咸阳市17例新型冠状病毒肺炎患者临床治疗经验总结

Clinical experience summary of clinical treatment of 17 cases corona virus disease 2019 in Xianyang

目的回顾性分析17例新型冠状病毒肺炎(COVID-19)患者的治疗过程、相关检查结果及预后情况,旨在为及时发现有重型倾向患者,并对其进行有效干预提供相关经验。方法以2020年1月21日我院收住的17例COVID-19确诊患者为研究对象,对其临床表现、治疗过程、化验及CT检查结果进行汇总分析,其中5例有重型倾向的患者给予静注甲泼尼龙及人免疫球蛋白治疗。结果16例患者经治疗后病情逐渐平稳,1例因病情进展迅速已达到危重型标准而转至我省危重症COVID-19定点医院进行救治。治疗后,患者的WBC、LY、CRP、SAA水平均改善(P<0.05)。17例患者中,12例为无重型倾向患者,5例有重型倾向患者。治疗前,有重型倾向患者的WBC、LY水平低于无重型倾向患者,CRP、SAA水平高于无重型倾向患者(P<0.05)。结论无重型倾向COVID-19患者通过规范治疗、密切观察均可痊愈;而对于发热持续时间长、脉压差低、血氧饱和度降低、胸部CT进展快的患者,建议尽早应用激素及免疫球蛋白阻断炎症反应,以提高救治成功率。

Objective The data of treatment course,relevant examination results and prognosis in 17 patients with corona virus disease 2019(COVID-19)were analyzed retrospectively,so as to provide relevant experience for timely detection and effective intervention of patients with severe tendency.Methods Taking 17 patients with COVID-19 admitted in our hospital on January 21,2020 as the research objects,the clinical manifestations,treatment process,laboratory test and CT examination results were analyzed.Among them,5 patients with severe tendency were given intravenous injection of methylprednisolone and human immunoglobulin.Results After treatment,the condition of 16 patients became stable gradually,and 1 patient was transferred to COVID-19 designated hospital for treatment because of the rapid progress of the disease,which reached the critical and severe standard.After treatment,the levels of WBC,LY,CRP and SAA of patients improved(P<0.05).Of the 17 patients,12 cases were normal patients(without severe tendency),5 cases were severe tendency patients.Before treatment,the WBC and LY levels of patients with severe tendency were lower than those of normal patients,and the CRP and SAA levels were higher than those of patients with general tendency(P<0.05).Conclusion The normal COVID-19 patients can be cured by standard treatment and close observation.For patients with long fever duration,low pulse pressure difference,low blood oxygen saturation and rapid progress of chest CT,it is suggested to use hormone and immunoglobulin as early as possible to block the inflammatory response,so as to improve the success rate of treatment.