奥司他韦雾化吸入联合口服治疗人感染H7N9禽流感四例效果观察

Clinical efficacy observation of atomization inhalation combined with oral administration of oseltamivir in 4 cases with H7N9 avian influenza

目的探讨奥司他韦雾化吸入治疗人感染H7N9禽流感病例的临床疗效。方法分析我院2017年3月6日至4月12日收治的4例H7N9禽流感患者诊疗过程，在常规抗病毒治疗（奥司他韦150mg，口服，2次／d）基础上尝试联用奥司他韦（奥司他韦75mg，胶囊内粉末融入20ml生理盐水，2次／d）雾化吸入，并同时予以抗菌、血液净化及免疫调节治疗，并观察其疗效。结果经治疗4例患者分别于治疗后第3、3、4、1天病毒核酸转阴；4例病例均治愈出院，无后遗症。结论奥司他韦雾化吸入联合口服治疗能明显缩短病毒核酸转阴时间，可提高抗H7N9禽流感病毒疗效，提高人感染H7N9禽流感患者治愈率。

Objective To investigate the clinical efficacy of atomization inhalation combined with oral administration of oseltamivir in treatment of human infection with H7N9 avian influenza. Methods To analyze the clinical data of 4 patients hospitalized from Mar 6th 2017 to Apr 12th 2017 with avian influenza （H7N9） infection treated by conventional therapy （osehamivir, 150 rag, po, Bid） plus with oseltamivir inhalation （75 mg dissolved in 20 ml N. S, Bid ） and administered with antibacterial treatment, blood purification and immunomodulators. Results Undergoing these comprehensive therapies, Bronchial lavage fluid and pharynx of 1 case was negative for H7N9 RNA after 24 h, 2 cases negative for H7N9 after 3 d and 1 case negative for H7N9 RNA after 4 d. All patients were cured and discharged without any complications. Conclusions Asehamivir inhalation combined with oral treatment can significantly shorten the time of virus nucleic acid turning negative, improve the efficacy of anti avian influenza virus H7N9, and increase the cure rate of avian influenza H7N9 infection patients.