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目的探讨SARS的临床特征。方法对广州市某SARS定点医院128例SARS住院病例的性别、年龄分布、接触史、症状、体征、实验室检查、影像学特点、并发症、治疗与预后等进行系统分析。结果本组患者平均年龄37.6±14.5岁,男性54例,女性74例,69例(53.9%)有SARS病人接触史,3例有明确的野生动物接触史;入院前平均病程为5.79±5.56d;入院时主要症状为发热(123例,96.1%)、咳嗽(74例,57.8%)、全身酸痛(26例,20.3%)、呼吸困难(12例,9.4%)和腹泻(10例,7.8%)等;实验室检查见白细胞计数低下(35例,27.3%)、肝功能ALT异常升高(35例,27.3%)、心肌酶CK异常升高(26例,20.3%)和肾功能Cr异常升高(3例,2.3%)。胸片显示89.1%(114例)的病例在入院时可发现肺部病灶,X线主要表现为渗出性病变,显示为淡薄云雾状或片状的浸润阴影,平均累积肺叶数为2.12±1.27;31.3%(40例)出现并发症;经过系统治疗,63.3%(81例)的病例在住院后10d内病灶已开始吸收。平均住院天数为20.73±11.68d。119例(93%)康复出院,9例死亡,病死率7%;22.7%(29例)出院时胸片仍显示存在纤维化病灶。结论SARS的临床特点主要表现为发热、咳嗽、全身酸痛、白细胞计数偏低、易累及心、肝、肾等脏器,胸片主要为片絮状阴影,经治疗多数病例预后良好,但要注意肺部的残留纤维化。
Objective To investigate the clinical features of SARS. Methods The sex, age distribution, history of exposure, symptoms, signs, laboratory tests, imaging features, complications, treatment and prognosis of 128 cases of SARS in a designated hospital of SARS in Guangzhou were systematically analyzed. Results The average age of patients in this group was 37.6 ± 14.5 years. There were 54 males and 74 females, including 69 cases (53.9%) with history of exposure to SARS and 3 cases with clear history of exposure to wildlife. The average duration of pre-hospital admission was 5.79 ± 5.56 days (123 cases, 96.1%), cough (74 cases, 57.8%), body aches (26 cases, 20.3%), dyspnea (12 cases, 9.4%) and diarrhea (35 cases, 27.3%), abnormal ALT of liver function (35 cases, 27.3%), abnormal CK (26 cases, 20.3%) and renal function Cr Abnormal increase (3 cases, 2.3%). Chest radiographs showed that lung lesions were found in 89.1% (114 cases) of patients admitted to hospital. The X-ray showed mainly exudative lesions, showing as light cloud or patchy infiltrating shadow with an average of 2.12 ± 1.27 ; 31.3% (40 cases) had complications; after systematic treatment, 63.3% (81 cases) of the cases had their lesions started to absorb within 10 days after hospitalization. The average hospital stay was 20.73 ± 11.68 days. 119 cases (93%) recovered and discharged, 9 died, the case fatality rate was 7%; 22.7% (29 cases) still showed fibrosis lesions on discharge. Conclusions The main clinical manifestations of SARS are fever, cough, body aches and pains, low white blood cell count, easy to affect the heart, liver, kidney and other organs. The chest radiographs are mainly flaky shadows. The prognosis of most cases is good, Pulmonary remnant fibrosis.