甲型H1N1流感患者临床并发症的回顾性病例研究

Retrospective case study of clinical complications on A(H1N1) influenzal patient

目的探讨甲型H1N1流感患者由重症发展成危重症甚至发生死亡的潜在危险因素。方法回顾性分析天津地区(含天津市11家医院)2009年9月至2009年12月收治的甲型H1N1流感重症及危重症患者确诊病例共计114例,根据疾病严重程度分为重症组(n=70)与危重症组(n=44),根据患者预后分成生存组(n=99)与死亡组(n=15),分别分析比较患者住院期间并发症的发生情况。结果 1.危重症组患者与重症组患者在出现气胸或纵膈气肿、ARDS、急性肾功能衰竭、肝损害并发症的比率比较差异有统计学意义。2.死亡组患者与生存组患者在出现气胸或纵膈气肿、ARDS、急性肾功能衰竭、肝损害、DIC、继发感染并发症的比率比较差异有统计学意义。结论当患者出现气胸或纵膈气肿、ARDS、急性肾功能衰竭、肝损害、继发感染并发症,以及DIC时,应警惕患者由重症发展成危重症的可能,及由重症发展成危重症甚至发生死亡的风险。

Objective To discuss the potential risk factors of the influenza A H1N1） patients from severe case develop into a critical illness or even death.Methods Retrospectively analysis 114 confirmed cases in accordance with the People＇s Republic of China H1N1 influenza treatment program 2009 third edition） diagnostic criteria） of se-vere and critical ill patients that were suffered from influenza A H1N1） of Tianjin area 11 hospitals） from September 2009 to December 2009.According to the severity level of the disease,the patients were divided into the severe group n=70） and critical group n=44） ,and according to the prognosis of patients were divided into the survival group n=99） and death group n=15）.The incidence of complications of the disease were analyze and compared. Results 1.The difference comparison between the critically sever group patients and critical group patients upon pneumothorax or mediastinal emphysema,ARDS,acute renal failure and liver damage complication was statistically significant.2.The difference comparison between deaths group patients and survival group patients upon pneumothorax or mediastinal emphysema,ARDS,acute renal failure,liver damage,DIC and secondary infection complication was statistically significant.Conclusion When suffered with pneumothorax or mediastinal emphysema,ARDS,acute renal failure,liver damage,secondary infection,DIC,the possibility of patients develop from severe to critical and the risk of patients develop from critical to death should be alerted.