1例尘肺结核合并危重型新型冠状病毒肺炎患者的诊治  

Diagnosis and treatment of a patient with pneumoconiosis and tuberculosis complicated with severe COVID-19

作　　者：惠越[1] 朱海珍 陈伟[1] 刘伯毅[1] HUI Yue;ZHU Haizhen;CHEN Wei;LIU Boyi(Department of Critical Care Medicine,Shiyan Taihe Hospital,Shiyan,Hubei 442000,China;Department of Gastroenterology,Shiyan Taihe Hospital,Shiyan,Hubei 442000,China)

机构地区：[1]十堰市太和医院重症医学科,湖北十堰442000 [2]十堰市太和医院消化内科,湖北十堰442000

出　　处：《环境与职业医学》2021年第9期1029-1032,共4页Journal of Environmental and Occupational Medicine

基　　金：2020年十堰市第一批市级新冠肺炎防控技术引导性应急科研项目(20Y25)。

摘　　要：尘肺患者呼吸系统的清除和防御机制受到损害,一旦尘肺合并其他肺部基础疾病患者感染新型冠状病毒后,容易进展为重症新型冠状病毒肺炎,其治疗难度大、死亡率高、预后差。本文报道1例尘肺结核合并危重型新型冠状病毒肺炎患者的诊治,积极给予抗病毒、抗感染、化痰、平喘、高流量氧疗等均不能改善患者的急性呼吸窘迫综合征症状,进一步给予气管插管、呼吸机辅助呼吸、肺保护性通气,患者呼吸衰竭无法有效改善,后借助体外膜肺氧合技术治疗,但患者最终临床死亡。The removal and defense mechanisms of the respiratory system of patients with pneumoconiosis are impaired.Once patients with pneumoconiosis and other underlying lung diseases are infected with novel coronavirus,they are likely to progress to severe cases with COVID-19,a tough condition with a high mortality and poor prognosis.Herein we presented a case of pneumoconiosis and tuberculosis complicated with severe COVID-19.Active administration of anti-viral,anti-infection,phlegm-removing,anti-asthmatic,and high-flow oxygen therapies did not alleviate the patient’s acute respiratory distress syndrome symptoms.Then tracheal intubation,ventilator assisted breathing,and lung protective ventilation were given but did not effectively treat the patient’s respiratory failure.Finally,the patient died clinically despite use of extracorporeal membrane oxygenation(ECMO).

关 键 词：体外膜肺氧合 尘肺 新型冠状病毒肺炎 肺结核 

分 类 号：R135[医药卫生—劳动卫生]