重症甲型H1N1流感78例临床体会.doc

重症甲型H1N1流感78例临床体会 张宏伟，李侗曾，姜太一，吴昊 首都医科大学附属北京佑安医院感染中心，北京 100069 通讯作者：吴昊，email：whdoc900@ 【摘要】 目的 探讨甲型H1N1流感重症病例的临床特点及诊疗体会。方法 回顾性分析北京佑安医院2009年6月至2010年1月收治的78例甲型H1N1流感危重病例，总结和讨论临床表现、实验室检查及影像学资料方面的特点。结果 重症病例的潜伏期平均为2.1天，范围1-7天，主要表现为发热、咽红、咳嗽，大多合并肺炎。年龄较大和伴有基础疾病者死亡率较高。X线胸片可见肺部单侧或双侧斑片影。结论 重症甲型H1N1流感病情凶险，病死率较高，应当密切关注年龄较大和伴有基础疾病的患者，及时给予抗病毒治疗。 【关键词】 甲型H1N1流感；病毒感染；临床分析 Clinical experience of 78 cases of severe Influenza A H1N1 ZHANG Hong-wei, LI Tong-zeng, JIANG Tai-yi, WU Hao Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China Corresponding author: WU Hao, Email: whdoc900@ 【Abstract】 Objective To investigate clinical features and treatment experience of severe cases of influenza A H1N1. Methods A retrospective analysis of 78 severe cases of influenza A H1N1 admitted in Beijing Youan Hospital from June 2009 to January 2010 were performed. Clinical manifestations, laboratory tests and imaging characteristics were summarized and discussed. Results The mean value of incubation period of severe cases was 2.1 days (range 1-7 days). The main clinical manifestations were fever, red throat and cough, mostly complicated with pneumonia. The mortality is higher in the elders and patients with underlying diseases. Chest X-ray showed unilateral or bilateral patchy shadows in lungs. Conclusion Severe influenza A H1N1 is a dangerous illness with high mortality. Close attention should be payed to the elder and patients with underlying diseases. It is important to take antiviral treatment in time. 【Keyword】 influenza A H1N1; virus infection; clinical analysis 2009年3月甲型H1N1流感，。甲型H1N1流感诊疗方案(2009年第三版)1.3 方法 整理归纳相关临床资料, 对临床表现，实验室检查，治疗和转归进行分析和评估。 1.4 统计方法 统计描述采用平均值±标准差，或百分比表示。 2．结果 2.1 一般情况 78例重症患者中男41例，女37例，男女比例约为1.11:1。本组患者中40例有明确的甲型H1N1流感患者接触史，从接触到发病的平均时间为2.1天(范围1～7天)，一些患者为散发病例，无明确的甲型H1N1流感接触史。从发病到就诊的中位时间为6天(范围2～11天)。重症病例主要发生于2009年10月至2010年1月，危重病例主要分布于15～50岁，死亡病例主要分布于50岁以上的患者。 2.2 临床表现 我们观察了发热、咳嗽、咽痛、乏力、恶心、呕吐、畏寒、寒战、鼻塞、流涕、头痛、肌痛、腹泻、腹痛、咽红和扁桃体肿大等症状和