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为探讨严重急性呼吸综合征(SARS)的临床特征以及治疗与预后,对2003年5月6日至6月27日宣武医院收治的220例SARS患者的临床、实验室、影像学资料,临床治疗及转归进行回顾性分析。结果220例SARS患者年龄7～86岁,平均(41.33±18.40)岁。男性112例(50.9%),女性108例(49.1%)。医务人员33例(15.0%)。有明确接触史148例(67.3%)。并存基础病60例(27.3%)。临床表现发热218例(99.1%),咳嗽144例(65.5%),畏寒64例(29.1%),气促91例(41.4%),胸闷80例(36.4%),肌痛66(30%)。血常规早期白细胞总数正常或降低、淋巴细胞降低。T细胞亚群CD3、CD4、CD8绝对值降低。胸部X线或高分辨率CT早期单侧或双侧局灶性斑片状渗出性改变,影像多变、短期内增多,进展高峰期呈云雾、磨玻璃影或实变影增大。在可分析的145例血气中,低氧血症63例(43.4%)。220例SARS患者发展为急性呼吸窘迫综合征(ARDS)25例(11.4%);使用机械通气31例(14.1%)。201例康复出院,19例死亡,病死率8.64%。早期鼻导管吸氧、进展期合理使用激素及机械通气可阻止病情进展。合理使用抗生素及抗真菌药物可预防及治疗混合感染(细菌、真菌)。提示流行病接触史、发热、白细胞计数正常或减少、淋巴细胞降低、胸部X线或CT显示渗出病灶是诊断SARS的临床依据。年龄、合并基础病、肺?
To investigate the clinical features, treatment and prognosis of severe acute respiratory syndrome (SARS), the clinical, laboratory, imaging and clinical data of 220 SARS patients admitted to Xuanwu Hospital from May 6, 2003 to June 27, 2003 And the outcome of a retrospective analysis. Results The 220 SARS patients were 7 to 86 years old with an average of (41.33 ± 18.40) years. There were 112 males (50.9%) and 108 females (49.1%). 33 medical staff (15.0%). A clear history of exposure to 148 cases (67.3%). Coexistence of basic disease in 60 cases (27.3%). Clinical manifestations were fever in 218 (99.1%), cough in 144 (65.5%), chills in 64 (29.1%), breathlessness in 91 (41.4%), chest tightness in 80 (36.4% ). The total number of normal white blood cells in normal or reduced blood, lymphocytes decreased. T cell subsets CD3, CD4, CD8 absolute value decreased. Chest X-ray or high-resolution CT early unilateral or bilateral focal patchy exudative change, the image changeable, short-term increase, the peak of the progress of the cloud, ground glass or real shadow increases. Of 145 analyzable blood gases, 63 were hypoxemia (43.4%). Twenty-two SARS patients developed 25 cases of acute respiratory distress syndrome (ARDS) (11.4%), and 31 cases (14.1%) received mechanical ventilation. 201 cases were discharged from hospital, 19 died, the case fatality rate was 8.64%. Early nasal catheter oxygen, the rational use of advanced hormones and mechanical ventilation can prevent the progression of the disease. Proper use of antibiotics and antifungal agents can prevent and treat mixed infections (bacteria, fungi). Prompt contact history of epidemics, fever, normal or reduced white blood cell count, lymphopenia, chest X-ray or CT exudation is the clinical diagnosis of SARS. Age, with underlying disease, lung?