引用本文:张记旺,向淑麟,陆 政,秦文波,黄 寨,韦秀甜,庞广保,赵宣亮,熊 滨.广西地区9例重型/危重型新型冠状病毒肺炎患者的临床特征分析[J].中国临床新医学,2020,13(12):1245-1249.
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广西地区9例重型/危重型新型冠状病毒肺炎患者的临床特征分析
张记旺,向淑麟,陆 政,秦文波,黄 寨,韦秀甜,庞广保,赵宣亮,熊 滨
530021 南宁,广西壮族自治区人民医院重症医学科
摘要:
[摘要] 目的 分析广西地区重型、危重型新型冠状病毒肺炎(COVID-19)患者的临床特征,为重型、危重型COVID-19患者临床诊治提供参考。方法 收集2020-02-16~2020-03-16广西壮族自治区人民医院邕武医院收治的9例重型、危重型COVID-19患者的病史、实验室检查、影像学等资料,总结临床诊疗经验。结果 9例重型、危重型COVID-19患者年龄41~85岁,男5例,女4例;重型2例,危重型7例。与重型COVID-19患者相比,危重型患者入院时中性粒细胞比例、D-二聚体、降钙素原、乳酸脱氢酶水平相对较高,淋巴细胞计数、血清白蛋白水平相对较低。2例重型患者均需鼻导管/面罩吸氧,2例危重型患者需高流量吸氧,5例危重型患者需行有创机械通气。2例危重型患者需体外膜肺氧合(ECMO)支持治疗。6例危重型患者并发急性呼吸窘迫综合征、肺部细菌真菌感染、多器官功能障碍综合征。入院后28 d评估病情转归,痊愈出院7例;截至3月16日,2例危重型患者COVID-19治愈后,因基础疾病转至非负压病房ICU治疗。结论 综合治疗及个体化治疗可有效改善重型、危重型COVID-19预后。
关键词:  新型冠状病毒肺炎  危重型  呼吸衰竭  机械通气  治疗
DOI:10.3969/j.issn.1674-3806.2020.12.15
分类号:R 511
基金项目:南宁市青秀区重点研发计划项目(编号:2019036);广西卫健委科研课题(编号:Z2011466)
Analysis of clinical characteristics of 9 patients with severe/critical 2019 corona virus disease in Guangxi area
ZHANG Ji-wang, XIANG Shu-lin, LU Zheng, et al.
Department of Critical Care Medicine, the People′s Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, China
Abstract:
[Abstract] Objective To analyze the clinical characteristics of patients with severe/critical 2019 corona virus disease(COVID-19) in Guangxi area, and provide the reference for clinical diagnosis and treatment of severe/critical COVID-19 patients. Methods The medical history, laboratory examination and imaging data of 9 patients with severe/critical COVID-19 admitted to Yongwu Hospital of the People′s Hospital of Guangxi Zhuang Autonomous Region from Febuary 16, 2020 to March 16, 2020 were collected and the clinical diagnosis and treatment experience was summarized. Results Nine patients with severe/critical COVID-19 were 41~85 years old, including 5 males and 4 females. Among the 9 cases, 2 cases were severe and 7 cases were critical.Compared with the severe COVID-19 patients, the critical COVID-19 patients had relatively higher neutrophil ratio, D-dimer, procalcitonin and lactate dehydrogenase on admission, and relatively lower lymphocyte count and serum albumin. Two cases of severe COVID-19 needed nasal catheter/mask oxygen inhalation; 2 cases of critical COVID-19 needed high flow oxygen inhalation and 5 cases of critical COVID-19 needed invasive mechanical ventilation. Two cases of critical COVID-19 needed extracorporeal membrane oxygenation(ECMO) support therapy. Six critical patients were complicated with acute respiratory distress syndrome(ARDS), pulmonary bacterial and fungal infection, and multiple organ dysfunction syndrome. The prognosis was evaluated 28 days after admission, and 7 cases were cured and discharged. Up to March 16, 2 cases of critical COVID-19 were cured and transferred to the Intensive Care Unit(ICU) of Non-negative Pressure Ward for treatment of their basic diseases. Conclusion Comprehensive and individualized treatments can effectively improve the prognosis of severe/critical COVID-19 patients.
Key words:  2019 corona virus disease(COVID-19)  Critical type  Respiratory failure  Mechanical ventilation  Treatment