Severe acute respiratory syndrome severe acute respiratory syndrome virus, also known as
SARS. Without identifying the cause before, called Atypical pneumonia, also known as severe acute respiratory syndrome (Severe Acute Respiratory Syndromes), referred to as SARS, is a result of SARS coronavirus infection caused by fever, dry cough, chest tightness, as the main symptoms, severe cases, rapid Progress in respiratory failure, is a new respiratory disease, highly contagious and rapidly progressive disease are the main features of the disease.
directory
About SARS clinical diagnosis of SARS symptoms and signs of SARS prevention of SARS virus how to treat SARS? (A) general treatment and disease monitoring (b) symptomatic treatment (c) the use of corticosteroids (four) antiretroviral therapy (v) immunotherapy (f) the use of antimicrobial agents (g) psychological therapy (viii) medical treatment 1 clinical treatment, monitoring and general treatment 2, the respiratory support treatment for 3, the application of corticosteroids 4, 5, clinical nutrition, prevention and treatment of secondary infection in patients recovering from SARS tracking and handling characteristics and treatment of children precautions to prevent non- Kan Miyoshi Code four sequels to do during the epic heroes of SARS prevention of SARS should be noted that the summer of four [1] [2]
About SARS patients as an important source of infection, mainly acute phase, when patients with respiratory secretions, blood virus levels, very high, and have obvious symptoms such as sneezing and so easy to spread viruses. SARS coronavirus main droplets by close contact with infectious secretions and close contact, is a new virus, people do not have immunity, are generally susceptible. Nearly 11% mortality of the disease, mainly in winter and spring disease. Its pathogenesis and immune system impairment. Virus penetrated the body, replication, can cause the body's abnormal immune response, due to damaged immune system, resulting in the patient's immune defect. SARS virus can also damage the immune system, particularly lymphocytes. Severe Acute Respiratory Syndrome (Atypical pneumonias), is defined as mycoplasma, chlamydia, legionella, rickettsia, adenovirus and other causes of pneumonia of unknown microorganisms. The typical pneumonia is defined by Streptococcus pneumoniae and other common bacterial lobar pneumonia or bronchopneumonia. In fact, the medical profession, people occurred in 2003, the name of this disease is controversial, as it has been identified, the disease is not really medically known as viral pneumonia. For this type of disease, people's understanding of a gradual process, the concept has become increasingly accurate. At first it was felt that chlamydia causes is, until March 2003 was to ascertain the causative agents of a China Guangdong doctor and the fight against disease, according to their clinical fever, cough, pneumonia, lung shadows and other common symptoms, but caused by the bacterium Streptococcus pneumoniae pneumonia and other than the lack of typical symptoms, pathogens have not yet entirely clear and infectious intensity, the use of features such as antimicrobial treatment ineffective, in January 22 for the first time using the The end of February, the World Health Organization's Italian infectious disease expert 卡洛厄巴尼 (Carlo Urbani) the doctor had already acquired under the conditions of their named severe acute respiratory syndrome (referred to as SARS), 3 月 15 Day World Health Organization formally in lieu of the ATP.
