不同严重急性呼吸综合征疗法的疗效评价

目的　评价不同疗法的治疗效果,为严重急性呼吸综合征(SARS)的正确治疗提供理论依据。方法　以2 0 0 3年3月至6月太原市收治的30 4例SARS患者为对象,比较分析三种疗法(甲组采用抗生素+抗病毒药治疗;乙组采用抗生素+抗病毒药+糖皮质激素治疗;丙组采用抗生素+抗病毒药+糖皮质激素+营养支持疗法治疗)。抗生素包括大环内酯类、喹诺酮类及头孢类;抗病毒药包括病毒唑、更昔洛韦(ganciclovir)、鱼腥草及清开灵;糖皮质激素包括甲泼尼龙(methylprednisokne)、地塞米松及氢化可的松(hydrocortisone)。营养疗法包括白蛋白、静脉高营养、输注血浆及全血)的发热持续时间、胸片转归情况、出院情况及住院时间等多项指标,并进行统计学分析。结果　三组发热持续时间分别为(6±4 )d、(4±3)d和(5±3)d(P =0 .13)。胸片吸收率分别为87. 9%、80 .0 %和74 .3% (P =0 . 0 3)。出院好转率分别为10 0 %、94 . 8%和86 . 8% (P <0 . 0 1)。住院时间分别为(2 2±7)d、(30±11)d和(31±12 )d(P <0 . 0 1)。结论　在疾病早期使用抗生素和抗病毒药,不仅可预防感染发生,且对降低体温,改善症状也有效。但对年龄偏大,伴有合并症的患者,加糖皮质激素治疗可取得满意的疗效。

Evaluating the effects of different treatments on severe acute respiratory syndrome

Objective To evaluate effect of three different t reatments and offer theoretic foundation for treating severe acute respiratory s yndrome (SARS).Methods Three hundreds and four SARS patients ho spitalized during the period of March to June 2003 in Taiyuan were studied.Stati stical analysis using software SAS 8.0 was employed to compare fever duration ti me.X-ray outcomes,curing outcomes and hospital stay among the three different t reatments.Results Fever duration time of three treatments was ( 6±4) days,(4±3) days and (5±3) days respectively (P=0 13).X-ray outcomes were 87.9%,80.0% and 74.3% respectively (P=0.03).Curing outcomes were 100%,94.8% and 86.8% respectively (P<0.01).Hospital s tay was (22±7) days,(30±11) days and (31±12) days respectively (P<0.01 ).Conclusion It can not only prevent the occurrence of infeclions ,but also bring down the body temperature and relieve the symptoms to use antibi otics and antivirus medications at the early stage of the disease.It is also eff ective to use cortisone in some old patients who have complications.