本文關(guān)鍵詞： 病毒性肺炎 甲型HN流感病毒 Ⅰ型呼吸衰竭 型糖尿病 奧司他韋 甲強(qiáng)龍 丙種球蛋白　出處：《山東醫(yī)藥》2017年34期 　論文類型：期刊論文

【摘要】：目的總結(jié)甲型H1N1流感病毒性肺炎并發(fā)Ⅰ型呼吸衰竭伴2型糖尿病的診治經(jīng)驗(yàn)。方法回顧性分析3例H1N1病毒性肺炎患者的臨床資料,分析診斷治療過程。結(jié)果 3例患者均伴有2型糖尿病,以高熱、咳嗽入院;患者病情進(jìn)展迅速,很快出現(xiàn)胸悶憋氣癥狀,血氧飽和度下降,抗感染治療效果差;血常規(guī)淋巴細(xì)胞比例均呈下降趨勢,淋巴細(xì)胞計數(shù)減少;血?dú)夥治鎏崾?Ⅰ型呼吸衰竭;胸部CT雙肺出現(xiàn)廣泛滲出性病變,以肺實(shí)變?yōu)橹?影像學(xué)呈多樣性�？紤]病毒性肺炎,及早給予奧司他韋、甲強(qiáng)龍、丙種球蛋白及高流量面罩吸氧、抗感染、補(bǔ)液、降糖等綜合治療后,患者病情好轉(zhuǎn),影像學(xué)檢查減輕,疾控中心呼吸道分泌物病毒學(xué)檢測為甲型H1N1病毒。結(jié)論對高熱、咳嗽、肺內(nèi)濕Up音、胸部CT示病灶明顯且白細(xì)胞及中性粒細(xì)胞不高的2型糖尿病患者,在無病毒學(xué)診斷依據(jù)情況下,及早行以抗病毒為主的綜合治療可達(dá)到較好療效。
[Abstract]:Objective to summarize the experience in diagnosis and treatment of patients with type 2 diabetes H1N1 influenza virus pneumonia complicated with type I respiratory failure. Methods a retrospective analysis of the clinical data of 3 cases of H1N1 patients with viral pneumonia, analysis of the process of diagnosis and treatment. Results 3 patients with type 2 diabetes, high fever, cough into hospital; patients with rapid progression, it is fast emergence of chest distress symptoms, decreased oxygen saturation, anti infection and poor treatment effect; blood lymphocyte ratio decreased, lymphocyte count decreased; blood gas analysis showed that type I respiratory failure; chest CT lungs extensive exudative lesions, with pulmonary consolidation, imaging showed diversity. Considering the viral pneumonia in order to oseltamivir, methylprednisolone, gamma globulin and high flow oxygen mask, anti infection, rehydration, hypoglycemic and other comprehensive treatment, the patient's condition improved, imaging examination to reduce respiratory tract, CDC Virological testing for influenza H1N1 virus secretion. Conclusion high fever, cough, lung wet Up, chest CT showed lesions significantly and white blood cells and neutrophils in patients with type 2 diabetes is not high, in the absence of virological diagnosis cases, comprehensive treatment and early antiviral based can achieve good curative effect.

【作者單位】： 山東中醫(yī)藥大學(xué)第二附屬醫(yī)院;
【分類號】：R511.7;R563.8;R587.1
【正文快照】： 甲型H1N1流感是一種呼吸道疾病,極易出現(xiàn)肺炎等肺部并發(fā)癥,致死率極高。目前,血清及痰液中分離培養(yǎng)并鑒定病毒是診斷的金標(biāo)準(zhǔn)[1],但是檢測周期≥72 h,延誤早期抗病毒治療,不利于改善患者預(yù)后[2]。因此,能否依據(jù)患者的臨床表現(xiàn)、影像學(xué)特點(diǎn)以及實(shí)驗(yàn)室檢查等早期檢測考慮甲型H1N，

本文編號：1472660