In fact, severe acute respiratory syndrome in this name and does not fully reflect the essential characteristics of the disease as early as it was suggested that it should be named as the Crown lung This proposal has yet to be social and the medical community to accept, but enough to support the SARS and SARS, as it reflects a certain stage are distinctive features of the understanding of things. The current treatment has been found, scientists in China and the EU together, success can be found in 15 compounds kill SARS virus, for the synthesis of SARS provides a new method of treatment. EU scientists, June 9, 2005 in Hangzhou, the end of the University of Hong Kong's recent research shows that bats may be the SARS virus wild Chinese character input host computer expert Zhou Gang in 2003 suggested However, it is recommended by the World Health Organization should be (WHO) named the principle of the medical profession called SARS (tone The medical profession in Hong Kong and WHO as the first time, changed to SARS, the Chinese mainland, because the people has been referred to as -------------------------------------------------- -------------------------------------------------- --------- SARS on traditional medicine is a relatively typical in terms of pneumonia, typical of pneumococcal pneumonia is usually caused by other common bacterial. The typical symptoms such as fever, chest pain, cough, sputum, etc., laboratory tests, increased white blood cells, antibiotic treatment is effective. SARS itself is not newly discovered disease, which more than by a virus, mycoplasma, chlamydia, caused by Rickettsia and other pathogens, symptoms, pulmonary symptoms, blood test results are not typical of pneumonia so obvious, a number of viral pneumonia antibiotics ineffective. Atypical pneumonia is a group of diseases caused by atypical pathogens mentioned above, rather than a clear diagnosis. The clinical features of occult onset, mostly dry cough, occasional hemoptysis, lung auscultation few positive signs; X-ray showed interstitial infiltration mainly; the disease process is usually lighter, less so in patients death. The name of SARS originated in late 1930, corresponding to a typical pneumonia, the latter mainly on the grounds bacterial lobar pneumonia or bronchopneumonia. 60 years of the 20th century, the Mycoplasma pneumoniae was found as the main pathogens of atypical pneumonia, but then found other pathogens, particularly Chlamydia pneumoniae. Now that the atypical pneumonia pathogens include Mycoplasma pneumoniae, Chlamydia pneumoniae, Chlamydia psittaci, Legionella and Rickettsia (Q fever caused by pneumonia), especially prior to the two more common, accounting for almost a year of adult people hospitalized patients with community-acquired pneumonia in 1 / 3. These cells are mostly parasitic pathogens, there is no cell wall, thus broad-spectrum antibiotics into the cell (mainly macrolides and tetracyclines) their treatment is effective, and β-lactam antibiotics ineffective. As for the atypical pneumonia caused by a virus, antibiotics are ineffective. -------------------------------------------------- ------------------------------------------- Huang Xingchu, China's first report on SARS patients (ie, mainland China, commonly known as -------------------------------------------------- -------------------------------------------------- -------- Ye Xin, in the war has made significant contributions of SARS in Guangdong Traditional Chinese Medicine Hospital emergency department nurse, in 1976 and graduated in the health information team, the year end 47 years of age. Deng Lianxian, branch secretary of the Third Hospital of Infectious Diseases is in the fight against atypical pneumonia in Guangdong Province in the second line of duty fighting the doctors, aged 53, Liang Shikui, unfortunately atypical pneumonia in the hospital, tenacious fight with the disease. In the case of extreme physical weakness, he thought of or someone else. April 24, 2003 morning, the medical treatment fails to rescue, Liang Shikui glorious comrades who died, aged 57, Chen Hongguang 1987 graduated from the Guangzhou City, Guangdong Medical College Chest Hospital, formed by hand intensive care unit of the hospital and served as Officer. Patients in the first-line rescue more than 70 days and nights, he personally was more than 100 critically ill patients on a ventilator tube, often will be blasting out of the sputum of patients, have a look of contaminated secretions. April 16, Chen Hongguang comrades were diagnosed as atypical pneumonia, despite full treatment, the end result of the heavy conditions in the early morning of May 7 unfortunately killed at age 39. Xiaohong Sheng Qianxi Beijing Armed Police Corps of the Second Division hospital physician. Battle in the fight against atypical pneumonia, she hard for 6 days, unfortunately, infected. April 16 morning, the end result He died lost their lives, the age of 29. Clinical diagnosis of SARS symptoms and signs of SARS during the Beijing subway
