38例重症SARS患者临床救治回顾分析

目的：探讨ICU救治重症严重急性呼吸综合征(SARS)患者的临床特点以及经验。方法：回顾分析2002年12月一2003年4月38例入住ICU救治的重症SARS患者的临床资料。初步分析治疗与预后的因果关系。结果：38例重症SARS患者中，合并有基础疾病者8例(21．1％)。起病初期均给予抗病毒对症支持和器官保护治疗，发展至重症阶段均给予抗生素、糖皮质激素抗炎、营养支持、免疫调节、人工通气辅助等治疗措施。30例最终病愈出院(78．9％)，其中ll例出院时X线胸片示有轻微的肺纤维化改变(36．7％，11／30)；8例死亡(病死率21．1％)。结论：重症SARS病情发展迅速，除了提倡早诊断、早隔离、早治疗外，合理使用糖皮质激素和人工通气辅助效果理想。

Clinical therapy of severe acute respiratory syndrome: 38 cases retrospective analysis

Objective: To analyze the clinical features and therapy experience of severe acute respiratory syndrome (SARS). Methods: From December 2002 to April 2003 in Guangzhou Institute of Respiratory Disease, 38 patients with severe SARS were retrospectively studied to evaluate the relationship between treatment strategy and prognosis.Results: Thirtyeight cases of severe SARS were diagnosed. Comprehensive measures most commonly included corticosteroids, antibiotics, antivirotics, nutritional support and mechanical ventilation. Thirty cases were cured (78 9%), of them 11 cases had pulmonary fibrosis(36 7%), 8 patients died(21 1%) in all cases. Conclusion: Severe SARS might develop rapidly. In addition to early diagnosis, prompt isolation, and emergency therapy,appropriate use of corticosteroid and noninvasive ventilation should be recommended.