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目的分析重症甲型H1N1患者临床资料,指导临床诊疗。方法随机选取2009年9月至2010年3月河南省各医院收治的重症甲型H1N1病例80例,收集其临床特征、实验室检查指标、影像学表现、治疗情况等临床资料,对此进行回顾性分析。结果 80例患者平均年龄(28.4±19.2)岁,临床表现以发热、咳嗽、咽痛、呼吸困难为主。所有患者均有影像学改变,多为双肺弥漫性病变,主要表现为斑片影、实变影、磨玻璃影。其中40例应用机械通气。所有患者治疗后病情好转60例,死亡或自动出院20例。结论甲型H1N1流感重症多见于青中年,死亡率高。患者早期症状不典型,双肺出现弥漫性斑片影、磨玻璃影、实变等影像学表现,需警惕H1N1感染;应尽早给予抗病毒药物,必要时应用机械通气,孕妇需尽早终止妊娠以改善预后。
Objective To analyze the clinical data of patients with severe type A H1N1 and guide the clinical diagnosis and treatment. Methods 80 cases of severe type A H1N1 cases admitted to hospitals in Henan Province from September 2009 to March 2010 were randomly selected and their clinical features, laboratory indexes, imaging findings and treatment were collected and reviewed. Sexual analysis. Results The average age of 80 patients (28.4 ± 19.2) years of age, clinical manifestations of fever, cough, sore throat, dyspnea. All patients had imaging changes, mostly diffuse lung lesions, mainly as patchy shadow, real change shadow, ground glass shadow. 40 cases of mechanical ventilation. All patients improved after treatment 60 cases, 20 cases of death or spontaneous discharge. Conclusion Influenza A (H1N1) flu is more common in young middle-aged, with a higher mortality rate. Patients with atypical early symptoms, pulmonary diffuse patchy shadow, ground glass, consolidation and other imaging findings, to be vigilant H1N1 infection; antiviral drugs should be given as soon as possible, the application of mechanical ventilation, pregnant women need to terminate the pregnancy as early as possible to Improve the prognosis.