论文部分内容阅读
目的 评价不同疗法的治疗效果,为严重急性呼吸综合征(SARS)的正确治疗提供理论依据。方法 以2 0 0 3年3月至6月太原市收治的30 4例SARS患者为对象,比较分析三种疗法(甲组采用抗生素+抗病毒药治疗;乙组采用抗生素+抗病毒药+糖皮质激素治疗;丙组采用抗生素+抗病毒药+糖皮质激素+营养支持疗法治疗)。抗生素包括大环内酯类、喹诺酮类及头孢类;抗病毒药包括病毒唑、更昔洛韦(ganciclovir)、鱼腥草及清开灵;糖皮质激素包括甲泼尼龙(methylprednisokne)、地塞米松及氢化可的松(hydrocortisone)。营养疗法包括白蛋白、静脉高营养、输注血浆及全血)的发热持续时间、胸片转归情况、出院情况及住院时间等多项指标,并进行统计学分析。结果 三组发热持续时间分别为(6±4 )d、(4±3)d和(5±3)d(P =0 .13)。胸片吸收率分别为87. 9%、80 .0 %和74 .3% (P =0 . 0 3)。出院好转率分别为10 0 %、94 . 8%和86 . 8% (P <0 . 0 1)。住院时间分别为(2 2±7)d、(30±11)d和(31±12 )d(P <0 . 0 1)。结论 在疾病早期使用抗生素和抗病毒药,不仅可预防感染发生,且对降低体温,改善症状也有效。但对年龄偏大,伴有合并症的患者,加糖皮质激素治疗可取得满意的疗效。
Objective To evaluate the therapeutic effects of different therapies and provide a theoretical basis for the correct treatment of Severe Acute Respiratory Syndrome (SARS). Methods A total of 304 patients with SARS who were treated in Taiyuan from March to June of 2003 were enrolled in the study. Three kinds of treatment were compared (Group A was treated with antibiotics and antiviral drugs; Group B was treated with antibiotics + antiviral drugs + sugar Corticosteroid treatment; group C using antibiotics + antiviral drugs + corticosteroids + nutritional support therapy). Antibiotics include macrolides, quinolones and cephalosporins; antivirals include ribavirin, ganciclovir, houttuynia, and qingkailing; glucocorticoids include methylprednisokone, Misong and hydrocortisone. Nutritional therapy including albumin, intravenous nutrition, infusion of plasma and whole blood) duration of fever, chest X-ray findings, discharge and hospitalization time and many other indicators, and statistical analysis. Results Duration of fever in the three groups were (6 ± 4) d, (4 ± 3) d and (5 ± 3) d, respectively (P = .13). The absorbance of the chest radiographs were 87.9%, 80.0% and 74.3%, respectively (P = .0 3). Discharge rates were 100%, 94.8% and 86.8%, respectively (P <0.01). The length of hospital stay was (22 ± 7) days, (30 ± 11) days and (31 ± 12) days (P <0. 01), respectively. Conclusions The use of antibiotics and antiviral drugs early in the disease can not only prevent the infection but also reduce the body temperature and improve the symptoms. But for older patients with comorbidities, glucocorticoid treatment can achieve satisfactory results.