Division of Infectious Diseases and Hospital Hygiene, Kantonsspital St. Gallen, St. Gallen, Switzerland.
Swiss Med Wkly. 2010 Jul 15;140:w13069. doi: 10.4414/smw.2010.13069. eCollection 2010.
During the first wave of the A/H1N1v influenza pandemic in Switzerland we followed the disease course of 15 patients with A/H1N1v-associated pneumonia. Oseltamivir treatment was initiated on day seven (median) after onset of symptoms. Of the patients studied 14 had to be hospitalised, with a median hospital stay of 8-9 days; 6 were admitted to intensive care, of whom 3 required intubation. According to WHO recommendations, oseltamivir should be started as early as possible, both in patients with risk factors for severe disease and in any patient presenting with symptoms of progressive disease. If treated early according to these guidelines, half of our patients might not have developed pneumonia at all. In the remaining patients without preexisting risk factors, the clinical course of pneumonia might have been milder. It is questionable whether the delayed oseltamivir treatment still influenced the clinical outcome, but no patient died; the two patients who were discharged with new home oxygen therapy apparatus had presented massive preexisting morbidities.
在瑞士甲型 H1N1v 流感大流行的第一波疫情期间，我们对 15 例甲型 H1N1v 相关肺炎患者的疾病进程进行了跟踪研究。奥司他韦治疗于症状出现后第 7 天（中位数）开始。在研究的患者中，有 14 人需要住院治疗，中位住院时间为 8-9 天；6 人入住重症监护病房，其中 3 人需要插管。根据世卫组织的建议，奥司他韦应尽早开始使用，无论是对有重症疾病风险的患者，还是对任何出现疾病进展症状的患者。如果按照这些指南进行早期治疗，我们一半的患者可能根本不会发生肺炎。在没有预先存在的风险因素的其余患者中，肺炎的临床病程可能较为轻微。奥司他韦治疗的延迟是否仍会影响临床结果尚存疑问，但没有患者死亡；两名出院并带有新的家庭氧气治疗设备的患者患有严重的预先存在的疾病。
