665例COVID-19确诊病例临床救治经验分析

Analysis of Clinical Treatment Experience of 627 Confirmed Cases of COVID-19

目的:回顾性分析样本医院2020年全年收治的665例COVID-19确诊患者的基本信息和临床救治方法,分析这些治疗方法在救治中发挥的实际效果,为后续疫情防控常态化过程中的疾病救治提供参考。方法:按照收治时间区分为四个阶段,采用统计学方法分析不同阶段病例在基本信息和诊疗效果是上的特点和差异。结果:四个阶段病例的性别分布上,差异无统计学意义(P>0.05),年龄分布上,差异有统计学意义(P<0.001);四个阶段的治疗方法上,氧疗、呼吸机辅助呼吸、糖皮质激素和抗病毒药物使用上,差异有统计学意义(P<0.001);输注康复期血浆,可以缩短核酸转阴时间,减少患者氧疗时间,差异有统计学意义(P<0.05);在所有临床治疗手段中,呼吸机使用风险比为31.82,表明呼吸机的使用是危重症患者救治中最重要的手段。氧疗、糖皮质激素以及抗病毒治疗等临床治疗的作用则不够显著。结论:减少抗病毒药物的使用,谨慎使用糖皮质激素,积极使用呼吸支持疗法和康复期血浆,实现了良好的救治效果。

Objective: The basic information and clinical treatment methods of 665 confirmed COVID-19 patients admitted to the sample hospitals in 2020 were retrospectively analyzed, and the actual effects of the treatment methods in treatment were analyzed, to provide reference for disease treatment in the process of normalization of subsequent epidemic prevention and control.Methods: According to the time of admission, it was divided into four stages, and statistical methods were used to analyze the characteristics and differences in basic information and diagnosis and treatment effects of cases in different stages. Results: There was no statistically significant difference in the gender distribution of the four stages(P>0.05), but there was statistically significant difference in age(P<0.001). There were statistically significant differences in the use of oxygen therapy, ventilatorassisted respiration glucocorticoid and antiviral drugs(P<0.001). Infusion of convalescent plasma can shorten the time of nucleic acid conversion to negative, and reduce the time of oxygen therapy of patients, and the difference was statistically significant(P<0.05). Among all clinical treatment methods, the risk ratio of ventilator use was 31.82, which indicated that the use of ventilator was the most important method in the treatment of critically ill patients. The effects of clinical treatments such as oxygen therapy,glucocorticoids and antiviral therapy were not significant enough. Conclusion: Reducing the use of antiviral drugs, using glucocorticoids cautiously, and actively using respiratory support therapy and convalescent plasma have achieved good treatment effects.