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中国临床研究:2021,34(4):517-521
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新型冠状病毒肺炎9例死亡病例临床分析
(1.湖北中医药大学第一临床学院,湖北 武汉430065;2.中国人民解放军中部战区总医院,湖北 武汉430065)
Clinical analysis of 9 deaths from coronavirus disease 2019
摘要
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投稿时间:2020-07-22   网络发布日期:2021-04-20
中文摘要: 目的 研究新型冠状病毒肺炎(COVID-19)死亡患者的主要临床特征及死亡原因。方法 回顾性分析2020年1月30日至2月20日中国人民解放军中部战区总医院确诊为COVID-19的197例病例中共计9例死亡患者的一般资料、就诊时实验室检查结果及一般治疗情况。结果 9例死亡病例均为危重型,男7例,女2例;年龄(82.1±12.4)岁;6例合并两种以上基础疾病;就诊时多数患者FPG、CRP、IL-6、D-二聚体、AST及BUN高于正常,氧饱和度、氧分压、二氧化碳分压、淋巴细胞计数、总T淋巴细胞绝对数、抑制/细胞毒性T淋巴细胞绝对数及辅助性T淋巴细胞绝对数低于正常。9例患者中,7例直接由危重型COVID-19导致呼吸衰竭死亡,1例死于急性肺栓塞,1例死于心跳骤停;其中6例合并多脏器功能衰竭综合征,3例继发感染,3例出现休克。结论 合并多种基础疾病的老年男性危重型患者存活率较低,密切监测患者动脉血气分析、血糖、血常规、T淋巴细胞分型、炎症指标及肝肾功能有助于推测病情发展和预后。
Abstract:Objective To study the main clinical features and causes of death of patients with coronavirus disease 2019 (COVID-19). Methods A retrospective analysis was performed on the general information,laboratory examination results and treatment of 9 deaths among 197 patients with confirmed COVID-19 from January 30 to February 20,2020 in the Central Theater Command General Hospital of PLA. Results All the 9 patients died of critical diseases,including 7 males and 2 females with average age of (82.1±12.4) years,and 6 patients were complicated with more than two basic diseases.In most patients at admission,the levels of fasting blood glucose (FPG),C-reactive protein (CRP),interleukin-6 (IL-6),aspartate aminotransferase (AST) and urea nitrogen (BUN) were higher than normal levels,while oxygen saturation,partial pressure of oxygen,partial pressure of carbon dioxide,lymphocyte count,total T lymphocyte absolute number,inhibitory/cytotoxic T lymphocyte absolute number and helper T lymphocyte absolute number were lower than normal.Among 9 patients,7 died of respiratory failure caused by critical COVID-19,1 died of acute pulmonary embolism,and 1 died of cardiac arrest;there were 6 cases complicated with multiple organ failure syndrome,with secondary infection in 3 cases and shock in 3 cases. ConclusionFor the patients with critical COVID-19,the survival rate of elderly male patients with multiple underlying diseases is low,and close monitoring of blood gas analysis,blood glucose,blood routine,T lymphocyte typing,inflammation indicators,liver and kidney function can help to predict the development and prognosis of patients.
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引用文本:
朱梓依,陈伟,乐岭.新型冠状病毒肺炎9例死亡病例临床分析[J].中国临床研究,2021,34(4):517-521.

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