中华传染病杂志
中華傳染病雜誌
중화전염병잡지
Chinese Journal of Infectious Diseases
2015年
8期
452-455
,共4页
郑以山%殷国平%潘剑%叶伟%江浩%程建%张继宗%孙丙虎%赵伟%杨永峰
鄭以山%慇國平%潘劍%葉偉%江浩%程建%張繼宗%孫丙虎%趙偉%楊永峰
정이산%은국평%반검%협위%강호%정건%장계종%손병호%조위%양영봉
埃博拉病毒%出血热 ,埃博拉%休克%水电解质失调%补液疗法
埃博拉病毒%齣血熱 ,埃博拉%休剋%水電解質失調%補液療法
애박랍병독%출혈열 ,애박랍%휴극%수전해질실조%보액요법
Ebolavirus%Hemorrhagic fever,Ebola%Shock%Water-electrolyte imbalance%Fluid therapy
目的：了解埃博拉病毒病发病特点、治疗方法、疾病转归等，为该病的早期临床识别与诊治提供实际参考。方法回顾性分析2015年3月15日至5月15日塞拉利昂中塞友好医院埃博拉留观治疗中心收治的5例埃博拉病毒病患者的临床表现与治疗经过，并结合文献讨论其发病特点及可能有效的治疗方法。结果5例患者中，4例有明确接触史，1例无明确接触史。5例患者经血清 PCR检验确诊，均有低热、头痛、关节痛。3例患者逐渐加重，出现恶心、呕吐、腹泻等严重消化道症状，进而出现休克倾向或低血容量性休克，急性期表现为心率增快、呼吸急促等炎性反应综合征表现，其中1例患者迅速出现肝区疼痛、黄疸继而无尿，最终死亡。3例重症患者在急性期经补液、维持循环稳定和调整电解质平衡，病情改善。结论埃博拉病毒病早期症状是低热、关节痛、恶心，出现频繁呕吐、腹泻、低血压和电解质紊乱等是重症表现，继发性休克、电解质紊乱是致死性并发症，及时识别、诊断、治疗是改善预后的关键。
目的：瞭解埃博拉病毒病髮病特點、治療方法、疾病轉歸等，為該病的早期臨床識彆與診治提供實際參攷。方法迴顧性分析2015年3月15日至5月15日塞拉利昂中塞友好醫院埃博拉留觀治療中心收治的5例埃博拉病毒病患者的臨床錶現與治療經過，併結閤文獻討論其髮病特點及可能有效的治療方法。結果5例患者中，4例有明確接觸史，1例無明確接觸史。5例患者經血清 PCR檢驗確診，均有低熱、頭痛、關節痛。3例患者逐漸加重，齣現噁心、嘔吐、腹瀉等嚴重消化道癥狀，進而齣現休剋傾嚮或低血容量性休剋，急性期錶現為心率增快、呼吸急促等炎性反應綜閤徵錶現，其中1例患者迅速齣現肝區疼痛、黃疸繼而無尿，最終死亡。3例重癥患者在急性期經補液、維持循環穩定和調整電解質平衡，病情改善。結論埃博拉病毒病早期癥狀是低熱、關節痛、噁心，齣現頻繁嘔吐、腹瀉、低血壓和電解質紊亂等是重癥錶現，繼髮性休剋、電解質紊亂是緻死性併髮癥，及時識彆、診斷、治療是改善預後的關鍵。
목적：료해애박랍병독병발병특점、치료방법、질병전귀등，위해병적조기림상식별여진치제공실제삼고。방법회고성분석2015년3월15일지5월15일새랍리앙중새우호의원애박랍류관치료중심수치적5례애박랍병독병환자적림상표현여치료경과，병결합문헌토론기발병특점급가능유효적치료방법。결과5례환자중，4례유명학접촉사，1례무명학접촉사。5례환자경혈청 PCR검험학진，균유저열、두통、관절통。3례환자축점가중，출현악심、구토、복사등엄중소화도증상，진이출현휴극경향혹저혈용량성휴극，급성기표현위심솔증쾌、호흡급촉등염성반응종합정표현，기중1례환자신속출현간구동통、황달계이무뇨，최종사망。3례중증환자재급성기경보액、유지순배은정화조정전해질평형，병정개선。결론애박랍병독병조기증상시저열、관절통、악심，출현빈번구토、복사、저혈압화전해질문란등시중증표현，계발성휴극、전해질문란시치사성병발증，급시식별、진단、치료시개선예후적관건。
Objective To analyze the clinical characteristics ,treatment and outcome of Ebola virus disease so as to provide early clinical recognition and treatment for this disease .Methods The clinical manifestations and treatment of 5 cases of Ebola virus disease in Ebola Holding Center of Sierra‐Leone China Friendship Hospital from 15 March 2015 to 15 May 2015 were retrospectively analyzed .And the clinical characteristics and possible effective treatment were discussed combined with related literature . Results Five patients were diagnosed with Ebola virus disease by polymerase chain reaction and 4 cases of 5 patients had confirmed contact history ,while 1 case had no clear contact history .All the 5 cases presented with low fever ,headache and joint pain .Three cases then progressed into severe gastrointestinal symptoms such as nausea ,vomiting ,diarrhea and hypovolemic shock .The patients presented with fast heart rate and shortness of breath and other inflammatory response syndrome in acute phase .One patient rapidly progressed to liver pain ,jaundice and anuria ,then died .Three severe cases recovered after treated with fluid resuscitation ,circulation maintenance and electrolyte balance in acute phase .Conclusions The early symptoms of Ebola virus disease are low fever ,joint pain and nausea .Frequent vomiting ,diarrhea , low blood pressure and electrolyte disorder indicate severe conditions .Shock and electrolyte disorder are deadly complications .Early recognition ,diagnosis and treatment are the key to improve the prognosis .
