目的 分析重癥甲型H1N1 流感患者的臨床特征, 總結(jié)和探討其治療方法。方法 回顧性分析2009 年10 月至12 月入住ICU的34 例危重癥甲型H1N1 流感患者的臨床資料。結(jié)果 患者年齡3 個(gè)月～60 歲, 平均( 13. 9 ±4. 5) 歲, lt;7 歲患者24 例。發(fā)熱、咳嗽、進(jìn)行性呼吸困難為主要癥狀。WBC 總數(shù)正常范圍21 例( 61. 8% ) , 下降7 例( 20. 6% ) , 增高6 例( 17. 7%) 。淋巴細(xì)胞正常16例( 47. 1% ) , 下降6 例( 17. 7% ) , 增高12 例( 35. 3%) 。胸片示雙肺野或單側(cè)肺小斑片狀模糊陰影。肺部CT 示彌漫性間質(zhì)性病變、胸腔積液或支氣管擴(kuò)張。肝功能酶譜和心肌酶譜指標(biāo)均異常。30 例應(yīng)用奧司他韋、利巴韋林抗病毒治療,4 例使用激素, 6 例使用丙種球蛋白治療。8 例行氣管插管機(jī)械通氣, 5 例行無創(chuàng)機(jī)械通氣治療。34 例患者全部好轉(zhuǎn)或痊愈出院。結(jié)論 肺、心、肝是甲型H1N1 流感病毒損傷機(jī)體的主要臟器。機(jī)械通氣支持治療是搶救危重癥患者的重要手段。
引用本文： 曾維忠,李舜午,周源,彭蘇娜,張溪. 重癥甲型H1N1流感病毒性肺炎34例臨床分析. 中國(guó)呼吸與危重監(jiān)護(hù)雜志, 2010, 9(3): 230-233. doi: 復(fù)制
| 1. | Adiego Sancho B, Omenaca Teres M, Martinez Cuenca S, et al.Human case of swine influenza A ( H1N1 ) , Aragon, Spain,November 2008. Euro Surveill, 2009, 14: 19120 . |
| 2. | 衛(wèi)生部甲型H1N1 流感診療方案( 2009 年試行版第三版) . 北京. 2009. |
| 3. | 馮旰珠, 周鋒, 黃茂, 等. 熱毒寧對(duì)流感病毒FM1 的抑制作用. 中國(guó)新藥與臨床雜志, 2007, 26 : 663-667. |
| 4. | Centers for Disease Control and Prevention ( CDC) . 2009 pandemic influenza A ( H1N1 ) virus infections - Chicago, Illinois, April-July 2009. Morb Mortal Wkly Rep, 2009 , 58: 913-918. |
| 5. | Jain S, Kamimoto L, Bramley AM, et al. Hospitalized patients with 2009 H1N1 influenza in the United States, April-June 2009. N Engl J Med, 2009, 361 : 1935 -1944. |
| 6. | 李冠華, 張力, 李月川, 等. 重癥甲型H1N1 流感病毒肺炎的臨床和病理特征. 天津醫(yī)藥, 2010, 38: 32-35. |
| 7. | Kobasa D, Takuda A, Shinga K, et al. Enhanced virulence of influenza A Viruses with the haemag glutinin of the 1918 Pandemic Virus. Nature, 2004, 431: 703-707. |
| 8. | Jung T, Choi C, Chae C. Localization of swine influenza virus in naturally infected pigs. Vet Pathol, 2002, 39 : 10-16. |
| 9. | Cao B, Li XW,MAO Y, et al. Clinical features of the initial cases of 2009 pandemic influenza A( H1N1 ) virus infection in china. N Engl J Med, 2009, 361 , 2507 -2517. |
| 10. | 姚蓉, 劉亞玲, 陳斌, 等. 四川省135 例重癥甲型H1N1 流感病例的臨床分析. 中國(guó)呼吸與危重監(jiān)護(hù)雜志, 2010 , 9, 7-11. |
| 11. | WHO guidelines for pharmacological managoment of pandemic ( H1N1 ) 2009 influenza and other influenza virues, Geneva: World Health organization, August 20, 2009. |
- 1. Adiego Sancho B, Omenaca Teres M, Martinez Cuenca S, et al.Human case of swine influenza A ( H1N1 ) , Aragon, Spain,November 2008. Euro Surveill, 2009, 14: 19120 .
- 2. 衛(wèi)生部甲型H1N1 流感診療方案( 2009 年試行版第三版) . 北京. 2009.
- 3. 馮旰珠, 周鋒, 黃茂, 等. 熱毒寧對(duì)流感病毒FM1 的抑制作用. 中國(guó)新藥與臨床雜志, 2007, 26 : 663-667.
- 4. Centers for Disease Control and Prevention ( CDC) . 2009 pandemic influenza A ( H1N1 ) virus infections - Chicago, Illinois, April-July 2009. Morb Mortal Wkly Rep, 2009 , 58: 913-918.
- 5. Jain S, Kamimoto L, Bramley AM, et al. Hospitalized patients with 2009 H1N1 influenza in the United States, April-June 2009. N Engl J Med, 2009, 361 : 1935 -1944.
- 6. 李冠華, 張力, 李月川, 等. 重癥甲型H1N1 流感病毒肺炎的臨床和病理特征. 天津醫(yī)藥, 2010, 38: 32-35.
- 7. Kobasa D, Takuda A, Shinga K, et al. Enhanced virulence of influenza A Viruses with the haemag glutinin of the 1918 Pandemic Virus. Nature, 2004, 431: 703-707.
- 8. Jung T, Choi C, Chae C. Localization of swine influenza virus in naturally infected pigs. Vet Pathol, 2002, 39 : 10-16.
- 9. Cao B, Li XW,MAO Y, et al. Clinical features of the initial cases of 2009 pandemic influenza A( H1N1 ) virus infection in china. N Engl J Med, 2009, 361 , 2507 -2517.
- 10. 姚蓉, 劉亞玲, 陳斌, 等. 四川省135 例重癥甲型H1N1 流感病例的臨床分析. 中國(guó)呼吸與危重監(jiān)護(hù)雜志, 2010 , 9, 7-11.
- 11. WHO guidelines for pharmacological managoment of pandemic ( H1N1 ) 2009 influenza and other influenza virues, Geneva: World Health organization, August 20, 2009.