重症SARS治疗中的有关问题  

Some Problems in Treatment of Critical Severe Acute Respiratory Syndrome

作　　者：陆伟[1] 张洪生[1] 王凤梅[1] 刘迎午[1] 王绍军[1] 吴宵迪[1] 张纳新[1] 阚志超[1] 秦英智[1] 肖琅[1] 

机构地区：[1]天津市第三中心医院,300170

出　　处：《天津医药》2003年第9期566-568,共3页Tianjin Medical Journal

摘　　要：目的 :探讨32例重症SARS救治中激素应用、机械通气等问题。方法 :治疗采用广谱抗病毒药物、糖皮质激素、机械通气、抗生素、免疫增强剂等。对治愈率、病死率、治疗并发症等进行统计。结果 :24例患者治愈出院 ,治愈率75.0 % ;2例患者死于呼吸衰竭 (病死率6.25 % )。15例使用激素时间较长、剂量较大的患者中有12例(80.0 % )出现二重感染 ,4例患者血糖升高 (26.67 % ) ,4例患者上消化道出血 (26.67 % ) ;17例使用无创呼吸机患者中3例 (17.65 % )造成肺损伤 (纵隔气肿、气胸等 ) ,6例出现左心功能衰竭。结论 :在对重症SARS救治中 ,应加强基础疾病的治疗 ,为避免二重感染等并发症的出现不宜长期使用激素 。Objective:To summarize the treatment a experience of32patients with critical severe acute resˉpiratory syndrome(SARS).Methods:The therapy included antiviral agents,glucocorticoid,mechanical ventilaˉtion,antibiotics and immunologic enhancement,etc.The cure rate,fatality rate and complication were analyzed statistically.Results:Among the32patients,24discharged(cure rate:75.0%),2died of respiratory failure(fatality rate:6.25%).Among15cases who received long-term and high dosage glucocorticoid,there were12cases of double infection(80.0%),4cases of hyperglycemia(26.67%)and4cases of upper gastrointestinal hemorrhage(26.67%).Among17cases who required noninvasive ventilation,there were3cases of lung injury(17.65%),such as mediastinal emphysema,pneumothorax,etc.In addition,there were6cases of left cardiac failure.Conclusion:The treatment of primary diseases should be strengthened in the therapy of critical SARS.Glucocorticoid should not be used over a long period of time.During the period of mechanical ventilation,the lung injury should be avoided.

关 键 词：严重急性呼吸综合征 SARS 治疗 激素 机械通气 抗病毒药 

分 类 号：R563.1[医药卫生—呼吸系统]