危重症甲型H1N1流感的临床分析(英文)

Clinical analysis of critically ill patients with H1N1 influenza

目的:分析危重症甲型H1N1流感的临床特点、主要治疗措施及转归,以期对危重症甲型H1N1流感进行更有效的治疗。方法:采用回顾性方法分析8例危重症甲流患者的临床特点、相关指标及转归。结果:APACHEⅡ评分(19.0±7.8)分;死亡5例,其中4例死于呼吸衰竭;死亡病例血小板较治愈及好转病例低(χ2=8.000,P<0.05)。4例使用糖皮质激素,均死亡;6例行有创机械通气的患者中,5例因无创机械通气失败而改为有创机械通气;其中3例在有创机械通气时并发气压伤,均死亡。结论:危重症甲流患者病死率高,呼吸衰竭为主要死亡原因。对危重症甲流患者不主张使用糖皮质激素;对于出现呼吸衰竭须机械通气者,建议直接采用小潮气量、低PEEP的有创呼吸支持。

Objective To determine the clinical characteristic,main treatment,and prognosis for the sake of more effective treatments for critically ill patients with H1N1 influenza.Methods Eight critically ill patients with H1N1 influenza in intensive care unit were retrospectively studied,including clinical characteristics,indexex of correlation,and prognosis.Results The acute physiology and chronic health evaluationⅡ score was 19.0±7.8.Five patients died,4 of whom were caused by respiratory failure.The number of platelets in dead patient was lower than that in healing and improved ones（χ2=8.000,P0.05）.All the 4 patients treated with glucocorticoid died,5 out of the 6 patients received invasive mechanical ventilation rather than noninvasive mechanical ventilation,and 3 of them who complicated barotraumas in the lung died at last.Conclusion Critically ill patients with H1N1 influenza have high mortality.Respiratory failure is the main cause of death.Critically ill patients with H1N1 influenza should not be treated with glucocorticoid.Patients who need mechanical ventilation should be treated with invasive mechanical ventilation with low tidal volume and low positive end-expiratory pressure.