广州地区2003年春季传染性非典型肺炎190例临床分析

目的 探讨广州地区暴发流行的传染性非典型肺炎的诊断和治疗方法。方法 对2003年1～3月广州地区发病的190例典型的非典型肺炎病人的临床特点、治疗效果进行了分析。结果 190例病人均以高热起病,近距离接触过传染源,潜伏期2～15d,175例病人伴有呼吸困难、咳嗽、心悸、乏力、头痛头晕,伴腹泻46例(24．2％)。133例病人肺部无明显体征,胸部X线片浸润性阴影在病程初期较轻,1周内逐渐或突然加重,其中波及两个肺野93例,两肺弥漫性渗出阴影36例。36例发展为急性呼吸窘迫综合征(ARDS),死亡11例。常规抗感染治疗无效,中毒症状明显和肺部阴影扩散时,及时应用持续气道正压通气(CPAP)和皮质激素可有效控制病情发展。结论 本病传染性强,主要经呼吸道传播,常规抗感染治疗无效。肺部阴影增多和呼吸困难加重时,及时应用CPAP和皮质激素是有效的治疗方法。

Clinical analysis of 190 cases of outbreak with atypical pneumonia in Guangzhou in spring, 2003

OBJECTIVE: To study methods of diagnosis and treatment for atypical pneumonia (Severe Acute Respiratory Syndrome), outbreak of the illness in Guangzhou during Jan. - Mar., 2003. METHODS: 190 cases with atypical pneumonia were analyzed, and the cases were admitted in Guangzhou municipal First Hospital and Guangzhou municipal Eighth Hospital. RESULTS: Patients were infected by close quarters contacting each other. All patients manifest high fever, and accompany by dyspnea, cough, palpitate, weakness, headache and swirl. Other 46 cases were accompanied by diarrhea. Most of patients, manifestation of lungs was negative. Chest X-ray, shadow of lungs were light in beginning, and change to severity slowly or suddenly during 5 - 10 days. Of these cases, 36 cases develop to ARDS and 11 cases died with severity ARDS. Using general antibiotic was of no effect for the illness. Continual positive airway pressure (CPAP) and glucocorticoid was required that can control deprivation of the disease when toxicosis symptom of patients was severity and shadow of lungs diffuse more and more. CONCLUSION: Infectivity of the illness is evidence and spread by airway. Using general antibiotic was of no effect for the illness. Continual positive airway pressure (CPAP) and glucocorticoid are effective for control of the disease.