investigation of epidemiological history is of great value in the final diagnosis of COVID-19 in Beiing.

关 键 词：新型冠状病毒肺炎(COVID-19) 发热门诊 临床特征 流行病学 

分 类 号：R563.1[医药卫生—呼吸系统]