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目的 了解严重急性呼吸综合征 (SARS)患者的临床特点及心理问题 ,探讨药物和心理干预治疗的作用和体会。方法 分析 5 1例SARS患者的临床和心理问卷资料 ,介绍药物治疗和心理干预的方法。结果 5 1例中男性 2 9例 ,女性 2 2例 ,平均年龄 (33 2± 8 0 )岁。临床表现发热 96 1% ,肌肉酸痛、乏力 80 4 % ,咳嗽 5 6 9% ,胸闷、气短 2 5 5 % ,头晕、头痛 2 7 5 % ,腹泻 3 9%。心理问卷结果 :存在抑郁、焦虑者 90 2 % ,失眠 5 1 2 % ,躯体化症状 31 7% ,绝望感 34 1% ,激越 6 5 9% ,出院后自卑感 6 1 0 %。应用抗病毒药物者 84 0 % ,为利巴韦林 0 4～ 1 2g/d ,疗程 7～ 14d ;抗生素者 70 0 % ,主要为阿齐霉素、左氧氟沙星等 ;应用激素者 5 7 0 % ,为甲基强地松龙 4 0～32 0mg/d ,疗程 3～ 15d ;心理干预包括 :支持性心理治疗、认知治疗、辅助用药、暗示疗法 ,电话谈心治疗等。 5 1例患者全部治愈或好转出院。结论 对SARS患者 ,恰当的综合药物治疗 ,可收到良好的效果。其中合理的应用糖皮质激素更为重要 ,心理干预是重要的辅助治疗措施
Objective To understand the clinical features and psychological problems of patients with severe acute respiratory syndrome (SARS) and explore the role and experience of drug and psychological interventions. Methods Clinical and psychological questionnaires of 51 SARS patients were analyzed and the methods of drug treatment and psychological intervention were introduced. Results Among 51 cases, 29 were males and 22 females, with an average age of (33 2 ± 80) years. Clinical manifestations of fever 96 1%, muscle soreness, fatigue 80 4%, cough 5 6 9%, chest tightness, shortness of breath 25 5%, dizziness, headache 27 5%, diarrhea 39%. Psychological questionnaire results: There were depression, anxiety 90 2%, insomnia 51.2%, somatic symptoms 31 7%, despair 34 1%, agitation 65 59%, discharge inferiority complex 61%. Antibiotics 84 0%, ribavirin 0 4 ~ 1 2g / d, treatment 7 ~ 14d; antibiotics 70 0%, mainly azithromycin, levofloxacin, etc .; application of hormones 5700% , For methylprednisolone 40 ~ 32 0mg / d, course of treatment 3 ~ 15d; psychological interventions include: supportive psychotherapy, cognitive therapy, adjuvant therapy, suggestive therapy, telephone talkative treatment. 5 1 patients were cured or better discharged. Conclusion For patients with SARS, the appropriate combination of drug treatment, can receive good results. The rational use of glucocorticoids is more important, psychological intervention is an important adjuvant therapy