急性传染病休克的临床诊治与转归分析

目的:探讨急性传染病休克患者的诊治策略,提高救治成功率.方法:回顾分析急性传染病休克患者的人口学、流行病学、病因分类、传染病发生至休克出现时间、早期临床诊治与转归等情况,总结诊治经验.结果:本组68例急性传染病休克主要来自呼吸道、消化道传染病,细菌和病毒是休克发生的主要病原,分别占54.4％和30.9％,仅25％的病例病前有明确的传染病接触史.51.9％的患者存在误诊误治现象.在明确休克发生病理机制的前提下,早期快速有效的抗休克、抗感染治疗,短期使用糖皮质激素,积极纠正酸碱、电解质紊乱,并给予必要的对症支持治疗,治愈出院率92.6％,平均康复住院时间3～11天,平均(5.8±2.4)天.结论:急性传染病休克早期误诊现象突出；给予积极抗体克、抗感染、激素治疗,纠正酸碱和电解质紊乱,结合对症支持治疗,可在短期内治愈患者.

The Diagnosis and Emergency Treatment of Patients with Acute Infectious Shock

Objective:To explore the strategy of diagnosis and treatment of shock in patients with acute infectious diseases,improve the rescue success rate.Methods:The clinical data,including demographic,epidemiology,etiology,the period of infectious diseases oc-currence to the shock appearance,early clinical diagnosis and treatment,and outcome,of 68 patients with acute infectious diseases were analysed.Results:The group of 68 cases of acute infectious diseases shock were mainly from the respiratory tract,gastrointestinal dis-eases.Bacteria and viruses were the main pathogens of the shock,which accounted for 54.4% and 30.9%,respectively.Only 25% of cas-es had a clear history of exposure of infectious diseases before.51.9% of patients had been misdiagnosed.On the basis of a clear patho-genesis of shock,early fast and effective anti-shock,anti-infective therapy,short-term use of corticosteroids,and actively correct the pH,electrolyte imbalance,and necessary support for symptomatic treatment were given.The cured rate was 92.6% and the rehabilitation length of stay was 3 to 11 days,the average(5.8 ±2.4) days.Conclusion:Misdiagnosed phenomenon highlights the acute infectious stage of shock.With positive anti-shock,anti-infective,hormone therapy,correcting acid-base and electrolyte imbalance,combined with symptomatic and supportive treatment,the patients can be cured in a short term.