121例成人重症登革热的临床特征及救治体会

发布时间：2018-01-03 21:39

本文关键词：121例成人重症登革热的临床特征及救治体会　出处：《中山大学学报(医学科学版)》2016年03期 　论文类型：期刊论文

【摘要】：【目的】为早期识别及更好地救治重症登革热(SD)提供依据。【方法】对我院2014年收治的121例重症登革热住院患者的临床和实验室资料及救治方案进行回顾性分析。【结果】121例重症登革热患者均为成人,65岁以上老年人占52.1%。常见基础疾病为高血压(36.4%),冠心病(18.2%)和糖尿病(16.5%)。SD发生严重出血者占52.1%,休克者占54.5%。严重器官功能损害者占71.9%,其中并发心肌炎者占46.3%,消化道出血者占21.5%,急性肾功能不全者占19.8%,急性呼吸窘迫综合征(ARDS)者占19%。实验室特征表现为血小板30×109/L者占45.5%,血红蛋白多正常或降低。主要的治疗措施是静脉补液,合并低蛋白血症者输注白蛋白,血小板30×109/L者输注血小板,生命支持治疗等。98.2%患者治愈出院,2例患者死于多器官功能衰竭。【结论】老年人及合并高血压、冠心病及糖尿病等基础疾病是重症登革热的高危因素。急性心肌炎、消化道出血、肾衰、ARDS等严重器官功能损害为SD的主要并发症。早期液体治疗、合理使用血小板及白蛋白等综合救治措施是降低病死率的关键。
[Abstract]:[objective] for early identification and better treatment of severe dengue fever (SDV). [methods] the clinical and laboratory data and treatment plan of 121 severe dengue fever patients admitted in our hospital in 2014 were analyzed retrospectively. [results] 121 patients with severe dengue fever were treated in our hospital. All adults. The common basic diseases were hypertension (36.4%). Patients with severe bleeding, shock and severe organ dysfunction accounted for 52.1%, 54.5% and 71.9% cases respectively. Among them, 46.3% were complicated with myocarditis, 21.5% had gastrointestinal hemorrhage and 19.8% cases had acute renal insufficiency. Acute respiratory distress syndrome (ARDS) was found in 19 patients with ARDS, and in 45.5% patients with 30 脳 10 9 / L platelet in laboratory. The main treatment measures were intravenous fluid infusion, albumin infusion in patients with hypoproteinemia and platelet transfusion in patients with 30 脳 109 / L platelets. Two patients died of multiple organ failure. [conclusion] the elderly and patients with hypertension. Coronary heart disease and diabetes mellitus are high risk factors of severe dengue fever. Acute myocarditis, gastrointestinal hemorrhage, ARDS and other serious organ dysfunction are the main complications of SD. Rational use of platelet and albumin is the key to reduce mortality.
【作者单位】：广州市第八人民医院感染科;
【基金】：广东省科技计划项目(2013A020229002,2013A020229001) 广州市健康医疗协同创新重大专项(201508020263) 广州市科技计划项目(2014Y2-00185)
【分类号】：R512.8
【正文快照】： [J SUN Yat-sen Univ(Med Sci),2016,37(3):333-336]表1 121例重症登革热伴基础疾病情况Table 1 The underlying diseases in 121 severe Dengue casesUnderlying diseasesHypertensionCoronary diseaseDiabetesSteatohepatitisCerebral infarctionChronic liver diseaseChron

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