目的 探討妊娠期甲型H1N1流感的臨床特點。 方法 對烏魯木齊市婦幼保健院2009年11月-2010年1月收治的妊娠期甲型H1N1流感臨床資料進行回顧性分析。 結果 同期住院非甲流孕產婦1 856例，確診甲型H1N1流感52例，發病率2.7%。妊娠期甲型H1N1流感的發熱時限及不同孕期與病程時限均無相關關系。使用磷酸奧司他韋(達菲)治療23例，較未使用此藥物患者病程顯著縮短[(4.79±2.04) d比(7.26±3.77) d，Plt;0.05]。合并肺炎6例，病程較無合并癥患者顯著延長[(9.83±4.70) d比(5.37±2.54) d，Plt;0.05]。 結論 妊娠期甲型H1N1流感應予以高度重視，在早預防、早診斷及早治療的基礎上，提早預防合并癥的發生。明確診斷后及早使用磷酸奧司他韋可縮短療程。
重視和總結我國臨床診治甲型H1N1流感的經驗
【摘要】 目的 了解北京地區400例新型甲型H1N1流感患者的流行病學和臨床特征，總結規律，進一步指導臨床診治。 方法 2009年5-12月期間，收治400例甲型H1N1流感確診病例，主要采用描述性流行病學方法對患者資料進行回顧性分析，并運用單因素方差分析的方法對結果進行檢驗。 結果 患者以青年和兒童人群為主，47.0%的患者有明確甲型H1N1流感接觸史，主要癥狀包括發熱（98.8%）、咳嗽（85.8%）、咽痛（58.5%）。咽部充血（94.0%）和扁桃體腫大（49.5%）為主要體征。外周血白細胞正常或偏低，349例（82.3%）患者血清鐵降低，268例（72.6%）患者C反應蛋白升高。在發病后不同時間內給予奧司他韋治療的患者發熱持續時間和咽拭子的陰轉時間有顯著差異（Plt;0.001）。 結論 新型甲型H1N1流感發病多以青年和兒童人群為主，以流感樣癥狀為主，多數癥狀輕微，預后良好，C反應蛋白和血清鐵的變化可能對于早期診斷有指導價值，奧司他韋早期抗病毒治療可以縮短病程。【Abstract】 Objective To investigate the clinical and epidemiologic characteristics of pandemic influenza A (H1N1) virus infection in Beijing. Methods The epidemiological information and clinical characteristics of 400 patients with pandemic influenza A (H1N1) virus infection hospitalized in Beijing 302 Hospital from May to December, 2009 were analyzed retrospectively by descriptive epidemiology. One-way ANOVA was used to assess the results. Results H1N1 virus infection preferentially affected adolescents and young adults. The mean age of the patients was 23 years. A total of 189 (47.0%) of the patients had an identifiable epidemiologic link to another confirmed patient. The most common symptoms were fever (98.8%), cough (85.8%) and sore throat (58.5%). The main physical signs were pharyngeal portion congestion (94.0%) and antiadoncus (49.5%). The number of leukocytes in the peripheral blood was normal or low. The decreased serum iron and elevated C-reaction protein were found in 82.3% and 72.6% of the patients. There was significant difference in the duration of fever and viral shedding from throat swabs among the patients who accept the antiviral medication within the different time. Conclusion H1N1 virus infection preferentially affects adolescents and young adults, and presents with influenza-like illness. The clinical course of H1N1 virus infection is generally mild. The change of C-reaction protein and serum iron may be favorable for the diagnosis of H1N1. Early antiviral treatment may shorten the duration of fever and viral shedding.
【摘要】 目的 探討甲型H1N1流感重癥與危重癥的護理干預。 方法 回顧分析2009年10月-2010年2月收治的20例甲型H1N1流感重癥與危重癥患者的治療方案及其護理干預措施。 結果 16例治愈出院， 4例死亡。其中7例需要呼吸機輔助通氣。 結論 甲型H1N1流感重癥與危重癥需要綜合治療，同時，有效的護理干預也是提高甲型H1N1流感危重癥患者治愈率和降低死亡率的關鍵。【Abstract】 Objective To evaluate the nursing intervention for patients with severe influenza A (H1N1). Methods The clinical data of 20 patients with severe influenza A (H1N1) from October 2009 to February 2010 were retrospectively analyzed. Results In 20 patients, 16 were cured and four died. A total of seven patients needed ventilation assisted with ventilators. ConclusionsThe patients with severe influenza A (H1N1) needs combined modality therapy. At the same time, active and effective nursing intervention is the key point of increasing the recovery rate and decreasing the mortality rate.
