甲型H1N1流感57例临床分析

Clinical analysis of S7 cases of A （H1N1） influenza

目的 分析甲型H1N1流感临床特点,探讨治疗方法,以期及早地控制病情,提高生存率.方法 回顾性分析57例甲型H1N1流感病例的临床资料.结果 57例甲型H1N1流感病例中轻症病例占89.47%,男女之比为2.16∶1;以青少年居多,30岁以下占87.72%.所有患者均有发热、全身酸痛等全身症状,具有季节性流感特征,但较季节性流感病程长.X线示肺纹理增粗为66.67%,10.53%患者合并肺炎.43.86%表现为心电图异常;部分有心肌酶学指标升高,尤以危重病例明显.26.32%患者有肝功能异常.40.35%的患者外周血象表现为白细胞降低,少数有血小板下降.17.54%患者伴有消化道症状.6例重症、危重症病例3岁以下2例,40岁以上3例,均并发肺炎、心肌炎,2例危重症病例并发Ⅰ型呼吸衰竭、低氯低钠血症等.本组病例经中西医结合治疗预后好,无后遗症及死亡病例.结论 甲型H1N1流感临床表现特异性不强,但有其特点,儿童及老年人易重症的高危人群;掌握临床特点,早期识别重症病例,有助于提高生存率.

Objective To analyze the clinical features of influenza A（ H1N1） and rearch the therapruic method,so as to control the disease early and improve survival rate. Methods The clinical olata of 57 influenza A （ H1N1 ） cases were analyzed retrospectively. Results Of the 57 influenza A （ H1N1 ） cases, mild cases accounted for 89.47%, the All the patients had fever, systemic pains and other symptoms, and had the characters of the seasonal influenza, but the duration was much longer. X-ray showed increased bronehovaseular shadows in 66.67% patients, and 10.53% patients complicated with pneumonia. 43.86% showed abnormal ECG. Some had elevated myocardial enzymes, especially in critical patients. 26.32% patients had abnormal liver function. The peripheral blood examination showed 40.35% cases with leukopenia, few with thrombocytopenia. 17.54% patients accompanied with gastrointestinal symptoms. In 6 severe and critically patients, 2 cases were under 3-year-old, 3 caes were over 40-year-old, all complicated with pneumonia and myocarditis, 2 cases of critical patients complicated with type Ⅰ respiratory failure and low chlorine hyponatremia.Patients obtained satisfactory efficiency after the treatment and the prognosis was good. No complications and deaths occured. Conclusions The clinical manifestations of A （H1N1） influenza are less specificity, but with its own characteristics, children and elderly people are at high risk. It is helpful to improve the survival rate through understanding the clinical features.