ISSN 2096-7446　CN 10-1655/R
主管：中国科协技术协会
主办：中华护理学会
中华急危重症护理杂志

中华急危重症护理杂志

• 新冠肺炎护理专题 • 上一篇    

新型冠状病毒肺炎死亡病例分析及对疾病管理的启示

邓娟 黄素芳 商薇薇 严丽 何家欢 肖亚茹   

  1. 华中科技大学同济医学院附属同济医院

Analysis of death cases due to COVID-19 and disease management strategies

DENG Juan，HUANG Sufang，SHANG Weiwei，YAN Li，HE Jiahuan，XIAO Yaru   

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摘要： 目的 分析32例新型冠状病毒肺炎死亡病例临床特征，为规范疾病临床管理与防控方案提供理论依据。方法 回顾性分析2020年1月9日要2020年1月24日官方媒体报告的32例新型冠状病毒感染后死亡病例，包括年龄尧基础疾病、临床首发症状、发病至就诊时间、发病至死亡时间等特征，结合当前国家政策与指南，探讨新型冠状病毒肺炎的临床管理策略。结果 32例死亡患者中男性25例，占比78.13%，发病年龄中位数为70岁，患者基础疾病包括高血压、糖尿病、心脏病、脑卒中、肺部疾病等；患者首发症状多样化，包括发热、咳嗽、胸闷气促、呼吸困难、乏力、肌肉酸痛、腹泻等；患者发病至就诊中位时间为6 d，发病至死亡中位时间为13 d。结论针对高龄、合并基础疾病的新型冠状病毒肺炎患者不建议居家隔离，应早发现、早干预、早治疗；治疗过程中应结合既往史、临床症状、实验室检查等全面评估和确定患者临床管理方案；对居家隔离患者要做到动态评估与监测，鼓励患者采取主动参与式疾病自我管理策略，及时筛查与就医。

关键词:

新冠肺炎, 疾病特征, 临床管理, 家庭护理

Abstract:

Objective We analyzed 32 death cases caused by COVID-19 to provide evidence for standardizing clinical management and prevention of the disease. Methods 32 cases died of COVID-19 from 9th to 24th January in 2020 were retrospectively analyzed. Age，comorbidity，first clinical symptom，time of illness onset，time from onset to medical consultation，time from onset to death and so on were collected. Then we explored the clinical management strategies for COVID-19 according to national policy and guideline. Results Among the 32 patients，25 were male accounting for 78.13% and the median age was 70 years old. The comorbidities included hyperten-

Sion，diabetes，heart disease，stroke，pulmonary disease and etc. The clinical symptoms varied，including fever，cough，chest tightness，dyspnea，fatigue，muscle ache，diarrhea and etc. The median time from the onset of illness to medical consultation was 6 days，the median time from the onset to death was 13 days. Conclusions We don t recommend home care for the elderly and patients with comorbidities. They should be detected and treated as early as possible. The clinical management plan should be made on the basis of a comprehensive evaluation of history，clinical symptoms and laboratory tests. We should dynamically assess and monitor patients in home care and encourage patients to take active part in self-management strategy，be screened and seek treatment timely.

Key words:

COVID-19, Disease Characteristics, Clinical Governance, Home Nursing