RESUMO
BackgroundSince January 2020, coronavirus disease 2019 (Covid-19) has spread rapidly and developing the pandemic model around the world. Data have been needed on the clinical characteristics of the affected patients in an imported cases as model in island outside Wuhan. MethodsWe conducted a retrospective study included all 168 confirmed cases of Covid-19 in Hainan province from 22 January 2020 to 13 March 2020. Cases were confirmed by real-time RT-PCR and were analysed for demographic, clinical, radiological and laboratory data. ResultsOf 168 patients, 160 have been discharged, 6 have died and 2 remain hospitalized. The median age was 51.0 years and 51.8% were females. 129 (76.8%) patients were imported cases, and 118 (70.2%), 51 (30.4%) and 52 (31%) of patients lived in Wuhan or traveled to Wuhan, had contact with Covid-19 patients, or had contact with Wuhan residents, respectively. The most common symptoms at onset of illness were fever (65.5%), dry cough (48.8%) and expectoration (32.1%). On admission, ground-glass opacity was the most common radiologic finding on chest computed tomography (60.2%). The elderly people with diabetes, hypertension and CVD are more likely to develop severe cases. Follow-up of 160 discharged patients found that 20 patients (12.5%) had a positive RT-PCR test results of pharyngeal swabs or anal swabs or fecal. ConclusionsIn light of the rapid spread of Covid-19 around the world, early diagnosis and quarantine is important to curb the spread of Covid-19 and intensive treatments in early stage is to prevent patients away from critical condition.
RESUMO
Objective To introduce the current status of treatment of severe acute pancreatitis (SAP). Methods This summarization paper of SAP was made on literature review. Results During the stage of acute reaction , therapy should be emphasized on non surgical management, such as maintaining the homodynamics ; inhibiting the overexpress of cytokines and pancreatic secretion; administering antibiotics preventively, TPN and improving the function of other damaged organs.The operation timing should be delayed if possible.Thus it could increas the cure rate, decrease complications and the possibility of reopeneration. But in the case of SAP with biliary obstruction, secondary infection with necrosis of pancreas; failure to respond to initial intensive treatment and clinical diagnostic was uncertain, early surgery should be performed. The operation should be easy to be done, ensuring enough drainage, and resolving the obstruction of biliary tract. During the septic stage, besides administerded antibiotics and EN, surgery is primary therapeutic method: necrosectomy and continuous closed lavage were considered as a better treatment of infected necrosis focus, while pancreatic absecess should be drained operatively. During the last stage of residual infection, abdominal abscesses should be drained thoroughly. Conculsions According to the etiology and stage of SAP, comprehesive management guided by "individualized plan"is probably a better strategy of treatment of SAP.
