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病例18-2020 ——一名患低氧血症型呼吸衰竭和心功能障碍的73岁男性
Case 18-2020 — A 73-Year-Old Man with Hypoxemic Respiratory Failure and Cardiac Dysfunction


Dhruv S. Kazi ... 呼吸系统疾病 • 2020.06.11
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病例陈述



Lila M. Martin医师:2020年3月,在2019冠状病毒病(COVID-19)大流行期间,一名73岁男性因急性低氧血症型呼吸衰竭被转到波士顿一家学术型医疗中心的重症监护病房(ICU)。

在此次转诊前6日,该患者出现了干咳、发热和疲劳加重,而之前处于平时的健康状态。2日后,患者症状仍未好转,因此到当地一家医院的急诊就诊。检查时,体温为38.8℃,血压为94/62 mmHg,心率为91次/分,呼吸频率为12次/分,患者呼吸环境空气时的氧饱和度为97%。而且患者看起来状态良好,肺部听诊声音清晰。白细胞计数为5,600/μL(参考范围,4,800~10,500);56%的细胞为中性粒细胞,33%为淋巴细胞。医师采集了一份患者的鼻咽拭子样本,并送到马萨诸塞州实验室(Massachusetts State Laboratory)进行SARS-CoV-2 RNA核酸检测。由于全州鼻咽拭子短缺,因此未对甲型流感病毒、乙型流感病毒和呼吸道合胞病毒进行检测。





作者信息

Dhruv S. Kazi, M.D., Lila M. Martin, M.D., M.P.H., Diana Litmanovich, M.D., Duane S. Pinto, M.D., M.P.H., Kevin J. Clerkin, M.D., Peter J. Zimetbaum, M.D., and David M. Dudzinski, M.D.
From the Departments of Medicine (D.S.K., L.M.M., D.S.P., P.J.Z.) and Radiology (D.L.), Beth Israel Deaconess Medical Center, the Departments of Medicine (D.S.K., L.M.M., D.S.P., P.J.Z., D.M.D.) and Radiology (D.L.), Harvard Medical School, and the Department of Medicine, Massachusetts General Hospital (D.M.D.) — all in Boston; and the Department of Medicine, New York Presbyterian–Columbia University Medical Center, and the Department of Medicine, Columbia University Vagelos College of Physicians and Surgeons — both in New York (K.J.C.).

 

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