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目的 探讨广州地区暴发流行的传染性非典型肺炎的诊断和治疗方法。方法 对2003年1～3月广州地区发病的190例典型的非典型肺炎患者的临床特点、治疗效果进行了分析。结果 190例患者均以高热起病,近距离接触过传染源,潜伏期2～15 d,175例患者伴有呼吸困难、咳嗽、心悸、乏力、头痛头晕,伴腹泻46例(24.2％)。133例患者肺部无明显体征,胸部X线片浸润性阴影在病程初期较轻,1周内逐渐或突然加重,其中波及两个肺野93例,两肺弥漫性渗出阴影36例。36例发展为急性呼吸窘迫综合征(ARDS),死亡11例。常规抗感染治疗无效,中毒症状明显和肺部阴影扩散时,及时应用持续气道正压通气(CPAP)和皮质激素可有效控制病情发展。结论 本病传染性强,主要经呼吸道传播,常规抗感染治疗无效,肺部阴影增多和呼吸困难加重时,及时应用CPAP和皮质激素是有效的治疗方法。
Objective To investigate the diagnosis and treatment of SARS outbreak in Guangzhou. Methods The clinical features and therapeutic effects of 190 cases of typical atypical pneumonia in Guangzhou from January to March in 2003 were analyzed. Results All the 190 patients developed fever and had close contact with the source of infection for 2-15 days. 175 patients were accompanied by dyspnea, cough, palpitation, fatigue, headache and dizziness, and 46 cases (24.2%) with diarrhea. 133 patients had no obvious pulmonary signs, chest X-ray invasive shadow in the early course of the lesion, gradually or suddenly aggravate within 1 week, which affects 93 cases of two lung fields, lung diffuse exudative shadow in 36 cases. 36 cases developed acute respiratory distress syndrome (ARDS), 11 died. Routine anti-infective therapy is ineffective, obvious symptoms of poisoning and lung shadow spread, the timely application of continuous positive airway pressure (CPAP) and corticosteroids can effectively control the progression of the disease. Conclusion The disease is highly infectious, mainly through the respiratory tract transmission, routine anti-infective therapy ineffective, increased lung shadow and increased dyspnea, the timely application of CPAP and corticosteroids is an effective treatment.