江苏省扬州地区确诊新型冠状病毒肺炎患者的中西医结合临床诊治和效果评价

Clinical diagnosis and integrated treatment of traditional Chinese and western medicine for confirmed patients with coronavirus disease 2019 in Yangzhou area of Jiangsu Province

目的总结和评价扬州地区新型冠状病毒肺炎(COVID-19)流行病学特征、临床症状、实验室检查结果、治疗方案及预后。方法收集扬州市传染病医院收治的23例COVID-19住院患者的诊治资料。结果①病例特征:23例患者咽拭子核酸检测阳性,其中重型1例,普通型22例;患者年龄23~72岁,男10例,女13例;有接触史21例(91.3%),其中7例为家族性聚集发病;疾病平均潜伏期5 d。②临床症状:主要表现为咳嗽、发热(78.3%),其次为咳痰症状(26.1%)、胸闷气喘(26.1%)、消化道症状(8.7%)。③血液学检查:COVID-19患者白细胞总数正常,16例入院时伴淋巴细胞降低,2例肝功能异常;患者出院时甘油三酯及胆固醇升高,C反应蛋白降低。④影像学检查:胸部CT显示胸膜下分布多发磨玻璃影,伴有间质增厚。⑤治疗方案:所有患者均给予抗病毒、抗感染、吸氧等治疗,仅1例重型患者给予无创呼吸机通气治疗,全部患者核酸检测转阴后出院。结论核酸检测阳性和胸部CT多发磨玻璃影、伴间质增厚是诊断COVID-19的重要依据。易感人群接触史、咳嗽发热症状、淋巴细胞低下是COVID-19感染的重要临床表现。中西药结合治疗是COVID-19的有效治疗方案。

Objective To summarize and evaluate the epidemiological characteristics,clinical symptoms,laboratory tests,treatment options and prognosis of novel coronavirus pneumonia(Coronavirus Disease 2019,COVID-19)in Yangzhou.Methods The clinical data of 23 COVID-19 hospitalized patients in Yangzhou Infectious Disease Hospital were collected and analyzed.Results①Case characteristics:nucleic acid tests(oropharyngeal swabs)were positive in 23 patients,including1 severe case and 22 common cases,aged 23 to 72 years,with 10 males and 13 females.There were21 cases(91.3%)with contact history,among which familial clustering occurred in 7 cases.The average incubation period was 5 days.②Clinical symptoms mainly included cough,fever(78.3%),followed by sputum symptoms(26.1%),chest tightness and asthma(26.1%),and digestive tract symptoms(8.7%).③Hematological examination:the total number of white blood cells was normal,with low lymphocytes occurring in 16 patients,abnormal liver function in two patients at admission;triglycerides and cholesterol increased,and C reactive protein(CRP)decreased at discharge.④Imaging examinations:CT scan of the chest showed that multiple ground glass shadows was seen under the pleura,complicating with interstitial thickening.⑤Treatments:all the patients were treated by antiviral,anti-infective,and oxygen inhalation treatments.Only one severe patient was given non-invasive ventilation.All patients were discharged after negative results of the nucleic acid test.Conclusions Positive nucleic acid test and multiple ground-glass shadows complicating with interstitial thickening by chest CT are important evidence for diagnosis of novel coronary pneumonia,and contact history of susceptible people,cough as well as fever symptoms,and low lymphocytes are important clinical manifestations of novel coronavirus pneumonia.In clinic,comprehensive treatment of Chinese and western medicine is an effective treatment for COVID-19.