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目的通过分析甲型H1N1流感重症和死亡病例的流行病学特点及临床特征,为评价甲型H1N1流感的危害程度,预防和控制甲型H1N1流感提供科学依据。方法对2009年11月-2010年2月河北省胸科医院、河北医科大学第四医院收治诊断的33例甲型H1N1流感重症病例的流行病学、临床特征和治疗转归进行回顾性分析及总结。结果 33例患者既往均没有流感疫苗接种史,有高危因素的有20例,占60.6%。甲型H1N1流感重症年龄多发于20~40岁人群,占本组病例69.7%。其中孕妇11例,肥胖患者4例,年龄≥65岁的老人4例。18.5%的重症病例和66.7%的死亡病例有慢性基础疾病,主要为肺部疾病、心血管疾病和代谢性疾病等。所有的重症病例和死亡病例均出现并发症。几乎所有的重症病例和死亡病例曾使用达菲进行治疗。在出现症状到病毒阴转时间上,多数在7~26d,平均12.7d;在给予治疗到病毒阴转时间上,多数在4~20d,平均7.6d。治疗痊愈出院27例,死亡6例。结论重症甲型HINI流感起病急,早诊断、早期积极合理治疗,绝大多数均能获得痊愈,预后良好。此外,孕妇、肥胖和有基础性疾病的人群是高危人群,是预防控制的重点。
Objective To analyze the epidemiological characteristics and clinical features of severe and death cases of Influenza A (H1N1) and provide a scientific basis for the evaluation of the degree of harm of Influenza A (H1N1) and the prevention and control of Influenza A (H1N1). Methods The epidemiological, clinical characteristics and treatment outcome of 33 cases of severe H1N1 influenza in Hebei Province Chest Hospital and No. 4 Hospital of Hebei Medical University from November 2009 to February 2010 were retrospectively analyzed. to sum up. Results None of the 33 patients had a previous history of influenza vaccination. There were 20 patients with high risk factors (60.6%). Influenza A H1N1 influenza severe age in 20 to 40-year-old population, accounting for 69.7% of the patients. Including pregnant women in 11 cases, obese patients in 4 cases, aged ≥ 65 years old in 4 cases. 18.5% of severe cases and 66.7% of deaths have chronic underlying diseases, mainly lung diseases, cardiovascular diseases and metabolic diseases. Complications occurred in all severe and fatal cases. Almost all severe cases and deaths have been treated with Tamiflu. In the symptoms to the virus time of negative conversion, the majority of 7 ~ 26d, an average of 12.7d; in the treatment of the virus to the negative time, most in 4 ~ 20d, an average of 7.6d. Treatment cured 27 patients discharged, 6 died. Conclusions Severe A-type HINI influenza is acute and early diagnosis, early positive and reasonable treatment, the vast majority can be cured, the prognosis is good. In addition, pregnant women, obese and people with underlying diseases are at high risk and are the focus of prevention and control.