The Clinical Analysis On The Characteristics And Treatment Of Influenza A H1N1

Background and objectiveInitial 2009, the first epidemic outbreak of respiratory disease in Mexico, gradually spread led to global pandemic, WHO has been would alert level from the first three, raised to six in the short term, which further indicates that the formation of a global pandemic, and later confirmed, the new swine flu epidemic was derived from the influenza virus A (H1N1) - (S-OIV) are present. This disease is a respiratory infectious disease and presented with fever, cough, sputum, sore throat, breathing difficulties and other respiratory symptoms more common, but many are not typical and non-specific, therefore prone to misdiagnosis and missed, resulting in more large-scale epidemic. The current research on the influenza A (H1N1) has become the focus of attention, its significance is not only to control the pandemic, but also guidance the outbreak of pandemic in the future.Taking into account the presence of virus mutation and timeliness of disease, etc., this collection focus on the outbreak of influenza illness 3 months ago, in the first Hospital of Jilin University. And diagnosed as influenza A(H1N1)and hospital treatment of 30 patients with isolated cases of data retrospective analysis, analysis of its epidemiology and clinical features, laboratory findings, diagnosis and treatment measures ,in order to arouse the attention of clinicians to avoid misdiagnosis and to enhance the level of diagnosis and treatment of the disease, which have some guidance in preventing of influenza pandemic broke out in the future.Materials and methodsIn this article, the virus nucleic acid detection were H1N1, and hospitalization data of 30 patients were retrospectively from the First Hospital of Jilin University from October 2009 to December 2009 period, the CDC line in Changchun City. The records of 30 patients with age, sex, disease duration ,variety of clinical features and laboratory parameters, then records the results were analyzed, concludes the characteristics and symptoms occur, laboratory results and treatment experiences, to constitute the incidence, etc. Through the image changes in patients with severe changes of understanding disease.Results:(1) 30 cases of Influenza A H1N1 influenza patients, 12 male patients, 18 females, aged 13-70 years, mean age 38 years, age 20-50 years with mostly young, most of them 20-29 years of age, age the elderly, hospital stay longer.(2) Onset of the disease, past more than a certain underlying diseases, pregnant women, the incidence rate was higher for high-risk groups, the incidence in patients with more direct isolation.(3) Clinical manifestations: 30 cases exist in the pathogenesis of fever, mostly irregular heat type, the other common symptoms are cough, sputum (83.3%), chest tightness, shortness of breath, difficulty breathing is even (50%), sore throat (53.3%), bloody sputum (13.3%), etc.(4) Laboratory:â‘ blood leukocyte counts were normal and decreased (73.3%) more than the percentage of lymphocytes decreased. Most patients with abnormal myocardial enzyme LDH increased in patients with disease higher than the apparent weight.â‘¡80% of early stage there is decreased serum albumin, and more volatile 25-30g / L.â‘¢the abnormal sputum culture in 5 cases, respectively, Stenotrophomonas maltophilia in 2 cases, 1 case of Enterococcus faecalis, in the amount of candida tropicalis in 1 case, 1 case of Mucor, the resistant and fungal infection, check the positive rate is not high.(5) Imaging for different levels of flaky, patchy infiltrative shadows, rapid progression, severe and even shows diffuse reticular, ground glass-like change. For there to change the image, and accompanied by flu-like symptoms in patients with hormone dosage of 40 ~ 160mg twice a day application of hormones, patients with more severe impact to the 500mg dose.(6) 2 cases of 30 patients died, all had underlying diseases, and another one case of multiple organ dysfunction syndrome, was discharged because of economic reasons.Conclusion:(1) The onset of influenza A(H1N1) peak concentration in young and middle age, and more directly admitted to isolation and treatment, incidence of older patients in hospital longer. (2) no obvious clinical symptoms and signs of specificity, similar to seasonal influenza, with fever as the main performance, may be associated with cough, sputum, sore throat, difficulty breathing and other non-specific symptoms. Rapid progression who may predispose to pneumonia, myocarditis, respiratory failure and other complications, even life-threatening. (3) leukocytes and lymphocytes in blood in order to reduce as the main performance, lactate dehydrogenase and albumin and have different levels of reduction, the results of sputum culture positive rates of lower,mostly resistant and fungal infections. (4) chest X ray and lung CT showed pulmonary interstitial and more substantial lesions, severe and critical patients in a short time a "white lung" performance, for the merger of pneumonia, the condition of patients with increased trend, advocates of early appropriate and reasonable to give antibiotics, hormone therapy, hormone dosage and administration time to be determined according to specific conditions, the application of antibiotic susceptibility qualitative results according to established multi-application broad-spectrum antibiotics. (5) Most patients with good prognosis Influenza H1N1 influenza, pneumonia, even if the merger is still curable, but only a rapid progression in patients with life-threatening.