重症SARS死亡高危因素分析

High Risk Factors in Severe Type Patients Died of Severe Acute Respiratory Syndrome

目的 探讨重症 SARS死亡高危因素 ,研讨 SARS安全有效的治疗方法 ,降低 SARS的病死率。方法 对死亡 8例 SARS进行回顾性分析。结果 SARS病死与家庭及群体聚集、强毒性病毒株、肺部病变性质和病变范围、院内感染、基础疾病、呼吸机的正确使用、多器官功能衰竭有关 ,与潜伏期长短、病程时间不相关。结论 正确选用呼吸机参数和适应个体耐受个性化是纠正低氧血症的重要手段 ,早期发现、有效治疗院内真菌感染是减少病死率的重要环节 ,综合治疗及人文关怀的实效性是最终治疗的关键。

OBJECTIVE To analyze the high risk factors in severe type patients died of severe acute respiratory syndrome (SARS). METHODS Eight death cases of SARS were analyzed retrospectively. RESULTS The death of severe type SARS patients was related to the infections links, strong toxicity of viral strain, sphere and character of the lesion in lung, co-infection, pre-SARS diseases, accurate using respirator, multiple organ dysfunction, abnormal mentality and no relationship to the time of incubation period and course of disease. CONCLUSIONS Accurately using respirator and better personal endurance will be to improve hypoxemia. Discovery and effective treatment of fungus infection in early stage will be help to decrease mortality rate. The actual effect of comprehensive treatment and humanistic care will be the best methods to rescue patients successfully.