南通海安地区5例新型冠状病毒肺炎的临床特征和诊疗体会

doi:10.3969/j.issn.1006-6233.2020.06.003

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Abstract Objective:To enhance the understanding of novel coronavirus pneumonia (COVID-19), to prevent misdiagnosis and to provide reference for the early diagnosis and treatment. Methods: All the COVID-19 patients who were isolated and treated in the department of infectious diseases of hai 'an hospital affiliated to nantong university and the infectious diseases department of the third people's hospital of nantong from January 21, 2020 to March 3, 2020 were selected, and their clinical characteristics including epidemiology, signs and symptoms, laboratory and imaging examinations were retrospectively analyzed. Results: A total of 5 confirmed COVID-19 patients were included in the study, including 4 males and 1 female. The age ranged from 32 to 59 years old, with an average of (43.6±5.7) years old. The time from onset to diagnosis was 5 ~ 10d, with an average of (7.8±1.5) d. Three patients had a history of residence or sojourn in wuhan, one had a history of close contact with a locally confirmed patient, and one female medical worker had a history of suspicious contact with a locally confirmed patient.There were 3 cases of normal type, 1 case of heavy type and 1 case of critical type. There were 5 cases of fever, 5 cases of cough, 4 cases of sputum, 5 cases of fatigue, 3 cases of muscle soreness, 3 cases of headache, 4 cases of shortness of breath, 4 cases of chest tightness, 1 case of mild abdominal pain and diarrhea. There were 2 cases of LYMPH decline, 1 case of accelerated ESR, 5 cases of abnormal myocardial enzyme spectrum, 3 cases of abnormal liver function, 3 cases of decreased PO₂ and 2 cases of decreased SO₂. Hs-crp increased in 2 cases and il-6 increased in 2 cases. Five patients tested positive for nucleic acid. MSCT showed 4 cases of bilateral pulmonary change and 1 case of right pulmonary change, most of which were segmental or subsegmental ground-glass like localized inflammatory infiltration. After receiving high flow oxygen therapy, assisted breathing, integrated traditional Chinese and western medicine and supportive treatment, they were cured and discharged from the hospital. The length of stay ranged from 16 to 34d, with an average of (17.8±3.7) d. No significant sequelae were found after 1 month of follow-up. Conclusion: The COVID-19 in hai 'an area was dominated by common cases with fever as the first symptom. In critical and severe cases, the course of disease is short, and the degree of inflammation and organ damage is significant. All cases were cured and discharged. Clinicians should improve the disease prevention and treatment level of COVID-19 in this region by combining the epidemiological history and clinical characteristics, nucleic acid detection and chest MSCT examination.

Key words： COVID-19 Clinical characteristics Diagnosis and treatment The prognosis

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2020.06.003 OR http://www.hbyxzzs.cn/EN/Y2020/V26/I6/892

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