严重急性呼吸综合征14例临床回顾分析

目的回顾性分析严重急性呼吸综合征 (SARS)的临床特征及治疗。方法在SARS流行期间对疑似患者早期隔离治疗 ,动态观察其临床症状、体征和胸部影像学变化 ;对明确诊断的 14例患者全部采用中西医结合的综合治疗措施 ;对 3例重型患者及时实施纤支镜引导下经鼻气管插管 ,低潮气量、高呼气末正压的通气策略。结果 14例SARS患者全部治愈出院。随访 6个月仅2例患者遗留轻度肺纤维化。所有参与救治的全部医务人员及患者家属无人被传染。结论对患者进行早期隔离、早期诊断、采取中西医结合的综合治疗措施以及对重症患者及时实施机械通气治疗都是成功救治SARS的重要因素。

Retrospective clinical analysis of 14 cases with svere acute respiratory syndrome

ObjectiveTo analyze the clinical characteristics and treatment of severe acute respiratory syndrome (SARS).MethodsDuring epidemic period of SARS,all suspected patients were isolated and treated at very early stage. Clinical symptoms, signs and changes of the chest film were observed carefully to make early diagnosis and begin early intervention. 14 SARS cases with definite diagnosis were treated by Western Medicine combined with Chinese Traditional Medicine.3 cases of them with severe type were treated by timely technical ventilation,which was nasotracheal intubition guided with fibronchoscope,with the principle of low tide volume and high PEEP to improve oxygen combination.ResultsAll patients were cured to discharge. Only two cases of mild pulmonary fibrosis were found after 2 months' follow-up. None of the medical workers taking part in rescuing and treating SARS patients and none of the family members of the patients were infected.ConclusionDuring SARS epidemic period,early isolation,early diagnosis,early combined treatment of Western Medicine and Chinese Traditional Medicine,and prompt technical ventilation intervention on severe cases are important factors to successfully rescue and treat SARS patients.