Nghiên cứu đặc điểm lâm sàng, cận lâm sàng và nhận xét kết quả điều trị của bệnh nhân Covid - 19 mức độ nặng tại Đơn vị C4

Nghiên cứu đặc điểm lâm sàng, cận lâm sàng và nhận xét kết quả điều trị của bệnh nhân Covid - 19 mức độ nặng tại Đơn vị C4 - Bệnh viện Đa khoa Đức Giang

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Tác giả: Hồng Trường Đỗ, Văn Nguyện Hồ, Thị Trang Hoàng, Hữu Tiến Nguyễn, Thị Minh Tuyến Nguyễn, Thị Hoài Trần

Ngôn ngữ: vie

Ký hiệu phân loại: 362.1962414 Physical illness

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2022

Mô tả vật lý: 266-274

Bộ sưu tập: Metadata

ID: 498972

Thêm vào giỏ

Nghiên cứu đặc điểm lâm sàng, cận lâm sàng và nhận xét kết quả điều trị của bệnh nhân Covid - 19 mức độ nặng tại đơn vị C4 - Bệnh viện Đa Khoa Đức Giang. Đối tượng và phương pháp nghiên cứu: nghiên cứu cắt ngang, mô tả, hồi cứu, tiến cứu. Đối tượng nghiên cứu gồm 50 bệnh nhân Covid-19 điều trị nội trú tại đơn vị covid C4 - Bệnh viện Đức Giang từ tháng 01/2022 đến tháng 03/2022. Kết quả: Tỷ lệ nữ giới chiếm 56%, nam giới chiến 44%. Tuổi trung bình của nữ là 79.6, của nam là 69 tuổi. Có 56% bệnh nhân đã tiêm vaccin. 54% bệnh nhân điều trị trước khi nhập viện. Bệnh nhân nhập viện với lý do khó thở chiếm tỷ lệ lớn nhất với 72%. 100% bệnh nhân nhập viện có khó thở, 98% bệnh nhân mệt. Khám phổi thấy rale nổ, ẩm có tỷ lệ lớn nhất 64%. Bệnh nhân nhập viện có tỷ lệ LDH trên 300 chiếm 46%, tỷ lệ Ferritin trên 500 chiếm 68%, D-dimer trên 1000 chiếm 38%
tỷ lệ bạch cầu lym pho thấp dưới 1 chiếm tỷ lệ lớn nhất với 62%. Có 98% bệnh nhân tổn thương phổi 2 bên. Ở phổi trái, tổn thương phối hợp trên XQ chiếm 64%, trong đó tổn thương đám mờ và chấm nốt là lớn nhất và cùng chiếm 60%. Phổi phải, tỷ lệ tổn thương phối hợp chiếm 60%, trong đó tổn thương chấm nốt chiếm 62%, đám mờ chiếm 54%. Có 56% bệnh nhân phải hỗ trợ hô hấp oxy mask và HFNC khi nhập viện, oxy kính chiếm 44%. Bệnh nhân chuyển tuyến dưới chiếm 58%, bệnh nhân chuyển đơn vị hậu covid chiếm 18%, bệnh nhân ra viện chiếm 14%, bệnh nhân tử vong chiếm 10% bệnh nhân điều trị., Kết Luận: Covid 19 là căn bệnh nguy hiểm trên thực hành lâm sàng, thường gặp bệnh nặng ở các đối tượng cao tuổi, chưa tiêm vaccin
đa phần bệnh nhân nhập viện vì lý do khó thở. Khó thở, mệt là những triệu chứng thường gặp nhất, Bệnh nhân nhập viện có rale ẩm, nổ chiếm tỷ lệ lớn nhất. Phần lớn bệnh nhân có bạch cầu lympho thấp, CRP, Ferritin cao hơn bình thường. Đa phần bệnh nhân tổn thương phổi 2 bên và tổn thương đám mờ, kẽ chiếm tỷ lệ lớn nhất. Bệnh nhân nhập viện phải hỗ trọ oxy mask và HFNC chiếm tỷ lệ lớn nhất với 56%. Tỷ lệ tử vong cao với 10% bệnh nhân.Study on clinical and subclinical characteristics and comment on treatment results of severe Covid-19 patients at unit C4 - Duc Giang General Hospital. Subjects and research methods: cross-sectional, descriptive, retrospective, prospective study. The study subjects included 50 Covid-19 patients inpatient treatment at covid C4 unit - Duc Giang Hospital from January 2022 to March 2022. Results: The percentage of women accounted for 56%, the male battle was 44%. The mean age of women is 79.6 years old and that of men is 69 years old. There are 56% of patients vaccinated. 54% of patients treated before admission. Patients admitted to the hospital with shortness of breath accounted for the largest proportion with 72%. 100% of hospitalized patients have difficulty breathing, 98% of patients are tired. Pulmonary examination showed explosive rales, humidity had the highest rate of 64%. Hospitalized patients with LDH rate over 300 accounted for 46%, ferritin rate over 500 accounted for 68%, D-dimer rate over 1000 accounted for 38%
the rate of low lymphocytes less than 1 accounts for the largest proportion with 62%. 98% of patients have bilateral lung damage. In the left lung, the combined lesions on X-ray accounted for 64%, of which opacities and nodules were the largest and together accounted for 60%. Right lung, the rate of combined lesions accounted for 60%, of which punctate lesions accounted for 62%, opacities accounted for 54%. There are 56% of patients who need oxygen mask and HFNC respiratory support when hospitalized, oxygen glasses account for 44%. Patients transferred to lower levels accounted for 58%, patients transferred to post-covid units accounted for 18%, discharged patients accounted for 14%, and death patients accounted for 10% of treated patients. Conclusion: Covid 19 is a dangerous disease in clinical practice, often severe illness in elderly, unvaccinated subjects
Most patients are admitted to the hospital because of shortness of breath. Shortness of breath and fatigue are the most common symptoms. Hospitalized patients with wet rales and explosions account for the largest percentage. Most patients have lymphocytes, CRP, and ferritin are higher than normal. Most patients have bilateral lung damage and opacities, interstitial lesions account for the largest percentage. Hospitalized patients required oxygen mask support and HFNC accounted for the largest proportion with 56%. High mortality rate with 10% of patients.

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