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目的分析埃博拉病毒病(Ebola virus disease,EVD)确诊患者临床特征及其转归,探讨该病的临床救治经验。方法归纳5例EVD确诊患者流行病学、症状、体征、治疗、转归情况,总结临床特点和规律。结果 5例患者年龄32~58岁,平均年龄46岁,男∶女为2∶3,重症3例、轻症2例。起病前21d内均有明确流行病学接触史,2例来自同一传播链;1例为医护人员。临床表现以发热、乏力或虚弱、厌食、腹泻、结膜充血等为主,1例发生消化道出血。5例患者均首次行埃博拉病毒(Ebola virus,EBOV)RNA PCR检测即为阳性。经尽快、早期采取严密隔离、退热、补液、预防并发症、治疗基础疾病等措施,3例患者治愈出院,2例死亡。结论尽早隔离传染源、管理接触者可有效阻断传播链;PCR核酸检测是诊断EVD的快速、方便、有效方法;尽早采取对症支持为主的综合治疗可改善治疗结局。
Objective To analyze the clinical characteristics and prognosis of Ebola virus disease (EVD) and to explore the clinical experience of Ebola virus disease. Methods The epidemiology, symptoms, signs, treatment and prognosis of 5 patients diagnosed by EVD were summarized and clinical features and regularities were summarized. Results The 5 patients were 32 to 58 years old with an average age of 46 years. There were 2 males and 2 females, 3 severe cases and 2 mild cases. Before the onset of 21d have a clear history of epidemiological exposure, 2 cases from the same transmission chain; 1 case of health care workers. Clinical manifestations of fever, fatigue or weakness, anorexia, diarrhea, conjunctival hyperemia, etc., one case of gastrointestinal bleeding. All 5 patients were positive for Ebola virus (EBOV) RNA PCR. As soon as possible, early strict isolation, antipyretics, rehydration, prevention of complications, treatment of underlying diseases and other measures, 3 patients were cured and discharged, 2 patients died. Conclusion As soon as possible to isolate the source of infection and manage the contacts, it can effectively block the transmission chain. PCR nucleic acid detection is a rapid, convenient and effective method to diagnose EVD. Comprehensive early symptomatic supportive treatment can improve the outcome of the treatment.