【摘要】 目的 :对 2 0 0 3年 4月 10日至 5月 12日我院SARS病房留观的全部 2 72例疑诊患者的初诊病历资料进行回顾性分析 ,总结这些初诊病例的临床特征。方法 :按照卫生部《非典型肺炎病例的临床诊断标准 (试行 )》和北京市防治非典型肺炎联合工作小组发布的《关于传染性非典型肺炎的诊断标准》确定留观病例 ,对病历记录的初诊资料进行分析。结果 :对初诊留观病例的性别组成、年龄分布、职业构成、接触史及曾接受的治疗等进行了描述性统计 ;对初诊临床症状、体征、血白细胞计数及X线胸片表现进行了分析 ;初诊留观的 2 72例患者中 ,最终确定诊断为SARS者为 14 5例 (5 3.3% ) ,而 97例被排除 (35 .7% )。结论 :疑诊的SARS病例在初诊时 ,应综合、全面考虑流行病学接触史、临床症状、实验室检查和影像学的表现 ,防止漏诊、误诊的发生 ;在留观过程中 ,根据病情变化不断修正初诊诊断 ,才能得出正确的诊断结论 ;目前急需病原学和血清学手段以提高诊断准确性更多还原

【Abstract】 Objective: The first visiting cases of total 272 SARS inpatients admitted in SARS wards in Third Hospital from April 10, 2003 to May 12 were analyzed retrospectively. The clinical characteristics and diagnostic decision for these patients were described. Methods: The enrollment of inpatients was ruled with two official standards, i. e ., ’Clinical Standards for Diagnosis of SARS, Trial Edition’ from Health Ministry, and ’Diagnostic Standards for SARS’ from Joint Force of Prevention and Therapy for SARS in Beijing, PRC. The present work was based on the first visiting case records of these SARS inpatients. Results: The characteristics of gender, age, occupation, contagious history and previous therapy were described in SARS inpatients when they visited the outpatient department for SARS in the first time; the clinical symptoms, physical signs, blood WBC counts and X ray in lungs were also analyzed. In 272 inpatients who were admitted into SARS wards at their first visiting, 145 patients (53.5%) were finally diagnosed as SARS, well as 97 patients (35.7%) were eliminated. Conclusion: In the first visiting of the suspectable SARS patients, the contagious history, clinical symptoms, laboratory results and lung X ray should be studied comprehensively and thoroughly to avoid omitted or mistaken diagnosis. Most final diagnosis came from the revising of the original decision. The advances in SARS virology and immunology may provide more accurate evidences in SARS diagnosis.更多还原