重症急性呼吸综合征22例临床特点及综合防治方法  

Clinical features of 22 cases of severe acute respiratory syndrome(SARS) and synthetic measures for prevention and treatment

作　　者：陈晓红[1] 赵柏良[1] 陈? 李卫平[1] 陆文烈[1] 胡学军[1] 余新涛[1] 陈浩波[1] 彭建雄[1] 邓卓恒[1] 张聪[1] 赵志毅[1] 

机构地区：[1]广东肇庆市第一人民医院,526021

出　　处：《中国基层医药》2003年第7期583-585,共3页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的　探讨重症急性呼吸综合征 (SARS)的临床特点和综合防治方法。方法　对 2 0 0 3年 2月至 5月我院收治的 2 2例SARS病人的临床表现、X线特征、实验室资料、综合防治方法等进行分析。结果　发病 2周内有密切接触SARS病人的 16例 ;宰杀过动物的 2例 ;潜伏期 3～ 12d。所有病人均以发热为首发症状 ,其中有高热 (39℃ )以上者占 91%。伴呼吸困难的 6 8% ,咳嗽 86 4 % ,乏力 72 7% ,全身酸痛 2 7% ,头痛 5 0 % ,头晕 2 2 7% ,胸痛 31 8% ,呼吸道卡他症状 13 6 % ,心悸 36 4 % ,腹泻 18 2 % ,血丝痰 9% ,畏寒18 2 % ,咽痛 9%。 77%的病人肺部无明显体征。X线胸片及肺部CT :单侧病灶 36 4 % ,双侧 6 3 6 % ,双肺弥漫性渗出 2 2 7%。ARDS 2例 ;死亡 1例 ,死亡率 4 5 %。规律应用皮质类固醇治疗的占 72 7%。应用无创正压通气 (NIPPV)的 5例 ;应用有创机械通气的 2例。通过规范的防护措施 ,一线医务人员感染率为零 ;医务人员家属感染率为零 ;院内交叉感染率为零。结论　综合治疗方案中 ,合理应用糖皮质激素是重要措施。重症病人应及早使用机械通气。Objective To explore the clinical features of SARS and synthetic measures for prevention and treatment.Methods The clinical manifestations,X ray characters,laboratory data and synthetic measures for prevention and treatment of 22 cases in hospital SARS form Feb.,2003 to May,2003 were reviewed.Results 16 cases had close contact history with SARS patients.2 cases had killed animal.The incubation period was from 3 to 12 days.The first symptom of all cases was fever,and 91% was high fever.Other accompanied clinical manifestations included:dyspnea 68%,fatigue 72.7%,systemic pain 27%,headache 50%,diziness 22%,chest pain 31.8%,respiratory catarrhous symptom 13.6%,palpitation 36.4%,diarrhea 18.2%,bloody sputum 9%,chilly sensation 18.2%,sore throat 9%.77% of all cases showed no obvious signs of lung.The features of X ray and CT scan of chest were:single lung focus 36.4%,both lung focuses 63.6%,both lung fields diffuse infiltration shadow 22.7%.2 cases complicated with ARDS.The mortality rate was 4.5%(only 1 case died).72.2% of all cases accepted regular corticosteroid therapy.5 cases accepted non invasive positive pressure ventilation.2 cases accetped invasive mechanical ventilation.No medical worker was infected,no family members of medical workers was infected.There was no cross infection in hospital.Conclusion Reasonable usage of corticosteroid was one of important measures in synthetic treatment scheme.Mechanical ventilation must be used early in severe cases.Standard prevention measures could prevent from infection.

关 键 词：重症急性呼吸综合征 临床特点 综合防治 SARS 传染性非典型肺炎型 糖皮质激素 

分 类 号：R511.9[医药卫生—内科学]