山西省102例重症SARS患者临床分析

Clinical analysis of critical SARS 102 cases in Shanxi Province

目的 分析山西省 10 2例重症SARS患者的临床特征、治疗效果和预后。方法 对山西省 2 0 0 3- 0 3- 0 7～ 2 0 0 3- 0 6- 0 4确诊的 10 2例重症SARS患者的临床资料进行回顾性分析。结果 10 2例患者男性 4 8例 (47.1% ) ,女性 5 4例(5 2 9% ) ;主要临床表现为发热 (10 0 % )、咳嗽 (5 4 .9% )、呼吸困难 (44 .1% )。早期平均白细胞数计数 (6 .0± 4 .2 )× 10 9/L ,淋巴细胞百分比 (16 0± 11 6 ) %。 10 2例都有胸部X线检查异常。疾病的早期使用呼吸机、心理治疗可阻止病情进展。多因素分析显示 :高龄、缺乏心理治疗是死亡独立危险因素。结论 重症SARS男女发病大致相等 ,无特征性临床表现。早期使用呼吸机 ,心理治疗有效。高龄是死亡独立危险因素 ,心理治疗是该病预后的保护因素。

Objective To investigate the clinical characteristics and prognosis of 102 cases of critical SARS in Shanxi Province. Methods The clinical data of 102 critical SARS cases were analyzed. Results In this group 48 were male and 54 female. The main clinical manifestations included fever (100%), cough (54.9%), and dyspnea (44.1%). The mean white blood cell count was (6.0±4.2)×10 9/L, and lymphocyte was (16.0±11.6)% at the early stage. All the cases had abnormal chest radiographs. Application of noninvasive mechanical ventilation and psychological therapy at the early stage could delay the progress of the disease. In multivariate analysis the predictors of adverse prognosis were advanced age and lack of psychological therapy. Conclusions Critical SARS has not specific clinical manifestations. Effective treatments include oxygen support and psychological therapy. Age and lack of psychological therapy are the independent predictors of death.