新型冠状病毒肺炎危重症患者的临床诊治

陈莉; 冯世艳; 王福祥; 陈楚明; 吴伟波; 江晓

doi:10.12025/j.issn.1008-6358.2020.20200236

新型冠状病毒肺炎危重症患者的临床诊治

Clinical diagnosis and treatment of critical patients with novel coronavirus pneumonia (report of 12 cases)

摘要

摘要:
目的分析新型冠状病毒肺炎（novel coronavirus pneumonia，NCP）危重症患者的流行病学及临床特征，总结临床诊治经验。
方法收集2020年1月深圳市第三人民医院隔离收治的12例NCP危重症患者临床资料，并进行分析。
结果患者均有明确流行病学史，且出现聚集性疫情。患者以发热、咳嗽为主要症状，部分有乏力、全身肌肉酸痛、腹泻等。患者平均年龄63岁，从发病到病情加重的中位时间是8 d，肺部病灶进展较快，几乎"白肺"，均行气管插管有创机械通气，2例行VV-ECMO（体外膜肺氧合）治疗，目前未发生死亡病例。
结论中老年人和患有高血压、糖尿病、心肺疾病等基础疾病的患者为NCP危重症的高危人群；危重症患者多在病程1周后出现病情进展。

Abstract:
Objective To analyze the epidemiology and clinical features of critical patients with novel coronavirus pneumonia (NCP) and summarize the experiences of clinical diagnosis and treatment.
Methods Clinical data of 12 severe NCP patients in the Third People's Hospital of Shenzhen in January 2020 were collected and analyzed.
Results All the cases had a clear history of epidemiology and a clustered epidemic was found. Fever and cough were the main symptoms, and some of the patients had fatigue, muscle soreness, diarrhea, etc. The mean age of patients was 63 years old, the median time from onset to exacerbation was 8 days. Lung lesions developed rapidly, almost into "white lung". All had been intubated with invasive mechanical ventilation, 2 cases were treated with VV-ECMO, no death had occurred so far.
Conclusions The middle-aged and elderly and patients with hypertension, diabetes and cardiopulmonary diseases are at high risk of critically ill NCP. Most critically ill patients develop disease progression after 1 week.

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