37例医务人员SARS的临床及治疗特点

The clinical features and treatment of 37 medical workers suffering from SARS

目的 :了解医务人员SARS感染的临床及治疗特点。方法 :回顾分析 37例医务人员SARS病例的临床资料 ,并与同期住院的非医务人员SARS患者比较。结果 :37例医务人员SARS患者中 ,医生占 32 .4 % ,护士占6 2 .2 % ,检验师占 5 .4 % ,聚集性发病占 78.4 %。其均有明确的直接或间接SARS病源接触史 ,97.3%的患者发病初期均有高热 (≥ 38℃ ) ,伴淋巴细胞减少者占 5 9.5 % ,X线胸片示双肺受累者占 5 6 .8% ,伴不同程度的肝功、血糖、乳酸脱氢酶及T淋巴细胞亚群异常者占 4 8.6 %、32 .4 %、4 0 .5 %及 2 4 .3% ,救治过程中使用无创正压机械通气者占 16 .2 % ,使用肾上腺糖皮质激素者占 94 .6 % ,出现继发感染等合并症者占 2 4 .3%。结论 :医务人员SARS具有聚集性特点 ,且病情较重、治疗难度较大 ,应引起特别的重视。

Objective:To investigate the clinical features and the effective treatments of medical workers who were infected with SARS. Methods:Analyzing the clinical documents of 37 medical workers with SARS by using retrospective survey study and compared them with the documents of non-medical worker-SARS patients who were in hospital in the same period. Results:In all the 37 medical workers, 32.4% were doctors , 62.2% were nurses and 5.4% were docimasters. And the onset of the disease of 78.4% of the patients belonged to collective outbreak. All the medical workers with SARS categorically had direct or indirect contact histories with SARS patients. Almost all the medical SARS patients started with hyperpyrexia (KT≥38℃). 59.5% of the patients were with significant decrease of lymphocytes percentage, and 56.8% of the patients showed pulmonary involvement on chest X-rays. 48.6%, 32.4%, 40.5% and 24.3% of the patients were with abnormal liver function, blood glucose, lactic dehydrogenase and T- lymphocyte subgroup, respectively. Non-invasive positive pressure ventilation (NIPPV) was used for 16.2% of the SARS patients in the process of treatment. Different dosages of glucocorticosteroids had been used for 94.6% of the patients in the process of treatment. Concurrent infections such as secondary infections occurred in 24.3% patients during the process of treatment. Conclusion:The features of SARS in medical workers were: collective outbreak, and serious. It is difficult in treating them. So special attention should be given to them.