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埃博拉病毒病死亡病例2例临床分析
李成忠1,2,周飞虎1,3,陈志辉1,2,郝春秋1,4,郭昌星1,5,阴继凯1,6,郭万刚1,7,张萍1,8,蔡颖1,9,杨建军1,10,李福祥1,11*
0
(1. 中国人民解放军第二批援利医疗队;
2. 第二军医大学长海医院感染科, 上海 200433;
3. 解放军总医院重症医学科, 北京 100853;
4. 第四军医大学唐都医院传染科, 西安 710038;
5. 第二军医大学长征医院急救科, 上海 200003;
6. 第四军医大学唐都医院普通外科, 西安 710038;
7. 第四军医大学唐都医院心内科, 西安 710038;
8. 成都军区昆明总医院急诊科, 昆明 650032;
9. 解放军324医院感染性疾病科, 重庆 400020;
10. 成都军区昆明总医院传染结核科, 昆明 650032;
11. 成都军区总医院重症医学科, 成都 610083
*通信作者)
摘要:
目的 分析埃博拉病毒病死亡病例的特征,为埃博拉病毒病的防治提供参考。方法和结果 中国人民解放军第二批援利医疗队于2015年初抵达利比里亚,历时2个月,共收治5例埃博拉确诊病例,死亡2例。病例1为年轻女性,表现为发热、乏力、纳差、腹泻、出血等症状,入院后迅速死亡,死亡后口腔分泌物检测确诊为埃博拉病毒病。病例2为老年男性,主要表现为发热、乏力、肌肉酸痛、纳差、剧烈腹泻,治疗过程中血液病毒载量居高不下。最终2例患者均死于低容量性休克。结论 接触者追踪隔离、感染者的早期诊治以及为感染者提供基本医疗护理是防治埃博拉病毒病的基本保障。
关键词:  埃博拉病毒病  死亡  临床分析  腹泻
DOI:10.3724/SP.J.1008.2015.00594
投稿时间:2015-04-02修订日期:2015-06-08
基金项目:
Clinical analysis of two death cases with confirmed Ebola virus disease
LI Cheng-zhong1,2,ZHOU Fei-hu1,3,CHEN Zhi-hui1,2,HAO Chun-qiu1,4,GUO Chang-xing1,5,YIN Ji-kai1,6,GUO Wan-gang1,7,ZHANG Ping1,8,CAI Ying1,9,YANG Jian-jun1,10,LI Fu-xiang1,11*
(1. The Second Medical Team of the Chinese People's Liberation Army to Liberia;
2. Department of Infectious Disease, Changhai Hospital, Second Military Medical University, Shanghai 200433, China;
3. Department of Critical Care Medicine, the General Hospital of PLA, Beijing 100853, China;
4. Department of Infectious Disease, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, Shaanxi, China;
5. Department of Emergency, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China;
6. Department of General Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, Shaanxi, China;
7. Department of Gardiovasology, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, Shaanxi, China;
8. Department of Emergency, Kunming General Hospital, PLA Chengdu Military Area Command, Kunming 650032, Yunnan, China;
9. Department of Infectious Disease, No. 324 Hospital of PLA, Chongqing 400020, China;
10. Department of Infectious Disease and Tuberculosis, Kunming General Hospital, PLA Chengdu Military Area Command, Kunming 650032, Yunnan, China;
11. Department of Intensive Care Medicine, General Hospital, PLA Chengdu Military Area Command, Chengdu 610083, Sichuan, China
*Corresponding authors)
Abstract:
Objective To analyze the clinical characteristics of the death cases of Ebola virus disease (EVD), so as to provide control and treatment reference for EVD. Methods and Results The second medical team of PLA to Liberia arrived in Liberia at the beginning of 2015 and stayed for two months. Totally we treated 5 confirmed EVD cases and 2 of them died. Case 1 was a young female patient; she had clinical manifestations of febrile, fatigue, anorexia, diarrhea and hemorrhage. She died soon after admission and was confirmed positive of Ebola virus (EOV) by swab sample. Case 2 was an old male patient who was presented to China Ebola Treatment Unit with symptoms of febrile, fatigue, muscular soreness, anorexia and severe diarrhea; and his viral load in blood remained high during the course of illness. Both patients died from hypovolemic shock. Conclusion Tracing and isolating the contacts, early diagnosis and treatment, and providing basic health care services for the infected are the cores for prevention of Ebola virus disease.
Key words:  Ebola virus disease  death  clinical analysis  diarrheas