河南新县新型冠状病毒肺炎临床特点及诊断困难患者的诊疗策略

目的分析河南新县11例新型冠状病毒肺炎患者的临床特点及诊断困难患者的诊疗策略,从而为全球疫情防控及临床诊疗提供依据。方法对2020年1月31日至2月26日期间在河南新县定点救治医院收治的11例新型冠状病毒肺炎患者的流行病学、临床表现、诊断及治疗等情况进行梳理,并提出诊疗应对策略。结果11例患者中明确有直接或间接疫区接触史的9例,无明确疫区接触史者2例;聚集性发病者8例,非聚集性发病者3例。诊断依靠流行病学史、临床表现综合分析,最终经咽拭子核酸检测确诊,其中3例在诊断上具有一定难度。治疗上9例依据诊疗方案进行抗病毒治疗,2例应用新型抗病毒药物治疗。11例患者中1例危重型患者经治疗稳定后转上级医院进一步治疗,其余10例均治愈出院。结论综合患者的流行病学史、提高胸部影像学检查的诊断参考分量、扩大咽拭子核酸检测的普及面、加快新型确诊检测手段以及抗病毒药物的研发推广力度可能对目前全球疫情防控形势下新型冠状病毒肺炎患者的临床诊疗提供帮助。

Clinical characteristics of novel coronavirus pneumonia in Xinxian county,Henan province and diagnosis and treatment strategies for patients with difficult diagnosis

【Objective】To analyze the clinical characteristics among 11 patients with COVID-19 at Xinxian county,Henan province,and strategies for diagnosis and treatment among patients difficult to be diagnosed,so as to support global epidemic prevention and control,as well as relevant clinical diagnosis.【Methods】The epidemiology,clinical manifestations,diagnosis and treatment among 11 patients with COVID-19 admitted to the designated hospital of Xinxian county,Henan province between January 31,2020 and February 26,2020 were reviewed,and relevant strategies for diagnosis and treatment were proposed.【Results】Among the 11 cases,9 cases had definite direct or indirect contact history,while 2 cases had no definite contact history,and 8 cases belonged to clustering onset,while 3 non-clustering onset.The diagnosis relied on a comprehensive analysis for epidemiological history and clinical manifestations,and the final diagnosis was confirmed by the nucleic acid test of pharyngeal swab.Among them,3 cases were difficult to diagnose,9 cases were treated by antiviral therapy according to the treatment plan,while 2 cases were treated with novel antiviral drugs.Among the 11 cases,there was one critical case transferred to a hospital at a higher level for further treatment after stable,and the remaining 10 cases were cured and discharged there.【Conclusion】Comprehensively analyzing on epidemiological history of the patients,more considering the diagnostic reference component of chest imaging,popularizing the nucleic acid detection of pharynx swabs,and accelerating development of new diagnosis methods and antiviral drugs,may conduce to clinical diagnosis and treatment of COVID-19 patients under current global epidemic prevention and control situation.