发热门诊62例病例分析

Analysis of 62 cases of fever clinic

目的通过分析中山大学附属第七医院发热门诊病例的流行病学、临床表现、实验室检查、X线表现等特点,了解新型冠状病毒(SARS-CoV-2)感染引起的可疑新型冠状病毒肺炎(Corona Virus Disease 2019,COVID-19)患者的特征。方法对我院于2020年1月23日至2020年2月6日发热门诊就诊的62例患者的流行病学及临床资料进行回顾性分析。结果1)白细胞计数大于9.17×10^9/L者14例,占22.6%,正常范围(3.69~9.16×10^9/L)者46例,占74.2%,小于(3.69×10^9/L)者2例,占3%,淋巴细胞计数比例低于20%者22例,占35.5%;2)62例门诊患者中47例完善胸部X线检查,结果提示大部分患者就诊时行胸部X线筛查结果提示未见异常,或轻微异常。具体X线表现为未见异常25.5%(12/47),两肺纹理增强48.9%(23/47);支气管炎8.5%(4/47),肺部感染10.6%(5/47),其他6.3%(3/47);3)对就诊的62例门诊患者中50例患者进行新型冠状病毒核酸检测发现,最终确诊3例,其中有流行病学的阳性2例,没有流行病学确诊1例;4)流感A+B检测对就诊的62例门诊患者中55例患者进行流感A+B检测,流感A+B阳性6例,第一次新型核酸检测阳性4例,二者互相不重合。结论随着疫情扩散,新型冠状病毒感染可能出现以消化道传播途径感染人群,感染者的表征不完全,甚至出现无症状,这加大了病毒广泛传播的担忧,尽早进行新型冠状病毒核酸筛查,发现和确定传染源、切断传播途径,是遏制疫情蔓延的有效途径。

Objective To understand the characteristics of patients with suspected new coronavirus pneumonia(Corona Virus Disease 2019,COVID-19)caused by new coronavirus(SARS-CoV-2)infection by analyzing the epidemiology,clinical manifestations,laboratory examinations,and X-ray findings of the fever cases in the Seventh Affiliated Hospital of Sun Yat-Sen University.Methods A retrospective analysis was performed on the epidemiological and clinical data of 62 patients who visited our hospital from 2020-1-23 to 2020-2-6.Results 1.There were 14 cases with white blood cell count greater than 9.17×10^9/L,accounting for 22.6%,46 cases with a normal range(3.69 to 9.16×10^9/L),accounting for 74.2%,and 2 cases less than(3.69×10^9/L,3%).There were 22 cases with lymphocyte count less than 20%,accounting for 35.5%.Of the 62 outpatients,47 cases had a complete chest X-ray examination.The results showed that most patients underwent chest X-ray screening showed no abnormalities or slight abnormalities.The specific X-ray showed 25.5%of no abnormalities(12/47),48.9%of enhanced texture of both lungs(23/47),8.5%of bronchitis(4/47),10.6%of pneumonia(5/47),and 6.3%of others(3/47).The new coronavirus nucleic acid test was performed on 50 of the 62 outpatients,and 3 cases were finally diagnosed,of which epidemiological 2 cases were positive and 1 case was not confirmed by epidemiology.Influenza A+B test was performed on 55 out of 62 outpatients,and 6 cases were positive for influenza A+B.4 cases tested positively for the first novel nucleic acid test,and the two tests did not overlap each other.Conclusion With the spread of the epidemic,new-type coronavirus infection may appear to infect people through the digestive tract.The infected person’s characterization is incomplete or even asymptomatic,which has increased the concern about the widespread spread of the virus.Finding and determining the source of infection and cutting off transmission routes are effective ways to curb the spread of the epidemic.