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| 5例确诊埃博拉病毒病患者临床特征分析 |
| 李福祥1,2,李成忠1,3*,周飞虎1,4,胡宗海1,5,陈志辉1,3,郝春秋1,6,杨建军1,7,郭昌星1,8,张萍1,9,蔡颖1,10,郭万刚1,11,阴继凯1,12 |
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(1. 中国人民解放军第二批援利医疗队;
2. 成都军区总医院重症医学科, 成都 610083;
3. 第二军医大学长海医院感染科, 上海 200433;
4. 解放军总医院重症医学科, 北京 100853;
5. 成都军区总医院实验医学中心微生物免疫科, 高温医学全军重点实验室, 成都 610083;
6. 第四军医大学唐都医院传染科, 西安 710038;
7. 成都军区昆明总医院传染结核科, 昆明 650032;
8. 第二军医大学长征医院急救科, 上海 200003;
9. 成都军区昆明总医院急诊科, 昆明 650032;
10. 解放军324医院感染性疾病科, 重庆 400020;
11. 第四军医大学唐都医院心内科, 西安 710038;
12. 第四军医大学唐都医院普通外科, 西安 710038
*通信作者) |
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| 摘要: |
| 目的 分析埃博拉病毒病(Ebola virus disease,EVD)确诊患者临床特征及其转归,探讨该病的临床救治经验。方法 归纳5例EVD确诊患者流行病学、症状、体征、治疗、转归情况,总结临床特点和规律。结果 5例患者年龄32~58岁,平均年龄46岁,男:女为2:3,重症3例、轻症2例。起病前21 d内均有明确流行病学接触史,2例来自同一传播链;1例为医护人员。临床表现以发热、乏力或虚弱、厌食、腹泻、结膜充血等为主,1例发生消化道出血。5例患者均首次行埃博拉病毒(Ebola virus,EBOV)RNA PCR检测即为阳性。经尽快、早期采取严密隔离、退热、补液、预防并发症、治疗基础疾病等措施,3 例患者治愈出院,2 例死亡。结论 尽早隔离传染源、管理接触者可有效阻断传播链;PCR核酸检测是诊断EVD的快速、方便、有效方法;尽早采取对症支持为主的综合治疗可改善治疗结局。 |
| 关键词: 埃博拉病毒病 流行病学 诊断 治疗 预后 |
| DOI：10.3724/SP.J.1008.2015.00584 |
| 投稿时间：2015-04-02修订日期：2015-05-17 |
| 基金项目: |
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| Clinical characteristic analysis of 5 patients with confirmed Ebola virus disease |
| LI Fu-xiang1,2,LI Cheng-zhong1,3*,ZHOU Fei-hu1,4,HU Zong-hai1,5,CHEN Zhi-hui1,3,HAO Chun-qiu1,6,YANG Jian-jun1,7,GUO Chang-xing1,8,ZHANG Ping1,9,CAI Ying1,10,GUO Wan-gang1,11,YIN Ji-kai1,12 |
(1. The Second Medical Team of the Chinese People's Liberation Army to Liberia;
2. Department of Intensive Care Medicine, General Hospital, PLA Chengdu Military Area Command, Chengdu 610083, Sichuan, China;
3. Department of Infectious Disease, Changhai Hospital, Second Military Medical University, Shanghai 200433, China;
4. Department of Critical Care Medicine, General Hospital of PLA, Beijing 100853, China;
5. Department of Microbiology and Immunology, Center of Laboratory Medicine, Key Laboratory of High Humidity Medicine of PLA, Chengdu General Hospital, PLA Chengdu Military Area Command, Chengdu 610083, Sichuan, China;
6. Department of Infectious Disease, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, Shaanxi, China;
7. Department of Infectious Disease and Tuberculosis, Kunming General Hospital, PLA Chengdu Military Area Command, Kunming 650032, Yunnan, China;
8. Department of Emergency, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China;
9. Department of Emergency, Kunming General Hospital, PLA Chengdu Military Area Command, Kunming 650032, Yunnan, China;
10. Department of Infectious Disease, No. 324 Hospital of PLA, Chongqing 400020, China;
11. Department of Cardiovasology, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, Shaanxi, China;
12. Department of General Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, Shaanxi, China
*Corresponding authors) |
| Abstract: |
| Objective To analyze the clinical characteristics and prognoses of patients with confirmed Ebola virus disease (EVD) and to summarize the clinical treatment experience. Methods The epidemiologic history, symptoms, signs, treatment, and prognoses of 5 confirmed EVD cases were summarized. And the relationship between clinical features and clinical outcomes was analyzed. Results The 5 patients, 2 men and 3 women, ranged in age from 32-58 years old, with a median age of 46. Three were severe cases when they were admitted while the others were relatively mild. All the patients admitted the exposure history within 21 days before onset of the symptoms, with two patients (one medical staff) from the same transmission chain. The main symptoms included fever, weakness or fatigue, lack of appetite, diarrhea and red eyes, with one patient having gastrointestinal bleeding. The first test of PCR Ebola virus (EBOV) RNA was positive in all the 5 cases. They were promptly isolated and treated with antipyretic and fluid replacement therapy. Meanwhile, prevention of complications and treatment of basic diseases were also conducted. Three patients survived at last and the other two died. Conclusion Prompt isolation of the infection source and tracing the contacts can effectively prevent the transmission of EVD. PCR assay is an effective, rapid and simple method to diagnose EVD. Early supporting treatment-centered multimodality therapy can improve the treatment outcome of EVD. |
| Key words: Ebola virus disease epidemiology diagnosis therapy prognosis |
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