甲型H1N1流感病毒性肺炎并发Ⅰ型呼吸衰竭伴2型糖尿病3例诊治分析

发布时间：2018-01-29 05:29

  本文关键词： 病毒性肺炎 甲型HN流感病毒 Ⅰ型呼吸衰竭 型糖尿病 奥司他韦 甲强龙 丙种球蛋白　出处：《山东医药》2017年34期 　论文类型：期刊论文

【摘要】：目的总结甲型H1N1流感病毒性肺炎并发Ⅰ型呼吸衰竭伴2型糖尿病的诊治经验。方法回顾性分析3例H1N1病毒性肺炎患者的临床资料,分析诊断治疗过程。结果 3例患者均伴有2型糖尿病,以高热、咳嗽入院;患者病情进展迅速,很快出现胸闷憋气症状,血氧饱和度下降,抗感染治疗效果差;血常规淋巴细胞比例均呈下降趋势,淋巴细胞计数减少;血气分析提示,Ⅰ型呼吸衰竭;胸部CT双肺出现广泛渗出性病变,以肺实变为主,影像学呈多样性。考虑病毒性肺炎,及早给予奥司他韦、甲强龙、丙种球蛋白及高流量面罩吸氧、抗感染、补液、降糖等综合治疗后,患者病情好转,影像学检查减轻,疾控中心呼吸道分泌物病毒学检测为甲型H1N1病毒。结论对高热、咳嗽、肺内湿Up音、胸部CT示病灶明显且白细胞及中性粒细胞不高的2型糖尿病患者,在无病毒学诊断依据情况下,及早行以抗病毒为主的综合治疗可达到较好疗效。
[Abstract]:Objective to summarize the experience in diagnosis and treatment of patients with type 2 diabetes H1N1 influenza virus pneumonia complicated with type I respiratory failure. Methods a retrospective analysis of the clinical data of 3 cases of H1N1 patients with viral pneumonia, analysis of the process of diagnosis and treatment. Results 3 patients with type 2 diabetes, high fever, cough into hospital; patients with rapid progression, it is fast emergence of chest distress symptoms, decreased oxygen saturation, anti infection and poor treatment effect; blood lymphocyte ratio decreased, lymphocyte count decreased; blood gas analysis showed that type I respiratory failure; chest CT lungs extensive exudative lesions, with pulmonary consolidation, imaging showed diversity. Considering the viral pneumonia in order to oseltamivir, methylprednisolone, gamma globulin and high flow oxygen mask, anti infection, rehydration, hypoglycemic and other comprehensive treatment, the patient's condition improved, imaging examination to reduce respiratory tract, CDC Virological testing for influenza H1N1 virus secretion. Conclusion high fever, cough, lung wet Up, chest CT showed lesions significantly and white blood cells and neutrophils in patients with type 2 diabetes is not high, in the absence of virological diagnosis cases, comprehensive treatment and early antiviral based can achieve good curative effect.

【作者单位】： 山东中医药大学第二附属医院;
【分类号】：R511.7;R563.8;R587.1
【正文快照】： 甲型H1N1流感是一种呼吸道疾病,极易出现肺炎等肺部并发症,致死率极高。目前,血清及痰液中分离培养并鉴定病毒是诊断的金标准[1],但是检测周期≥72 h,延误早期抗病毒治疗,不利于改善患者预后[2]。因此,能否依据患者的临床表现、影像学特点以及实验室检查等早期检测考虑甲型H1N，

本文编号：1472660