3例危重型新型冠状病毒肺炎患者临床分析

目的 分析海南省人民医院成功诊治的3例危重型新型冠状病毒肺炎（coronavirus disease 2019,COVID-19）的临床特征及治疗,为诊治危重型COVID-19患者提供科学依据。方法 对2020年1月底至2月初成功救治的3例危重型COVID-19患者进行回顾性分析。结果 3例患者中,男性2例,女性1例,平均年龄42岁。2例为二代病例,1例为本土病例。平均住院天数16.67 d,发病初期均有发热,2例有咳嗽,进展期出现重症肺炎。2例患者白细胞计数正常,1例白细胞计数、中性粒细胞计数减少,2例中性粒细胞计数升高,3例淋巴细胞计数减少, C-反应蛋白升高,恢复期淋巴细胞计数恢复正常。患者胸部影像学提示双肺渗出影、部分实变及磨玻璃影。入院后经积极抗病毒、抗感染、免疫调节、营养支持、CRRT、机械通气结合中医调理,全部康复出院。结论 危重型COVID-19患者病情进展快,病程中合并多种并发症,早期诊断并及时综合支持治疗是治疗成功的关键。

Clinical analysis of 3 patients with severe COVID-19

Objective The clinical characteristics and treatment of 3 patients with severe coronavirus disease 2019 (COVID-19) successfully treated by Hainan Provincial People's Hospital were analyzed to provide scientific basis for diagnosis and treatment of patients with severe COVID-19. Methods A retrospective analysis was conducted of 3 patients with severe COVID-19 admitted from the end of January to early February 2020. Results The 3 patients enrolled, including 2 male and 1 female, with an average age of 42 years. 2 were second-generation cases, 1 was a native case.The average hospital stay was 16.67 d. All patients had fever in the early stage, 2 cases had cough, and severe pneumonia appeared in the advanced stage.Two patients had normal white blood cell counts, one had a decreased white blood cell count and neutrophil count, two patients had a high neutrophil count, and three patients had a decreased lymphocyte count, and an increase in C-reactive protein. The lymphocyte count returned to normal during the recovery period.The patient's chest imaging revealed bilateral lung exudation, partial consolidation, and ground glass.All the patients were recovered and discharged after active antiviral, anti-inflammatory, immune regulation, nutritional support, CRRT, mechanical ventilation combined with traditional Chinese and Western medicine. Conclusion The critical condition of COVID-19 patients progresses rapidly, with multiple complications in the course of the disease, and early diagnosis and timely comprehensive support treatment are the keys to successful treatment.