33例SARS死亡病例的临床分析

Clinical analysis of 33 SARS death cases

目的 通过对 33例确诊SARS死亡病例的临床分析 ,总结导致SARS死亡的可能因素。方法 按照卫生部《非典型肺炎病例的临床诊断标准》 ,对临床诊断的 33例SARS死亡病人的年龄、症状、分型、分期、血清酶结果、血气分析指标、胸片病变范围、基础病等情况进行分析。结果 年龄超过 5 0岁的 2 8例 (84 .9% ) ,体温均在 38℃以上 ;33例均为临床重型或极重型 ;病程处于极期 2 8例(84 .9% ) ;ALT异常 2 8例 (84 .9% )或心肌酶异常 2 5例 (75 .8% ) ;血气分析显示血氧分压低于 70mmHg者 30例 (90 .9% ) ;伴有基础疾病者 31例 (93.9% )。 结论 发病年龄、基础病 (尤其糖尿病 )、就诊时间、血清酶指标、血氧分压、胸片病变范围可能与SARS死亡有关。全方位综合治疗是降低病死率的关键。

Objective To summarize the possible clinical factors related to the death of SARS through the clinical analysis of 33 probable SARS cases.Methods To analyse the factors such as age,symptom,classification,stage,serum enzyme level,blood gas analysis result,X-ray change extension,basic diseases,etc,according to “The Criteria for Clinical Diagnosis of SARS' issued by the Ministry of Health.Results Of the 33 cases,28 were over 50 years old (84.9%),all with fever over 38℃ lasting for more than 3 days.All 33 cases were clinically classified as serious and very serious cases,in the utmost stage of the disease,28 cases showed abnormal ALT (84.9%) and 25 cases (75.8%) with abnormal cardio enzyme.Blood gas analysis showed partial pressure of oxygen lower than 70 mmHg in 30 cases (90.9%).21 cases with X-ray shadows over 4 lung fields (63.6%) and 31 cases with companying basic diseases such as diabetes (93.9%).Conclusion The age,basic diseases,treatment starting time,serum enzyme level,partial pressure of oxygen and the extension of X-ray shadow were the possible factors related to the death of SARS.So the comprehensive treatment proved to be essential in reducing the fatality rate of SARS cases.