重症及危重症甲型H1N1流感146例病例的回顾性分析
Retrospective Analysis of 146 Severe or Critically Ill Patiens with influenza A H1N1
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摘要: 目的 探讨重症及危重症甲型H1N1流感病例临床发病特征和治疗情况.方法 采用回顾性分析,收集146例重症及危重症甲型流感住院患者的临床资料建立数据库进行分析.结果 Logistic回归分析:入院时消化道症状、体温、呼吸频率、啰音范围、LYM绝对值、Plt、CK、CREA、PaO2及乳酸为独立的影响疾病进展因素;无激素治疗组与小剂量激素治疗组有效率比较差异有统计学意义(P<0.05),无激素治疗组与大剂量+小剂量维持治疗组有效率比较差异有统计学意义(P<0.05),小剂量激素治疗组与大剂量+小剂量维持治疗组有效率比较差异无统计学意义(P>0.05);对于危重症患者小剂量组与大剂量冲击+小剂量比较差异有统计学意义(P<0.05);激素早期治疗组与中晚期治疗组的有效率比较有统计学意义(P<0.05);激素应用疗程7~14 d组的有效率前后比较无统计学意义(P>0.05),>14 d组三个时段有效率两两比较差异无统计学意义(P>0.05);死亡率无创+有创通气组最高,其次为有创通气组,最低为无创通气组,三组比较有统计学意义(P<0.05).结论 研究表明入院时消化道症状、体温、呼吸频率及啰音范围与疾病进展有密切的关系,淋巴细胞、血小板、肌酐、肌酸激酶、氧分压及LAC都与本病的疾病进展有关.研究中激素的应用,无创机械通气治疗也起到了很好的治疗作用.Abstract: Objective To investigate the clinical characteristics and treatment of severe and critically ill patients with influenza A H1N1.Method The data of 146 severe and critically ill patients with influenza A H1N1 were collected to establish a database and analyzed retrospectively.Results Logistic regression analysis:gastrointestinal symptoms on admission,body temperature,respiratory rate,rales range,LYM absolute,Plt,CK,CREA,PaO2,and lactic acid were independent factors of disease progression.There was a signific...
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Key words:
- Influenza A H1N1 /
- Severe and critically ill patients /
- Clinical features /
- Treatment
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