人感染禽流感的诊断和治疗详解演示文稿.pptVIP

人感染禽流感的诊断和治疗详解演示文稿 当前第1页\共有38页\编于星期四\15点 （优选）人感染禽流感的诊断和治疗 当前第2页\共有38页\编于星期四\15点 截止2014-01-21 当前第3页\共有38页\编于星期四\15点 当前第4页\共有38页\编于星期四\15点 指导文件 《人感染H7N9禽流感诊疗方案（第二版）》(2013-4-10) （Diagnostic and treatment protocol for human infections with avian influenza A (H7N9) ?(2nd edition, 2013)） 当前第5页\共有38页\编于星期四\15点 2013-4-25卫计委人感染H7N9禽流感医疗救治工作会议 人感染H7N9禽流感医疗救治专家公识 当前第6页\共有38页\编于星期四\15点 当前第7页\共有38页\编于星期四\15点 Clinical Findings in 111 Cases of Influenza A (H7N9) Virus Infection The median age was 61 years, and 42.3% were 65 years of age or older; 31.5% were female. ?76.6% were admitted to an intensive care unit (ICU), and 27.0% died.? A total of 61.3% of the patients had at least one underlying medical condition.? （n=68） 当前第8页\共有38页\编于星期四\15点 Fever and cough were the most common presenting symptoms On admission, 108 patients (97.3%) had findings consistent with pneumonia Bilateral ground-glass opacities and consolidation were the typical radiologic findings. Lymphocytopenia was observed in 88.3% of patients, and thrombocytopenia in 73.0%.? 当前第9页\共有38页\编于星期四\15点 Treatment with antiviral drugs was initiated in 108 patients (97.3%) at a median of 7 days after the onset of illness.? The median times from the onset of illness and from the initiation of antiviral therapy to a negative viral test result on real-time reverse-transcriptase–polymerase-chain-reaction assay were 11 days (interquartile range, 9 to 16) and 6 days (interquartile range, 4 to 7), respectively. 当前第10页\共有38页\编于星期四\15点 Multivariate analysis revealed that the presence of a coexisting medical condition was the only independent risk factor for the acute respiratory distress syndrome (ARDS) 当前第11页\共有38页\编于星期四\15点 主要共识 早发现、早诊断 及时发现可能发展为重症的患者 重症患者的治疗策略 当前第12页\共有38页\编于星期四\15点 主要共识 早发现、早诊断 及时发现可能发展为重症的患者 重症患者的治疗策略 当前第13页\共有38页\编于星期四\15点 诊断原则 根据流行病学接触史、临床表现及实验室检查结果，可作出人感染H7N9禽流感的诊断。 在流行病学史不详的情况下，根据临床表现、辅助检查和实验室检测结果，特别是从患者呼吸道分泌物标本中病原学检测阳性，可作出诊断。 当前第14页\共有38页\编于