重症传染性非典型肺炎2例治疗体会

Management and review of documents of critical SARS: report of two cases

目的 :总结 2例重症传染性非典型肺炎患者的救治经验和教训。方法 :回顾 2例重症SARS患者资料并结合文献进行分析。结果 :2例患者均及时应用糖皮质激素、抗感染药物和综合治疗 ,症状很快改善 ,胸部X线示阴影吸收。但 1例因应用广谱抗生素品种过多、时间过长而出现药物热 ;1例因激素应用时间过长继发上消化道出血。 2例经过积极的综合治疗 ,均救治成功。结论 :早期诊断 ,加强支持治疗 ,合理应用糖皮质激素和抗感染药物 ,适时应用无创正压通气 ,可望降低重症传染性非典型肺炎的病死率。

Aim: To gain the experience and lesson from two critical SARS cases. Methods: Analyzing the results by reviewing the management and combining the literature. Results: Two cases were treated timely by using corticosteroid, anti-infection pharmaceuticals and comprehensive supportive management. Their clinical symptoms ameliorated quickly. Chest X-ray revealed that the shadows were absorbed progressively. But drug fever occurred in one case because of antibiotics abuse for a long time; upper digestive tract peptic ulcer occurred in one case because of long-term use of corticosteroid. Both cases were successfully recovered by adopting positive measures. Conclusions: Early diagnosis, comprehensive supportive management, reasonable corticosteroid therapy and anti-infection pharmaceuticals, noninvasive positive press ventilation are important to decrease the mortality of patients with critical SARS.