23例甲型H1N1流感合并肺炎的临床分析

Clinical analysis of influenza A(H1N1) complicated with pneumonia in 23 cases

目的探讨甲型H1N1流感合并肺炎的临床特点及治疗经验。方法对确诊为甲型H1N1流感合并肺炎的23例病例临床资料进行回顾性分析。结果在23例病例中,56.5%的患者有基础疾病;青少年及儿童占60.9%;所有患者均有高热和咳嗽,但仅有21.7%的患者肺部有较多湿啰音;予支持对症、保护脏器功能、抗病毒、抗菌药物、糖皮质激素、氧疗、机械通气等综合治疗,95.7%的患者痊愈或好转,死亡1例。结论甲型H1N1流感合并肺炎患者以青少年及儿童居多;症状较重而体征轻;应早诊断、早治疗,大多数患者经积极的综合治疗可好转或治愈,重症患者病死率高。

OBJECTIVE To study the clinical characteristics and treatment experience of influenza A（H1N1） complicated with pneumonia.METHODS The retrospective analysis of the clinical features of 23 cases of influenza A（H1N1） complicated with pneumonia was conducted.RESULTS Among the 23 cases,56.5% of the patients had accompanying underlying diseases,and adolescents and children accounted for 60.9% of all the patients.All the patients had high fever and cough,however,only 21.7% of the cases were detected more moist rale by lung auscultation.The combined therapies included supportive and symptomatic therapy,protection of organ function,antibiotics treatment,antivirus therapy,using of glucocorticoid hormone,oxygen therapy,mechanical ventilation and so forth;95.7% of the patients were fully recovered or improved while 4.3%（1 case）was dead.CONCLUSION Most of patients with influenza A（H1N1） complicated with pneumonia are adolescents or children.The patients have severe symptoms but accompanied with less physical signs;Earlier diagnosis and treatment are necessary,and most cases may be improved or fully recovered after active treatment,however,mortality rate is high in severe cases.