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目的探讨广州地区传染性非典型肺炎临床诊断和治疗方法。方法对2003年1月～5月广州地区确诊为传染性非典型肺炎186例病人的临床资料和治疗效果进行回顾性分析。结果 186例患者多有近距离接触传染源史,潜伏期1～11天,163例以发热为首发症状,155例全身乏力,半数以上病人有咳嗽、气促,可伴有畏寒、头晕头痛,肌肉、关节酸痛,心悸。48例(占25.8％)白细胞计数减少,68例(占36.6％)血小板计数减少,177例(占95.2％)外周血淋巴细胞绝对值计数正常。T-淋巴细胞亚群检测显示CD_3~+,CD_4~+,CD_8~+细胞数量均明显减少。X线胸片全部病例均有不同程度渗出阴影。应用左氧氟沙星、阿奇霉素、美满霉素基础上,早期持续低流量鼻管吸氧和早期规律合理使用皮质激素治疗能有效地缩短发热时间,改善全身中毒症状,减少气促,减少肺纤维化,防止和控制急性呼吸窘迫综合征(ARDS)的发生。本组病人治疗(包括好转)率94.6％,死亡率5.4％。结论本病由变异冠状病毒引致,以呼吸道传播为主,传染性极强的呼吸道传染病。应用针对性综合治疗能有效提高治疗率。
Objective To investigate the clinical diagnosis and treatment of SARS in Guangzhou. Methods A retrospective analysis was performed on the clinical data and treatment effect of 186 cases of SARS confirmed in Guangzhou from January to May in 2003. Results A total of 186 patients had history of close contact with infection, with an incubation period of 1 to 11 days. Of the 163 patients, fever was the first symptom and 155 were malaria. More than half of the patients had cough and shortness of breath with chills, dizziness and headache, Muscle, joint pain, heart palpitations. 48 cases (25.8%) decreased the number of white blood cells, 68 cases (36.6%) decreased platelet count, 177 cases (95.2%), the absolute value of peripheral blood lymphocytes count was normal. T-lymphocyte subsets showed that the number of CD_3 ~ +, CD_4 ~ + and CD_8 ~ + cells were significantly decreased. All cases of X-ray showed varying degrees of exudation. Application of levofloxacin, azithromycin, minocycline on the basis of early continuous low-flow nasal oxygen and early regular use of corticosteroids reasonable treatment can effectively reduce the time of fever, reduce the symptoms of systemic poisoning, reduce shortness of breath, reduce pulmonary fibrosis and prevent and Control of acute respiratory distress syndrome (ARDS). The treatment of this group of patients (including improvement) rate of 94.6%, the mortality rate of 5.4%. Conclusion The disease is caused by the variant coronavirus, mainly respiratory tract transmission, highly contagious respiratory diseases. Targeted comprehensive treatment can effectively improve the treatment rate.