43例新型冠状病毒肺炎流行病学特点及临床诊治分析

The epidemiological characteristics and clinical diagnosis and treatment of 43 cases of novel coronavirus pneumonia

目的回顾性分析43例新型冠状病毒肺炎流行病学及临床诊治特点,为下一步的预防控制工作提供依据。方法对43例新型冠状病毒肺炎患者的流行病学史、临床症状、肺部CT变化特点、治疗方案(是否激素干预)、核酸阴转时间等进行总结分析。结果 43例患者均有明确接触史,其中通过会议经麦克风传播人数最多(13例);危重症2例,重症4例,普通型37例;以发热(30例,69.8%)、咳嗽(40例,72.1%)为主要症状;肺部CT以单发或多发磨玻璃影为主要表现(40例),经治疗病灶均吸收,其中28例在治疗过程中病灶曾有一过性加重;43例均采用中西医结合治疗,2例危重型病例应用无创呼吸机,19例应用小剂量激素;核酸阴转时间平均13.28 d,是否应用激素对核酸阴转时间无明显影响(P>0.05)。结论新型冠状病毒肺炎以普通型多见,危重型病例早期给予呼吸支持治疗可获效;是否应用激素对核酸阴转时间无明显影响;密闭环境下密切接触会增加传播风险。

Objective To retrospectively analyze the epidemiological and clinical characteristics of novel coronavirus pneumonia(COVID-19),and to provide evidence for its further prevention and control.Methods The epidemiological history,clinical symptoms,pulmonary CT changes,treatment plan(hormone intervention or not),and negative conversion time of nucleic acid were summarized and analyzed in 43 COVID-19 patients.Results All the 43 patients had clear contact history,among which the number of patients transmitted from conference microphone was the largest(13 cases).There were 2 cases of critical disease,4 cases of severe disease and 37 cases of common type.The main symptoms were fever(30 cases,69.8%)and cough(40 cases,72.1%).Lung CT mainly showed single or multiple ground glass shadows(40 cases),which were all absorbed by the treated lesions,among which 28 cases had a transient aggravation of the lesions during the treatment.All the 43 cases were treated with integrated traditional Chinese and western medicine,2 cases in critical condition were treated with non-invasive ventilator,and 19 cases were treated with low-dose hormone.The average nucleic acid negative conversion time was 13.28 days,and the use of hormones had no significant effect on the negative conversion time(P>0.05).Conclusions COVID-19 of common type is the commonest.Early respiratory support therapy is recommended for critical cases.Hormone intervention makes no obvious influence on the negative conversion time of nucleic acid.Close contact in a closed environment greatly increases the risk of transmission.