摘要
目的:通过分析本院确诊新型冠状病毒肺炎(COVID-19)的职工,了解医院职工COVID-19的临床特征,以减少院内感染,提高治愈率,减少死亡率。方法:本次研究为回顾性研究,选取均为2020年1月31日—2月10日武汉大学人民医院隔离病房95例确诊COVID-19的本院职工作为研究对象,收集其临床资料,分析临床症状、血液检查、呼吸道病毒鼻咽拭子核酸检测、新型冠状病毒核酸检测(痰液、大便)、胸部CT影像学、临床转归等。结果:①本院职工COVID-19感染患者中,发病中位数年龄为35岁。女性(61例)明显多于男性(34例)。医务人员(81例)明显高于非医务人员(14例)。既往有慢性基础疾病患者12例(12.6%)。行有创性操作(气管插管、胃镜、鼻咽喉镜、血液透析等)9例(9.5%)。按临床分型分为轻型5例(5.3%),普通型84例(88.4%),重型5例(5.3%),危重型1例(1.1%)。从发病到住院时间中位数为5 d。②发病时临床症状主要表现为发热67例(70.5%)、咳嗽60例(63.2%)、乏力39例(41.1%)等。③白细胞总数正常或减低90例(94.7%),中性粒细胞计数正常75例(78.9%),淋巴细胞计数减少29例(30.5%)。超敏C-反应蛋白升高有21例(22.1%)。血小板计数、肾功能(肌酐)等指标基本上无明显改变。其中43例(45.3%)患者出现总蛋白下降,36例(37.9%)患者出现白蛋白下降,其中12例(12.6%)患者出现转氨酶升高。其中78例患者行其他常见呼吸道病毒鼻咽拭子核酸检测,仅3例患者核酸阳性。④根据影像学检查,有5例患者胸部CT无肺炎样改变,90例患者肺部呈肺炎样改变。其中66例(69.5%)患者表现为双肺肺炎。其中70例(73.7%)患者表现为片状、斑片状、结片状磨玻璃影或絮状影,部分伴条索影。其中3例(3.2%)病变以实变为主要表现,部分可见支气管充气征。1例(1.1%)患者合并胸腔积液、心包积液。结论:医院职工COVID-19在临床症状、血液检查、胸部CT表现与普通患者基本类
Objective: To investigate the clinical characteristics of hospital staff with COVID-19, so as to reduce hospital transmission, improve the cure rate and reduce the mortality.Methods: A total of 95 staff with COVID-19 in the isolation ward of Renmin Hospital of Wuhan University were selected as the study subjects from January 31 to February 10, 2020. Their clinical symptoms, results of blood test, respiratory virus nasopharyngeal swab RNA detection, novel coronavirus RNA detection(sputum, stool), chest CT imaging, and clinical outcomes were reviewed.Results:(1) Among the staff with COVID-19 infection, the median age was 35 years old. The cases of female were more than male cases(61 cases versus 34 cases), and most cases(81 cases) were doctors, nurses, or medical technicians. Twelve(12. 6%) patients had chronic diseases. Invasive operations(endotracheal intubation, gastroscopy, nasopharyngoscopy, hemodialysis, etc.) were performed in 9 cases(9. 5%). According to the clinical classification, 5 cases were mild(5. 3%), 84 cases were in common type(88. 4%), 5 cases were severe(5. 3%), and one case was in very severe type(1. 1%). The median time from onset of symptoms to first hospital admission was 5 days.(2) The most common symptoms at onset were fever in 67 cases(70. 5%), cough in 60 cases(63. 2%), fatigue in 39 cases(41. 1%),and so on.(3) The total leukocyte count was normal or decreased in 90 cases(94. 7%), the neutrophil count was normal in 75 cases(78. 9%), and lymphocyte count decreased in 29 cases(30. 5%). Hypersensitive C-reactive protein increased in 21 cases(22. 1%). There was no significant change in platelet count and renal function(creatinine). 43(45. 3%) patients had decreased total protein, 36(37. 9%) patients had decreased albumin, and 12(12. 6%) patients had elevated transaminase. Among them, 78 patients were tested for RNA from nasopharyngeal swabs of other common respiratory viruses, and only 3 patients were positive.(4) According to CT imaging, there were pneumonia-like changes in the lungs of 90 p
作者
殷静
李瑞云
吴小军
YIN Jing;LI Ruiyun;WU Xiaojun(Dept.of Respiratory and Critical Care Medicine,Renmin Hospital of Wuhan University,Wuhan 430060,Hubei,China)
出处
《武汉大学学报（医学版）》
CAS
2021年第2期250-255,共6页
Medical Journal of Wuhan University
