53例重症甲型H1N1流感临床分析

目的了解重症甲型H1N1流感的临床特点,探索其治疗方法。方法回顾性分析53例重症甲型H1N1流感患者的临床资料,总结其临床规律及特点。结果重症甲型H1N1流感好发于20～40岁,20例（37.74%）伴有各种基础疾病。51例（96.23%）有发热,且48例（90.57%）为首发症状,多伴随有畏寒、咳嗽、咳痰、乏力、胸闷和气急等症状。发病早期血常规检查白细胞及中性粒细胞多正常或下降;胸部影像学检查提示33例（62.26%）患者继发不同程度的支气管炎或肺炎。患者经奥司他韦或帕拉米韦抗病毒治疗及相应的抗感染、针对基础疾病治疗等,除2例患者自动出院外,余均痊愈出院。结论重症甲型H1N1流感起病急,早诊断、早期积极合理治疗,能改善预后。

Clinical analysis of severe influenza A/H1N1 in 53 patients

Objective To study the clinical characteristics and treatment of patients with severe influenza A/H1N1.Method Clinical data of 53 patients with severe influenza A/H1N1 were retrospectively analyzed.Result Severe Influenza A/H1N1 occurred in the age range of 20~40 years. 20 cases （37.74%） were accompanied by a variety of underlying diseases. 51 cases （96.23%） were accompanied by fever,the initial symptom of 48 patients （90.57%）,with accompanying symptoms such as chills,cough,expectoration,fatigue,chest tightness,shortness of breath and other symptoms. Eukocyte and neutrophil levels were normal or decreased at early stage. Chest imaging examinations showed 33 cases （62.26%） of patients developed various degrees of secondary bronchitis or pneumonia. All patients,except two against-advise discharges,were discharged after treatment. Conclusion Severe influenza A/H1N1 begins abruptly. Early diagnosis and early reasonable therapy may be effetive for better prognosis.