25例甲型H1N1流感重症及危重症确诊病例临床特征及治疗分析

Clinic feature and therapy effect analysis of 25 severe and critical A H1N1 influenza cases

目的探讨甲型H1N1流感重症及危重症的临床特征和治疗效果。方法动态观察25例确诊甲型H1N1流感重症及危重症病例的临床特征,对诊治情况进行回顾性分析。结果 25例患者中,男11例,女14例,重症9例,危重症16例,25例均发生肺部感染,所有患者均有发热,平均发热持续3.64d入院,咳嗽、乏力、肌肉酸痛、胸闷、恶心等全身症状较多;早期的抗病毒治疗及短期3-7d的小剂量糖皮质激素及晚期的提高免疫力治疗及广谱包括真菌的抗菌药物使用在部分病例中获得成功。结论甲型H1N1流感病毒致病力及致死率与季节性流感相似,重症/危重症需要早期的抗病毒治疗和后期的抗菌治疗及精细的加强治疗以提高存活率。

Objective To proble the clinic feature and therepy effect of severe and critical A H1N1 influenza cases.Methods Dynamicly observing the clinic feature of 25 severe and critical A H1N1 influenza cases,and retrospective analyzing the therapy effect.Results In the 25 cases,of 9 cases were severe,and 16 cases were critical;11 were male,and the other were female;all of the 25 cases had lung infection;All the cases had fever,the average time from onset to admission persisted 3.64 days;the general symptom were common,like：cough,hypodynamia,muscle ache,chest distress,nausea.Early anti-virus and 3-7days low-dose glucocorticoids therapy,later period immunity enhancement and antibacterial therapy gained success in some cases.The intimate cooperation of multi-department staff and refined therapy were very important.Conclusion the virulence and mortality of A H1N1 influenza is similar to season influenza.As to severe and critical A H1N1 influenza cases,we should afford Inchoate anti-virus,later period antibacterial therapy and subtle intensive therapy to improve survival.