重症传染性非典型肺炎临床特征分析及治疗体会

Analysis of the clinical features and treatments in patients with severe acute respiratory syndrome

目的 分析重症传染性非典型肺炎 (SARS)临床特征 ,探讨有效的治疗方法。方法 对 5例重症SARS患者的临床特征如体温、心率、脉搏、血氧饱和度、血常规、X线胸片、血气结果进行分析 ;采用抗病毒、抗菌、免疫增强剂、皮质激素、无创正压通气等治疗 ,并分析其治疗效果。结果 5例重症SARS患者经过上述治疗 ,4例康复 ,1例死亡 ,使用无创正压通气及大剂量甲基强的松龙可以减轻患者症状 ,有效控制呼吸衰竭。结论 体温、白细胞及胸片阴影变化是监测重症SARS病情的重要指标 ,使用大剂量皮质激素可控制病情恶化 ,但要注意指征 ;无创正压通气是有效治疗手段之一 ,综合治疗才能达到康复患者的目的。

Objective Analysis of the clinical features in patients with severe acute respiratory syndrome and discussion of the effective treatments.Method To analyse the clinical features such as temperature,pulse,heart rate,blood oxygen saturation,blood routine,X-ray and blood gas in five patients with SARS, and to treat the patients with antivirus drugs,anti-bacterium agents,immune enhancement agents,large dose of methylprednisolone and noninvasive ventilation.Result Four patients with SARS recovered and one died after the treatments.Large dose of methylprednisolone and noninvasive ventilation can effectively reduce symptom and control respiratory failure.Conclusion Fever pattern,white cell count and changes of radiographic shadow as important monitoring indexes should be investigated in the patients with a novel infectious SARS.The large dose of steroid can prevent the clinical deterioration when it was suitably used,but patients'situation should be assessed because of steroid′s severe side-effects.Noninvasive ventilation is one of therapeutic methods altogether only comprehensive treatments can cure patients.