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目的 初步探讨重症急性呼吸综合征 (SARS)的流行规律、发病特点、临床特征、治疗及预防。方法 分析我院聚集性感染的SARS患者的临床资料。结果 SARS患者 96例 ,男 2 0例 ,女76例 ,年龄 16～ 6 2岁 ,其中医务人员 90例 ,占 93 8% ,均受感染于同一社区患者 ,同期发病。潜伏期1～ 2 0d ;初始体温 (38 3± 0 6 )℃ ,最高体温 (39 2± 0 6 )℃ ;持续发热 (9 0± 4 2 )d。主要症状有乏力、咳嗽、少量咳痰、畏寒、头痛、全身酸痛、肌痛。X线胸片显示肺部病变以双侧、中下肺野为主。6 7 7%患者外周血白细胞计数减少。鼻导管吸氧状态下最低脉搏血氧饱和度为 (94 8± 3 1) %。6 8 8%患者使用甲泼尼龙 ,初始剂量为 (6 7 3± 2 8 2 )mg/d ,最大剂量为 (82 4± 30 5 )mg/d ,持续使用时间 (4 9± 2 4 )d。痊愈出院 95例 (99 0 % ) ,住院时间 8～ 4 7d。结论 SARS发病可呈医院聚集性 ,起病急 ,进展迅速 ,X线胸片显示以双侧肺部受累为主 ,适时使用包括糖皮质激素、抗生素、丙种球蛋白、α 干扰素、抗病毒药物等在内的综合治疗可能有助于减轻病情或缩短病程。
Objective To investigate the prevalence, incidence, clinical features, treatment and prevention of severe acute respiratory syndrome (SARS). Methods The clinical data of SARS patients with agglutinate infection in our hospital were analyzed. Results 96 cases of SARS patients, 20 males and 76 females, aged 16 to 62 years old, including 90 medical staff, accounting for 93.8%, were infected with the same community patients, the same period of onset. Incubation period was 1 ~ 20 days; initial body temperature was 38 3 ± 0 6 ℃; maximum body temperature was 39 2 ± 0 6 ℃; and persistent fever was 90 ± 4 2 d. The main symptoms are fatigue, cough, a small amount of expectoration, chills, headache, body aches, myalgia. X-ray showed lung lesions in both sides, mainly in the lower lung field. 6 7 7% of patients with peripheral white blood cell count decreased. The minimum oxygen saturation of nasal cannula was (94 8 ± 3 1)% under oxygen inhalation. Methylprednisolone was used in 68.8% of the patients, with an initial dose of (62 7 ± 2 8 2) mg / d, a maximum dose of (82 4 ± 30 5) mg / d and a sustained use time of 49 ± 2 4 d. 95 cases were cured (99 0%), hospitalization time 8 ~ 47d. Conclusion The incidence of SARS can be collected in hospital, the incidence of acute and rapid progress, X-ray showed mainly bilateral lung involvement, including the timely use of glucocorticoids, antibiotics, gamma globulin, alpha interferon, antiviral drugs Combined treatment, etc. may help to reduce the disease or shorten the course of the disease.