太原地区严重急性呼吸综合征63例临床分析

Clinical analysis of 63 patients with severe acute respiratory syndrome in Taiyuan areas

目的 对太原市严重急性呼吸综合征 (SARS)的流行病学、临床表现及实验室检查、治疗和转归进行探讨 ,为防治SARS提供经验和依据。方法 采用回顾性方法对本院所收治的 6 3例SARS病例进行分析。结果 6 3例SARS患者中 ,平均年龄 (35 .1± 14 .4 )岁 ,有明显接触史 36例 ,呈聚集发病 2 2例 ,医务人员感染 3例。平均潜伏期 (6 .2± 3.1)d ,太原市 4月份发病人数最多占 73% ,2 0～ 4 0岁年龄段发病者占 5 9.4 %。临床上以发热 (98.4 % )、咳嗽 (80 .95 % )、末梢血白细胞计数正常或低于正常为主 (88.9% ) ,病后 1周内胸片呈渗出性改变者占 92 .3% ,以双肺、双下肺及右下肺受累最多见 (6 6 .7% ) ,平均住院 (11.6± 5 .9)d时胸片显示炎症开始吸收 ;住院 (2 2 .9± 6 .7)d时炎症基本吸收。 6 3例中 ,重型 14例 (2 2 .2 % ) ,死亡 6例 (9.5 % )。结论 SARS呈明显的聚集发病现象 ,以近距离接触飞沫传播方式为主 ,临床以发热、白细胞总数正常或低于正常、胸片渗出性改变为特点。

Objective To understand Severe Acute Respiratory Syndrome(SARS)better and accumulate more experience of preventing and treating this disease. Methods 63 cases of SARS patients diagnosed during March and May of 2003 were studied by retrospective. Results The average age of patients was(35.1±14.4) years old. Among them, 36 patients had the histories of closing contact with diagonosed patients and 22 patients showed infectious links. There were 3 medical staff patients infected. The average incubations period was (6.2±3.1) days and the SARS epidemic pick in Taiyuan is on April of 2003. People between 20～40 years old had the highest incidence. The most common symptom is fever. The second is dry cough. Most of the patients with SARS had normal or lower white blood counts than normal. The chest radiographs showed infiltration signs such as ground-glass opacities, focal consolidation or pathy consolidation within one week after being ill. The Average period of beginning absorption of the infiltration on chest radiograph is (11.6±5.9) days and the average period of completely resolution is (22.9±6.7) days after being admitted in hospital. There were 14 cases of severe type and 6 patients died of ARDS among 63 patients. Conclusions SARS patients showed obvious infectious link. Therefore it supports the view that SARS is mainly conmmunicated by close air droplets. The main characteristics of SARS are fever, normal or lower white blood cells counts and abnormal chest radiographs.