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[医院内严重急性呼吸综合征暴发的临床调查]

[Clinical investigation of outbreak of nosocomial severe acute respiratory syndrome].

作者信息

Gao Zhan-cheng, Zhu Ji-hong, Sun Yan, Ding Xiu-lan, Ma Ji-shun, Cui Yu-xian, Du Xiang-ke, Gao Tong, He Quan-ying

机构信息

Department of Respiratory Medicine, Peking University People's Hospital, Beijing 100044, China.

出版信息

Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2003 Jun;15(6):332-5.

Abstract

OBJECTIVE

To summarize and analyze the clinical manifestation, diagnosis and therapeutic strategy of severe acute respiratory syndrome (SARS), and its characteristics of outbreak in hospital via infection transmission cluster associated with SARS patients.

METHODS

(1) Two hospitalized community acquired SARS cases with their clinical data and epidemiologically linked transmission clusters in our hospital were analyzed; (2) The clinical data from 41 SARS cases were summarized.

RESULTS

(1) The contagiousness of SARS virus in SARS patients was extremely strong, especially in their acute stage. (2) The majority of clinical manifestations were fever (100% cases), and there were no obvious respiratory symptoms in more than half of the patients (53.7%) at early SARS stage (day 1 to day 3), accompanied by leucopenia(52.6%) and lymphopenia (68.4%). (3) Timely administration of Ribavirin, Methylprednisolone, immunoenhancer (such as interferon alpha-2b, thymosin-alpha1) to SARS patients was efficacious to certain extent in controlling the development of the disease.

CONCLUSION

It is very important for clinicians to pay great attention to protect themselves from infection of SARS. Early discovery of SARS, early isolation of SARS patients, and early treatment are very helpful to improving patient's prognosis and controlling SARS overspread.

摘要

目的

总结分析严重急性呼吸综合征(SARS)的临床表现、诊断及治疗策略,以及其在医院内通过与SARS患者相关的感染传播聚集性发病的特点。

方法

(1)分析我院收治的2例社区获得性SARS病例及其临床资料和流行病学关联的传播聚集性情况;(2)总结41例SARS病例的临床资料。

结果

(1)SARS患者体内SARS病毒传染性极强,尤其在急性期。(2)多数临床表现为发热(100%病例),SARS早期(第1天至第3天)超过半数患者(53.7%)无明显呼吸道症状,伴有白细胞减少(52.6%)和淋巴细胞减少(68.4%)。(3)及时给予SARS患者利巴韦林、甲泼尼龙、免疫增强剂(如干扰素α-2b、胸腺肽α1)在一定程度上对控制病情发展有效。

结论

临床医生高度重视预防SARS感染非常重要。早期发现SARS、早期隔离SARS患者及早期治疗对改善患者预后及控制SARS传播非常有帮助。

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