肾综合征出血热患者治疗的临床研究

Clinical studies on treatment of the patients with HFRS

目的探讨治疗肾综合征出血热(HFRS)患者的疗效。方法108例HFRS患者随机分为对照组与治疗组。对照组53例,发热期静脉滴注维生素C等;低血压休克期给予快速晶体液扩容等治疗;少尿期给予利尿剂或等待肾功能自然恢复。治疗组55例,发热期给予病毒唑、赛庚啶及654-2以抗病毒,抗过敏及改善微循环;低血压休克期给予晶胶结合扩容,改善微循环和纳洛酮等治疗;少尿期联用心得安和酚妥拉明,或单用维拉帕米治疗。结果治疗组与对照组相比,在发热期治疗后热程平均少1. 13d、P<0. 01,越期率(超越低血压休克期和少尿期之和)增加17. 80%、P<0. 05;在低血压休克期抗休克治疗后0.5h、1h和2h休克纠正率分别升高30. 05 (P<0. 05 )、21. 21% (P<0. 05 )和21. 72% (P<0. 05 ),难治性休克发生率降低5.30%、P>0. 05;在少尿期少尿持续时间平均少1. 63d、P<0. 01,血压正常分别为15和8例、P<0. 05;肾功能恢复正常时间数平均少1. 32d、P<0. 01,病死率下降3. 91%、P>0. 05。结论治疗组疗效明显优于对照组。

Objective To investigate the efficacy on treatment of the patients with hemorrhagic fever syndrome (HFRS). Methods 108 patients with HFRS in febrile stage were randomly divided into the control group and the treatment group. 53 in the control group were treated with the fluid contained vitamine C dripped intravenously in the febril stage ;with quick venoclysis of crystalloid fluid for the primary shock; with the diuretic or the traumatic renal function returned spontaneously to normal in the oliguric stage. 55 patients in the treatment group were treatsd with virazole, periactin and 654-2 for antivirus, anti-anaphylaxis and improvement of microcirculation in the febrile stage;with venoclysis of crystalloid and colloid fluid, improvement of microcirculation and naloxone,et al for the primary shock; with inderal united with regitine or verapamil used alone in the oliguric stage. Results As compared with the control group, the treatment group showed that the average duration of the febrile course after the treatment had decreased by 1.13 days(p<0.01), the rate of the cases who did not undergo hypotensive-shock and oliguric stages had increased by 17.80% (p<0.05), in the febrile stage; after anti-shock treating for 0.5 hour,1 hour and 2 hours, the rate of the case to free from shock had inreased by 30.05% (p<0 05), 21.21% (p<0.05) and 21.72% (p<0.05),respectively, the rate of the cases with rebellious shock had decreased by 5.30% (p>0.05), in the hypotensive-shock stage; the average duration of oliguria had dereased 1.63 days (p<0.01),the cases who did not undergo hypertension were 15 and 8 (p<0.05), respectively, in the oliguric stage; the average duration of the renal function returned to normal had decreased by 1.32 days (p<0.01),the fatality rate had decresed by 3.91% (p>0.05). Conclusion There is significant difference on the therapeutic efficacy, the treatment group is evidently more efficient.