1. Epidemiological history was 1.1 2 weeks prior to the onset of close contact with patients or similar with clear evidence of transmission to others living in the endemic area of 1.2 or 2 weeks before the onset of SARS is spreading through the region 2. symptoms and signs of fever (> 38 ℃) and cough, rapid breathing, shortness of breath, or respiratory distress syndrome, pulmonary rales or signs of pulmonary consolidation more than one . 3. Laboratory examination of early blood WBC count is not increased or decreased. 4. Lung lung imaging in different degrees of flake patchy or reticular infiltrative shadows like changes 5. Antimicrobial treatment had no significant effect. According to the clinical diagnosis of SARS cases in the epidemiological data, symptoms and signs, laboratory tests, lung imaging to determine the clinical diagnosis of integrated, once pathogens identified specific detection method, namely the establishment of diagnosed cases according to epidemiological data, symptoms and signs, laboratory tests, lung imaging studies were integrated to determine the clinical diagnosis, to determine if pathogens, detection methods specific, namely the establishment of the definition of confirmed cases. Suspected cases: 1.1 +2 +3 or 1.2 +2 +3 +4 clinically diagnosed cases: 1.1 +2 +3 +4 or 1.2 +2 +3 +4 +5 SARS cases of severe disease diagnostic criteria for SARS patients meet the following criteria which one can be diagnosed as SARS, severe cases: 1. Multi-leaf disease or X-ray 48 hours of disease progression> 50% 2. dyspnea, respiratory rate> 30 beats / min; 3. hypoxemia, oxygen 3-5 L / min conditions, SaO2 38.5 ℃, with obvious or body aches, use of antipyretic analgesics. Fever were given ice, alcohol sponge bath, cooling blankets, and other physical cooling measures, disabled children, salicylic acid anti-inflammatory drugs. 2, cough, expectoration may give antitussive, expectorant. 3, heart, liver, kidney and other organ dysfunction, should take the appropriate treatment. 4, diarrhea, patients should pay attention to rehydration and correction of water and electrolyte imbalance. (C) the use of glucocorticoids purpose of glucocorticoids is to inhibit an abnormal immune pathological response, reduce the systemic inflammatory response status, thus improving the general condition of the body, reducing the lung's leaking, damage, prevent or mitigate the late pulmonary fibrosis of. Application of the indication as follows: ① serious poisoning symptoms, persistent fever to subside and symptomatic treatment more than 3 days after the maximum temperature still exceeds 39 ℃; ② X-ray showed multiple or large areas of shadow, the rapid progress of lesion area within 48 hours by Large> 50% of the anteroposterior chest radiograph and in the lungs of the total area accounted for over 1 / 3; ③ to acute lung injury (ALI) or ARDS diagnostic criteria. Can be applied with one or more indications. Adult recommended dose of methylprednisolone is equivalent to 80 ~ 320mg / d, the specific dose intravenous condition and individual differences can be adjusted. When clinical improvement or chest X-ray showed the shadow of some absorption of the lungs, gradually reducing disabled. General reduction of 3 to 5 days per 1 / 3, usually administered intravenously 1 to 2 weeks after oral prednisone can be changed or thrown nylon. Generally not more than 4 weeks, should not be too large doses or long course of treatment, should also apply Antacids and gastric mucosal protective agent, also guard against secondary infections, including bacteria and / or fungal infections, but also pay attention to the potential tuberculosis infection proliferation. (D) anti-viral therapy has not yet found specific for SARS-CoV drugs. Retrospective analysis of clinical data, ribavirin and other antiviral drugs commonly used for treatment of this disease is not clear. Protease inhibitor class of drugs to try slightly horse ritonavir Kaletra (Lopinavir) and Ritonavir (Ritonavir) and so on. (E) Thymosin immunotherapy, interferon, gamma globulin with non-specific immune stimulants on the efficacy of the disease has not yet sure, not recommended for routine use. The clinical efficacy of SARS convalescent serum has not been confirmed, the diagnosis of definite high-risk patients can be closely observed by the trial. (F) the use of antimicrobial agents application of antibiotics is the main purpose of the two, one for experimental treatment of suspected patients to help the differential diagnosis; the second is used for the treatment and control of secondary bacterial, fungal infections. In view of SARS often associated with community-acquired pneumonia (CAP) to be confused, which is common pathogens Streptococcus pneumoniae, Mycoplasma, Haemophilus influenzae, and so the diagnosis is unclear when the use of new quinolones or β-lactam combined with high Experimental treatment of drug ring lactones. Secondary infection of pathogens,
