新型冠状病毒肺炎重型患者临床特征分析

目的:回顾性分析12例新型冠状病毒肺炎(COVID-19)重型患者的临床特征,总结诊治经验。方法:选取2020年1月到2020年2月在我院隔离3区收治的12例COVID-19重型患者为研究对象,通过观察临床症状、血常规淋巴细胞计数、氧合指数、肝肾功能、胸部CT的动态变化,分析其临床特征。结果:重型患者症状主要为发热(11例)、干咳(12例)、呼吸困难(9例)、乏力(11例)、纳差(11例);患者淋巴细胞计数绝对值明显下降,最低值(0.66±0.23)×10^9/L,持续(12.09±5.91)d;氧合指数下降明显,最低至(166.08±59.50)mmHg(1 mmHg=0.133 kPa),300 mmHg以下持续(10.00±4.95)d。早期胸部CT显示,双肺呈多叶多发斑片或片状磨玻璃;进展期阴影范围增多,部分实变,少数伴胸水;恢复期66.67%患者出现纤维条索影。结论:血常规淋巴细胞计数、氧合指数、早期胸部CT表现均为COVID-19重型患者诊断的重要指标,对早期诊治意义重大。

Clinical characteristics analysis of severe novel coronavirus pneumonia cases

Objective: To guide clinical diagnosis prediction and treatment by analyzing the clinical characteristics of 12 patients with severe novel coronavirus pneumonia (COVID-19) retrospectively. Methods: 12 patients with severe COVID-19, who were treated in the third isolation area of Guangzhou Eighth People''s Hospital from Janunary to February 2020 were selected. Dynamic changes of clinical symptoms, routine blood test of lymphocyte count, oxygenation index, liver and kidney function, and chest CT were observed to analyze its clinical characteristics. Results: 11 severe COVID-19 patients had fever, 12 cases coughed, 9 cases with dyspnea, 11 cases with fatigue, and 11 cases of anorexia. The absolute value of lymphocytes in severe COVID-19 patients decreased significantly. The lowest value was (0.66±0.23)×10⁹/L, which lasted for (12.09±5.91) days. The oxygenation index decreased significantly, its lowest value was (166.08±59.05) mmHg(1 mmHg=0.133 kPa), and the oxygenation index below 300 mmHg lasted for (10.00±4.95) days. Early chest CT showed multi-lobed with multiple patches or ground glass in both lungs. The range of the image increased as the disease progressed, the lungs were partially consolidated, a few with pleural effusion. Chest CT image showed that 66.67% patients in the recovery period with fiber strands image. Conclusions: Blood routine lymphocyte value, oxygenation index value, and early chest CT characteristics represent the important indicators for the patients with severe COVID-19, and are of great significance in early treatment for severe COVID-19 patients.