甲型H1N1流感并发肺部感染85例临床分析

目的 了解甲型H1N1流感并发肺部感染的临床特征,提高临床医师对本病的认识.方法 回顾性分析我院2009年8月1日至2009年12月31日收治的85例甲型H1N1流感合并肺部感染确诊病例资料.结果85例患者中,56例为学生,11例有明确接触史.昆明地区79例,其余6例分别来自于3个县.临床主要表现为流感样症状,包括发热(85例)、咳嗽(85例)、咽痛(67例)等.体征包括咽部充血(82例)、扁桃体肿大(79例)、双肺呼吸音粗或可闻及干、湿性啰音(85例)等.外周血WBC偏低51例,占60.0%.胸部CT或X线检查主要表现为肺纹理增粗、支气管炎、支周炎、肺炎、胸腔积液、胸膜增厚.治疗首选奥司他韦(达菲),未见不良反应,多数患者可以耐受.结论 新型甲型H1N1流感传染性强,合并肺部感染时症状加重,易发展成重症,应引起临床医师的高度重视.

Clinical analysis of 85 cases of A(H1N1)influenza complicated with pulmonary infection

Objective To understand clinical features of A(H1N1)influenza complicated with pulmonary infec-tion,improve the clinicians a better understanding of this disease.Methods The data of 85 A(H1N1)influenza cases with pulmonary infection from August 1st 2009 to December 31st 2009 in our hospital were analyzed retrospetively.Results Of the 85 cases,56 cases were students,11 cases had a clear exposure history.79 cases were from Kunming,the remain cases were from three counties.The main clinical manifestations of influenza-like symptoms included fever(85cases),cough(85cases),sore throat(67 cases).Signs included throat congestion(82 cases),swollen tonsils(79 cases),lungs or audible breath sounds coarse and dry,moist tales(85 cases)and so on.The total number of peripheral blood WBC in 51 cases was low.Chest CT or X-ray showed lung markings mainly thickening,bronchitis,pneumonia,pleural effusion,pleural thickening.Oseltamivir treatment was the first choice,rare adverse reactions,most patients could be tolerated.Conclusions This new A(H1N1)influenza was highly contagious,the cases with pulmonary infection were severe and the mortality increased,clinicians should pay much attention.