Gupta Pratyush, Trikha Anjan
Department of Anaesthesiology and Intensive Care, All India Institute of Medical Sciences, New Delhi 110029, India.
Trans R Soc Trop Med Hyg. 2008 Feb;102(2):143-7. doi: 10.1016/j.trstmh.2007.11.002.
Dengue fever (DF), dengue haemorrhagic fever (DHF) and dengue shock syndrome (DSS) have emerged as public health problems of international concern. During a dengue outbreak in north India in October 2006, more than 10000 patients presented to hospital with fever. We retrospectively analysed the presenting features, treatment given and the outcome of patients admitted to the Intensive Care Unit (ICU), All India Institute of Medical Sciences (AIIMS): a tertiary care hospital in New Delhi. A total of 72 critically ill patients were referred for admission to the ICU. The common symptoms were fever (100%), myalgia (40%) and gastrointestinal bleed. Menorrhagia and haematuria were seen as the sole presenting features in many females. Treatment consisted of bed rest, oxygen therapy, intensive monitoring, antipyretics, platelet transfusions, hydration and electrolyte correction. On average, six units of platelets were required per patient. The average duration of stay in the ICU was 3 d. There were eight deaths. Adequate hydration and platelet replacement with transfusions, especially apheresis platelets to a target level above 60000 platelets/mm3, were effective means of combating the disease.
登革热(DF)、登革出血热(DHF)和登革休克综合征(DSS)已成为国际关注的公共卫生问题。在2006年10月印度北部的一次登革热疫情期间,超过10000名发热患者前往医院就诊。我们回顾性分析了全印度医学科学研究所(AIIMS)——新德里一家三级护理医院重症监护病房(ICU)收治患者的临床表现、治疗情况及预后。共有72名重症患者被转诊至ICU。常见症状为发热(100%)、肌痛(40%)和胃肠道出血。许多女性患者的唯一临床表现为月经过多和血尿。治疗包括卧床休息、氧疗、密切监测、使用退烧药、输注血小板、补液及纠正电解质。每位患者平均需要输注六个单位的血小板。患者在ICU的平均住院时间为3天。有8例死亡病例。充分补液及通过输血,尤其是单采血小板将血小板水平提升至60000/立方毫米以上进行血小板替代,是对抗该疾病的有效手段。