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目的探讨危/重症甲型H1N1流感的临床特征、治疗和转归情况。方法设计调查表,了解安徽医科大学第一附属医院甲流专病病房21例危/重症甲型H1N1流感病例(研究组)的人口学特征、临床症状和体征、实验室检测、治疗及转归,同时使用曹彬等关于中国2009大流行甲型流感(H1N1)病毒感染最初病例的研究样本作为对照,其中危/重症诊断按照卫生部颁布的诊断标准进行,对不同时间点的相关指标也进行比较分析,采用SPSS17.0软件进行统计学分析。结果两组间性别、年龄分布差异无统计学意义,研究组发热持续时间较长,肝功能不良事件发生率也明显高于对照组(P<0.01);研究组入院时高热、咳嗽、咳痰、疲乏、腹泻/腹痛、呼吸困难、咽充血、扁桃体肿大发生率均明显高于对照组(P<0.05);与对照组相比,研究组更容易出现白细胞升高(P<0.01)及C反应蛋白升高(P<0.01),血清CK、CK-MB、LDH、ALT、AST以及胸部X线检查异常均明显增加(P<0.05),血清钾、血清钠也较对照组低(P<0.05);随治疗时间延长,患者氧分压有所升高、心率降低、血小板增加;痊愈出院20例,死亡1例。结论危/重症甲型H1N1流感病例与普通感染者有较大差异,体温高、热期长,容易出现多器官系统损害及继发感染,经良好治疗,大多数可以痊愈。
Objective To investigate the clinical characteristics, treatment and prognosis of severe / severe H1N1 influenza. Methods Design a questionnaire to understand the demographic characteristics, clinical symptoms and signs, laboratory tests, treatment and outcome of 21 cases of A / H1N1 flu (study group) in the First Affiliated Hospital of Anhui Medical University At the same time, Cao Bin et al. Used as a control sample of the initial case of pandemic influenza A (H1N1) 2009 pandemic in which critically ill patients were diagnosed in accordance with the diagnostic criteria promulgated by the Ministry of Health. Relevant indicators were also carried out at different time points Comparative analysis, using SPSS17.0 software for statistical analysis. Results There was no significant difference in sex and age distribution between the two groups. The duration of fever and the incidence of hepatic dysfunction in the study group were significantly longer than those in the control group (P <0.01). In the study group, fever, cough and expectoration , Fatigue, diarrhea / abdominal pain, dyspnea, pharyngeal congestion and tonsil enlargement were significantly higher than those in the control group (P <0.05). Compared with the control group, the study group was more prone to leukocytosis (P <0.01) and (P <0.01). The levels of serum CK, CK-MB, LDH, ALT, AST and chest X-ray were all significantly higher than those of the control group <0.05). With the prolongation of treatment time, oxygen partial pressure increased, heart rate decreased and thrombocytosis increased. 20 patients were discharged and 1 died. Conclusions There is a big difference between the cases of dangerous and severe type A (H1N1) flu and the common ones. High body temperature and prolonged heat period are prone to multiple organ system damage and secondary infection. After good treatment, most of them can be cured.