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目的 探讨广州地区暴发流行的传染性非典型肺炎的诊断和治疗方法。方法 对2 0 0 3年 1～ 3月广州地区发病的 190例典型的非典型肺炎病人的临床特点、治疗效果进行了分析。结果 190例病人均以高热起病 ,近距离接触过传染源 ,潜伏期 2～ 15d ,175例病人伴有呼吸困难、咳嗽、心悸、乏力、头痛头晕 ,伴腹泻 4 6例 (2 4 .2 % )。 133例病人肺部无明显体征 ,胸部X线片浸润性阴影在病程初期较轻 ,1周内逐渐或突然加重 ,其中波及两个肺野 93例 ,两肺弥漫性渗出阴影 36例。 36例发展为急性呼吸窘迫综合征 (ARDS) ,死亡 11例。常规抗感染治疗无效 ,中毒症状明显和肺部阴影扩散时 ,及时应用持续气道正压通气 (CPAP)和皮质激素可有效控制病情发展。结论 本病传染性强 ,主要经呼吸道传播 ,常规抗感染治疗无效。肺部阴影增多和呼吸困难加重时 ,及时应用CPAP和皮质激素是有效的治疗方法。
Objective To investigate the diagnosis and treatment of SARS outbreak in Guangzhou. Methods The clinical features and therapeutic effects of 190 cases of typical atypical pneumonia in Guangzhou from January to March in 2003 were analyzed. Results Totally 190 patients were exposed to high fever with a latent period of 2 ~ 15 days. 175 patients were accompanied by dyspnea, cough, heart palpitations, fatigue, headache and dizziness, 46 cases with diarrhea (24.2% ). There were no obvious signs in the lungs of 133 patients. The invasive thoracic X-ray shadow was lighter during the early course of the disease and gradually or abruptly increased within one week. Of these, 93 cases were affected in both lung fields and 36 diffusely exudative shadows in both lungs. 36 cases developed acute respiratory distress syndrome (ARDS), 11 died. Routine anti-infective therapy is ineffective, obvious symptoms of poisoning and lung shadow spread, the timely application of continuous positive airway pressure (CPAP) and corticosteroids can effectively control the progression of the disease. Conclusion The disease is contagious and mainly spreads through the respiratory tract. Conventional anti-infective therapy is ineffective. Increased lung shadow and increased breathing difficulties, the timely application of CPAP and corticosteroids is an effective treatment.