四川省首发六例人感染H7N9禽流感重症患者的临床特征分析

发布时间：2018-05-05 17:31

本文选题：人感染HN禽流感 + 重症肺炎　；参考：《中国呼吸与危重监护杂志》2017年02期

【摘要】：目的分析人感染H7N9禽流感重症患者的临床特征,以期总结出适合基层医院实施的早期诊断、早期治疗方案。方法搜集6例人感染H7N9禽流感重症患者发病初期的临床症状、实验室检验结果、影像学资料以及在各级医院的诊疗经过,找出其共有的临床特征。结果 6例患者均有禽类接触史,临床表现为发热、咳嗽、咳痰等症状;血常规中白细胞和(或)淋巴细胞计数显著降低,血小板计数降低,血生化中血磷、血钙均降低;胸部CT检查均提示以下肺为主、双肺受累、进展迅猛的渗出和实变病灶,以及不同程度的胸腔积液;初期的常规抗感染治疗均无效。结论人感染H7N9禽流感重症患者具有高热、咳嗽的症状,特征性的白细胞、淋巴细胞计数降低,迅猛进展的病情变化,典型的CT影像特征,以及禽类接触史。这些临床特征和流行病学史有助于早期诊断、早期治疗。
[Abstract]:Objective to analyze the clinical features of severe cases infected with H7N9 avian influenza in order to summarize the early diagnosis and treatment scheme suitable for primary hospital. Methods the clinical symptoms, laboratory results, imaging data and diagnosis and treatment in all levels of hospitals were collected from 6 patients with H7N9 avian influenza in the early stage of the disease, and the common clinical characteristics were found out. Results all of the 6 patients had a history of poultry contact, the clinical manifestations were fever, cough, expectoration and other symptoms, the white blood cell and / or lymphocyte counts in routine blood examination were significantly decreased, the platelet count was decreased, the blood phosphorus and calcium in blood biochemistry were all decreased. Chest CT examination showed that the following lungs were predominant, bilateral lung involvement, rapidly progressive exudate and solid lesions, and pleural effusion of varying degrees, but the initial routine anti-infective therapy was ineffective. Conclusion severe patients with human H7N9 avian influenza have high fever, cough, characteristic white blood cell, lymphocyte count, rapid progression of disease, typical CT imaging features, and poultry contact history. These clinical features and epidemiological history contribute to early diagnosis and treatment.
【作者单位】：遂宁市中心医院;遂宁市第一人民医院;遂宁市中医院;四川大学华西医院呼吸与危重医学科;
【分类号】：R511.7

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