CAJ | 학술논문

目的了解温州地区住院重症甲型H1N1流行性感冒(流感)的临床特征并探索临床有效的治疗方法.方法分析住院的42例重症甲型H1N1流感病例临床资料,总结重症甲型H1N1流感的临床特点及发展规律.结果 42例重症甲型H1N1流感病例均以发热、咳嗽起病,39例有咳痰,其他依次为咽痛、畏寒等;WBC正常或降低,C反应蛋白升高30例,血细胞沉降率增快30例,40例患者出现肺部影像学改变.所有患者常规予奥司他韦抗病毒治疗,并及时予有效抗菌药物治疗及对症处理,均未使用糖皮质激素.对有基础疾病者给予相应的对症治疗.3例患者予抗真菌治疗,3例妊娠患者适时终止妊娠.结论重症甲型H1N1流感病情进展快,迅速累及下呼吸道,应在出现发热症状后尽早诊断和治疗,预后良好.
목적 료해온주지구주원중증갑형H1N1류행성감모(류감)적림상특정병탐색림상유효적치료방법.방법 분석주원적42례중증갑형H1N1류감병례림상자료,총결중증갑형H1N1류감적림상특점급발전규률.결과 42례중증갑형H1N1류감병례균이발열、해수기병,39례유해담,기타의차위인통、외한등;WBC정상혹강저,C반응단백승고30례,혈세포침강솔증쾌30례,40례환자출현폐부영상학개변.소유환자상규여오사타위항병독치료,병급시여유효항균약물치료급대증처리,균미사용당피질격소.대유기출질병자급여상응적대증치료.3례환자여항진균치료,3례임신환자괄시종지임신.결론 중증갑형H1N1류감병정진전쾌,신속루급하호흡도,응재출현발열증상후진조진단화치료,예후량호.
Objective To investigate the clinical features and effective treatment of patients with severe type A H1N1 flu in Wenzhou. Methods The clinical data of 42 hospitalized patients with severe type A H1N1 flu were analyzed and the clinical features were summarized. Results A total of 42 patients with severe type A H1N1 flu all began with fever and cough. The symptoms of expectoration, pharyngalgia, chilly accounted for 92. 9%, 90. 5% and 42. 9%, respectively. The peripheral leucocyte counts were normal or reduced. C-reactive protein and erythrocyte sedimentation rate levels both increased in 30 patients (71.4%). About 95.2% (40/42) patients had changes of pulmonary imaging. All of the patients were treated with oseltamivir and effective antibiotic drugs as well as symptomatic management. No patients was treated with glucocorticoid. The patients with underlying diseases were given proper treatment. Three cases were treated with antifungal therapy and 3 pregnant patients were timely terminated of pregnancy. Conclusions Severe type A H1N1 flu progresses rapidly and the lower respiratory tract is involved soon after onset. Therefore, the patient should be diagnosed early and treated promptly after presenting fever, which will lead to good prognosis.