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2003年春季广州190例非典型肺炎暴发的临床分析

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

作者信息

Zhao Zi-wen, Zhang Fu-chun, Xu Min, Huang Kan, Zhong Wei-nong, Cai Wei-ping, Yin Chi-biao, Huang Shao-dan, Deng Zhe-tong, Wei Min

机构信息

Guangzhou Municipal First People's Hospital, Guangzhou 510180, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2003 May 10;83(9):713-8.

Abstract

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.

摘要

目的

研究非典型肺炎(严重急性呼吸综合征)的诊断和治疗方法,以及2003年1月至3月广州该病的疫情情况。

方法

对190例非典型肺炎病例进行分析,这些病例均收治于广州市第一人民医院和广州市第八人民医院。

结果

患者通过密切接触相互感染。所有患者均表现为高热,并伴有呼吸困难、咳嗽、心悸、乏力、头痛和头晕。另外46例伴有腹泻。多数患者肺部体征阴性。胸部X线检查,肺部阴影初期较淡,在5至10天内可缓慢或突然加重。其中36例发展为急性呼吸窘迫综合征(ARDS),11例因严重ARDS死亡。使用普通抗生素对该病无效。当患者中毒症状严重且肺部阴影逐渐增多时,需要持续气道正压通气(CPAP)和糖皮质激素来控制病情。

结论

该病传染性强,通过呼吸道传播。使用普通抗生素对该病无效。持续气道正压通气(CPAP)和糖皮质激素对控制该病有效。

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