nike air force 1 high, including gram-negative bacteria, resistant Gram-positive bacteria, fungi and Mycobacterium tuberculosis, should be targeted to the choice of appropriate antibiotics. (G) Psychological treatment of suspected cases admitted to the conditions should be reasonable arrangements to reduce the cross infection of patients worry about the pressure; of the confirmed cases, care and interpretation should be strengthened to guide patients to enhance the self-limiting disease awareness and cure. (Viii) medical treatment of the disease found Immunotoxin evil because of their disease, by the nose and mouth into the room, mainly located in the lung disease also can affect other organs; the basic pathogenesis of the cult poison obstruct the lung, wet phlegm, lung canopy, Qi and Yin deficiency. The principles of Chinese medicine treatment is early treatment, re-Quxie, as early as righting, anti-mass change. 1, Differential Treatment (1) Immunotoxin Fanfei card: more common in early. Symptoms: fever since the beginning of, or aversion to cold; headache, body pain, limb difficulties; dry cough, little sputum, or sore throat; shortness of breath, fatigue, dry mouth. White or yellow tongue coating, slippery pulse number. Governing Law: Qingfei detoxification, chemical wet evil. Basic method and the reference dose: Yinhua 15g 10g skullcap side Bupleurum Alice 10g 15g 15g white Kou annua 6g (play) fried almonds 15g 9g Radix Health reed rhizome 15g 15g Coix subtraction: (1) No sweat by adding mint ; (2) hot fraudulent claims add gypsum, Anemarrhena; (3) greasy by Jia Lei Hong, Perrin; (4) diarrhea to Anemarrhena, plus berberine, Bao Jiang; (5) nausea and vomiting plus system Pinellia , Zhuru. (2) Immunotoxin obstruct the lung: more common in early and progressive. Symptoms: high fever, sweating hot puzzled, body pain; cough with little phlegm, chest tightness, shortness of breath; diarrhea, nausea, vomiting, or abdominal distention or constipation, or loose stools unhappy; dry mouth and do not want to drink, shortness of breath, fatigue; even the restless. Tongue is red or purple-red, yellow greasy moss, pulse a few slip. Governing Law: detoxification, Xuanfei dampness. Basic method and reference dose: gypsum 45g (Xian Jian) Silver Flower Anemarrhena 10g 20g 6g moxibustion ephedra Health Yiyiren fried almonds 10g 15g 10g Zhejiang shellfish raw licorice 10g 10g heterophylla subtraction: (1), irritability, dry mouth and tongue purple-red by adding habitat, red peony, Dan; (2) shortness of breath, fatigue, dry mouth and severe to participate in American ginseng, Prince; (3) nausea and vomiting plus Pinellia system; (4) were added to whole Trichosanthes constipation, rhubarb; (5), abdominal distention, loose stools are uncomfortable plus coke nut, woody. (3) Asthmatic pulmonary closed card: more common in advanced and severe SARS. Symptoms: high fever began to subside or diminish; breathing difficulties, chest tightness, breath, wheezing, shortness of breath; or a dry cough, little sputum, blood or sputum; shortness of breath, fatigue, weakness. Lips dark purple, red or dark red, yellow and greasy fur, slippery pulse. Governing law: heat Xiefei, stasis Huazhuo, combined with righting. Basic method and the reference dose: 15g Tinglizi Morus alba Scutellaria 10g 15g 30g turmeric 10g whole Trichosanthes 12g castor seed solution silkworm sand 10g (packs) Denmark ginseng 15g 30g 15g Patrinia subtraction: (1) shortness of breath, fatigue, severe asthma plus cornus; (2) abdominal distention, poor appetite were increases Magnolia, malt; (3) plus Panax lips cyanosis, Motherwort. (4), closed off outside the permit: seen in severe SARS. Symptoms: respiratory distress, suffocation breathlessness, respiratory and more smoke less; voice was low, dry disturbed disturbed, rather then the coma, sweating, cold extremities. Dark purple lips, tongue, dark red, yellow greasy moss, pulse small stricken. Governing Law: convergence Qi Yin, yang solid back off, Huazhuo opening and closing. Basic method and the reference dose: Red Ginseng 10 ~ 30g (fried against the other services) gun Fuzi Radix 15g 30g 10g turmeric 10g cornus thirty-seven 6g Modified: 1 Shenhun are top of the delivery service Angongniuhuang; 