包头地区14例SARS患者的救治体会

Evaluation on the treatment of 14 cases of SARS in Baotou district

目的 分析严重急性呼吸综合征(SARS)患者的临床特点,并对其诊断和治疗方法进行探讨。方法 对2 0 0 3年4月5日～6月3日包头地区收治的临床诊断为SARS的14例患者的临床、实验室、影像学资料及治疗进行回顾性分析。结果 14例患者中,5例为一个家族的成员,另有3个家族各发病2例;平均潜伏期为8.36±4 .2 9d ;有发热、咳嗽、胸闷、气短者10例(71.4 3% ) ,血丝痰2例(14 .2 9% ) ;血常规:白细胞>10 .0×10 9/L和<4 .0×10 9/L者各5例(各占35 .71% ) ;均有X线胸片异常改变,多叶病变13例(92 .86 % )。激素治疗,首选甲基强的松龙,4 0～16 0mg/d ,平均疗程13.79±8.5 2d ,无不良反应及二重感染。结论 流行病学接触史、发热、X线肺部炎症征象及白细胞计数正常或减少是诊断本病的临床依据;早发现,早隔离,早治疗是避免疫情播散,改善预后的关键。

Objective To analyze the clinical features of patients with severe acute respiratory syndrome (SARS) and evaluate the diagnosis and treatment of the disease. Methods Fourteen patients with SARS in Baotou district hospitals from April 5 to June 3, 2003 were studied retrospectively. The data included clinical manifestations, laboratory and roentgenological examination. Results Among 14 patients, 5 were members of the same family, the other three families had 2 cases respectively, the average incubation period was 8.36± 4.29 days, clinical symptoms were fever, cough, chest distress and short breath (10 cases, 71.43%), blood sputum (2 cases, 14.29%). Blood routine examination showed white blood cells (WBC) >10.0×10 9/L and <4.0×10 9/L in 5 patients ( 35.71%) respectively, 13 patients (92.86%) had abnormal chest X-ray changes. Methylprednisolone was the first choice of hormone for treatment, the dosage was 40～160 mg/d, the average treatment course was 13.79± 8.52 days. Patients had no adverse reaction and double infection. Conclusion A history of close contact, fever, X-ray signs of pneumonia and normal or lowered WBC counts are helpful for the diagnosis of SARS. The keys to the prognosis are early discovery, early isolation and early treatment.