【摘要】 目的 了解甲型H1N1流感發熱病區門診就診高峰期患者焦慮狀況及相關因素，采取針對性護理措施減輕患者焦慮情緒。 方法 2009年11月上旬-12月上旬采用一般資料調查和Zung′s焦慮自評量表（SAS）對219例患者進行調查分析。 結果 219例患者SAS平均分為（33.70±8.60）分，其中17例SAS總分≥50分，存在焦慮情緒，發生率7.76%。多元回歸分析結果顯示，在年齡、性別、城鄉差異、發熱程度等因素中，與焦慮癥狀有關的主要因素為年齡和發熱程度。 結論 甲型H1N1流感發熱病區門診就診高峰期患者焦慮情緒明顯高于常模，應引起重視，在門診工作中加強心理護理，減輕和盡力消除患者的焦慮情緒，以免對病情產生不利影響，不利于控制流感疫情。【Abstract】 Objective To investigate the anxiety status and related factors of H1N1 patients at influenza peak of fever clinics,and to take specific measures to reduce anxiety in patients. Methods The general information and Zung′s self rating anxiety scale (SAS) were taken to analyze 219 patients from early November to early December 2009. Results The average SAS score of the 219 patients was 33.70±8.60, in which there were 17 patients (7.76%) with total scores ≥ 50 and anxiety. Multiple regression analysis showed that the age and temperature were related factors among age, gender, urban-rural differences, and fever. Conclusion The survey suggests that the pafients at the H1N1 influenza peak of fever clinics are significantly more anxious than normal anxiety. Out-patient work should strengthen psychological care to reduce and try to eliminate the anxiety of patients, in order to avoid adverse impact which is not conducive to control influenza outbreaks.
【摘要】 目的 總結甲型H1N1流感病毒性肺炎患者的胸部X線和CT表現特征。 方法 回顧分析2009年3月-11月3例經臨床表現及病原學檢查證實的甲型H1N1流感病毒性肺炎的胸部X線、CT表現。 結果 肺部病灶多呈散在小片狀高密度影，邊緣模糊，鄰近胸膜；病變最常累及肺基底段；病灶多有少量胸腔積液；病灶有擴散迅速，合理用藥后消失較快的特點；病灶吸收落后于臨床表現。 結論 甲型H1N1流感病毒性肺炎的X線、CT表現具有一定的特點，總結并掌握這些特點，有利于早期診斷。其確診有賴于實驗室檢查和流行病學調查。【Abstract】Objective To explore the chest X-ray, CT manifestations of pneumonia of patients with influenza virus A/H1N1 infection. Methods The pulmonary X-ray and CT findings of 3 patients who were confirmed by laboratory results and epidemiology with infection of influenza virus A/H1N1 were retrospectively analyzed between March 2009 to November 2009. Results Both sides of the lung field showed many small cloudy infiltration in chest X-ray and CT film. The lesions of the lung were mostly near the pleural. They were often found in basal segment. Pleural effusion may be observed. Radiology dynamic changes showed the diffusion of the lesions of the lung was quick in a short time, and scattered and disappeared quickly after rational use of drugs. The lesions vanished later than clinical disappearance. The lesions of the lung may appear fibrosis at the period of the end. Conclusion Some radiographic characteristics exist in the pneumonia of patients with influenza virus A/H1N1 infection. It will be helpful for early diagnosis when getting familiar with its X-ray and CT manifestations, but the final diagnosis depends on the laboratory results and epidemiological history.
糖皮質激素在甲型H1N1流感中的應用探討
目的:探討甲型H1N1流感患者安全轉運中的消毒措施和防護流程。方法:對我國首例甲型H1N1流感患者轉運的各個環節,包括工作人員的個人防護、車輛要求、物品消毒規范和操作流程進行分析。結果:應對首例甲型H1N1流感突發疫情的能力得到提高,轉運順利,安全將該例甲型H1N1流感患者接回醫院,在轉運過程中無交叉感染情況發生。結論:嚴格的消毒措施、規范的著裝,以及有效的監督等措施,是我們面對突發疫情應急工作任務時,防止防止交叉感染的關鍵。