2 cold sweat dripping by adding calcined Longmu; 3 limbs were Guizhi, Ginger; 4 throat phlegm dates were added with the monkey loose. (5) Qi and Yin deficiency, phlegm meridian syndrome: more common in the recovery period. Symptoms: chest tightness, shortness of breath, fatigue strength supplement, moving the asthma; or see cough; consciously fever or low fever, spontaneous perspiration, anxiety, insomnia, poor appetite, dry mouth and throat. Mamillata Shaojin, or greasy yellow tongue coating, thin weak pulse common Shen. Governing Law: Reinforcing Qi, phlegm meridians. Basic method and the reference dose: Radix Codonopsis 15g 15g 15g Radix Rehmannia Radix 12g 15g 15g Aster malt 15g 10g beta Zhejiang Modified: (1) shortness of breath, severe asthma, who added the dark tongue Panax, Schisandra, mountain cornelian cherry meat; (2) fever or heart Fanre conscious, dark tongue, who added Artemisia annua, Gardenia, Dan; (3) stool partial pond were added Poria, Atractylodes; (4) anxiety by vinegar Bupleurum, Hong attached; (5) Add fried Zaoren insomnia, Polygalaceae; (6) elevated transaminase liver injury increases capillaris, Schisandra. 2, the application of proprietary Chinese medicine should be dialectical use, can be combined with traditional Chinese medicine decoction. (1) fever categories: for the early progress of the fever, fever optional cream melon capsule, Zixue, new snow particles, small purple Hu tablets (or granules), Purple oral liquid. (2) Qingrejiedu categories: for the early progress of the epidemic toxin d the lung, Immunotoxin obstruct the lung, pulmonary closed asthmatic card. Injection can be used Qingkailing injection, injection, SHL injection, matrine injection and so on. Oral agents can choose Qingkailing Oral (capsule), Qingrejiedu oral solution (particle), SHL oral liquid, Jin Lianqing thermal particles, particles of a bitter, Gegenqinlian pellets Meihuadianshe Dan, Zijin ingots and so on. (3) blood stasis, phlegm dampness categories: for the progress of closure and severe asthmatic lung SARS card. Injection can be used injection, Hong Dan injection, Chuanxiong injection, such as Erigeron injection. Oral agents can choose Xuefuzhuyu Oral Liquid (or particles), CSDP, Huoxiangzhengqi oral (capsule), monkeys and other scattered dates. (4) centralizer categories: applicable to all of those who are upright deficiency. Students can choose injection injection, injection, injection, astragalus and so on. Oral agents can choose ShengmaiYin, Bailing capsule, Jinshuibao capsule, Ning Xin Bao Capsule, Nuodikang capsule, Liu Wei Di Huang Wan, Bu Zhong Yi Qi balls. Principle of treatment of severe SARS, although the majority of SARS patients can naturally relieve the condition, but about 30% of cases are severe cases, some of which may progress to acute lung injury or ARDS, and even death. Therefore, patients must be closely for severe dynamic observation, intensive care, respiratory support given in time, the rational use of corticosteroids, nutritional support and strengthen the protection of organ function, attention to water-electrolyte and acid-base balance, prevention and treatment of secondary infection, the timely processing of complications . 1 clinical treatment, monitoring and general treatment and disease monitoring and general treatment of non-critically ill patients the same, but the critically ill patients vital signs should be strengthened, and out of fluid volume, electrocardiogram and blood glucose monitoring. When higher than normal blood glucose levels, insulin can be controlled in the normal range, may help reduce complications. 2, respiratory support therapy in severe SARS patients should regularly monitor changes in SpO2. SpO2 decreased after the event is an early manifestation of respiratory failure, should be given timely treatment. (1) Oxygen Therapy: For severe cases, even in the resting state, the performance of oxygen, continuous nasal catheter should also be given oxygen. Who have hypoxemia, usually require a high inspired oxygen flow to maintain SpO2 93% or more, if necessary, use oxygen masks. From oxygen therapy should be avoided activities (eg: toilet, medical examinations, etc.). If the oxygen flow rate ≥ 5L/min (or fraction of inspired oxygen ≥ 40%) conditions, SpO2 30 times / min; ② 5L/min oxygen conditions, SpO2 allergic rhinitis
http://wjbjzddeyy.blog.163.com/blog/...1010991423922/
3
prevention of SARS should be noted that the summer of four
http://www.52tushu.com/a/107/137/120818.html
Further reading: 1
knowledge of prevention and treatment of SARS:
http://www.52tushu .com/a/107/137
Open Category: medical, disease, internal medicine, SARS, an acute infectious disease I have to improve the
农妇历时10余年写成40万字古典小说(图)
Linear Mode
