Experts talk about new crown pneumonia treatment is currently effective way is oxygen therapy.

category:Health
 Experts talk about new crown pneumonia treatment is currently effective way is oxygen therapy.


Cai Weiping: both coronaviruses can cause fatal pneumonia. But from the perspective of infectious capacity, the new coronavirus has stronger transmission ability than SARS coronavirus. From the patients we contact, family gathering is quite common, which shows that it has a strong ability of transmission.

From the point of view of treatment, the incidence of severe pneumonia in SARS is even higher, while the severe rate of new crown pneumonia is relatively low, and the incubation period is slightly longer than that of SARS. This is the tricky place of the virus. It enters the body until it gets sick. The latent time is longer, making it more difficult for the immune system to recognize it.

The most annoying thing is that the time from onset to exacerbation varies from 3-5 days for some people to 10 days for others, and 8-10 days for exacerbation is the most common. Most of the SARS cases were aggravated at an earlier stage. There is no regular development of the disease, which brings great difficulty to the treatment.

This kind of uncertainty is more than that of the last SARS. The improvement of pulmonary inflammation in patients is also slower than that of SARS. This leads to a longer hospital stay.

Cai Weiping: actually, there are some rules, but they are not very common. Now we find that if the patients throat swab and blood at the same time detect a positive nucleic acid, he has a very high risk of serious disease.

The second is some changes of lymphocytes. When the patients lymphocytes are particularly low, attention should also be paid.

Some people dont progress quickly at first, but get worse in a short time. The factors that make the patients condition suddenly worse are actually not sure. Most of them are related to the inflammatory waterfall, that is, a very acute immune response suddenly occurs, and then the whole lung turns white.

The old and infirm may be due to the low immunity, unable to clear the virus, and then the delay time will be longer, and later may be combined with some other infections, leading to the final aggravation of his condition.

Respiratory department, infectious department, severe medicine department, three departments cooperation

Reporter: at present, there is no effective medicine for new crown pneumonia. What treatments are effective in clinic?

Cai Weiping: now the safest and most effective way is oxygen therapy. Now as long as there is pneumonia, all patients will give him oxygen. In other pneumonia, oxygen therapy is not used so much, but this new crown pneumonia, if the patient has lung inflammation, regardless of whether the severity of the disease is anoxia, it is recommended that they go to oxygen inhalation. For severe cases, oxygen therapy is the most critical treatment. If I cant keep up with the oxygen therapy, I dont think the other treatments will work.

Cai Weiping: during the treatment of SARS, we found that although most of the patients were admitted to the special infectious disease hospital, the infectious disease hospital must have the ability of severe treatment. The expert group of SARS was made up of three subjects, Department of respiration, infectious disease and intensive care. This year, we fought against the new crown pneumonia. In accordance with the experience of that year, we put forward very early experts to participate in the treatment.

The previous SARS and several epidemics also gave us the opportunity to break in. In fact, I think the infectious disease hospital should be a comprehensive hospital, with all kinds of disciplines, especially the critical medicine department and respiratory department, so as to really take on the task of treating infectious diseases.

Test error plus sampling irregularity will result in error of results

Reporter: how to treat the false negative problem of nucleic acid detection in the new crown pneumonia?

Cai Weiping: the epidemic quickly identified that it was a new coronavirus. Soon, nucleic acid reagents came out, and the virus could be found through swab nasal swabs, which was much better than that of SARS. However, the current nucleic acid detection also has some confusion. One third of them may be positive only after repeated tests, and even some people cant find it for a long time, but only through deeper airway secretions. The place where we can usually sample is the upper respiratory tract, which makes our judgment difficult.

If the etiology test is reliable, of course, it is necessary to determine whether the infection is based on the etiology test. But now it is possible to make some miscalculations based on etiological tests. So now we usually do not diagnose according to only one standard. Even if this persons nucleic acid test is negative, but he has lung inflammation, white blood cells are not high, especially with a history of epidemiology, contact with people from or out of Wuhan, the possibility of infection is very high.

Cai Weiping: in fact, etiology test depends on sampling to a large extent. You can see which part of the sample is taken. For the samples taken by the same person at the same time, some of them are negative, while others are positive. When the sampling requirements are very high, the detection error is inevitable.

Now some doctors think that the throat swab can be wiped casually in the pharynx. In fact, the whole jaw bow should be wiped, and the positive rate will be high. If you just wipe it in the throat, the positive rate is very low. If there are errors in the detection, and the sampling is not standardized, the results will show errors. Reporter: false negative can affect clinical treatment? Cai Weiping: because of the uncertainty of nucleic acid test, the discharge standard cant be relaxed. At first, it was said that as long as two negative tests were found the next day, they could be discharged from the hospital. Now it seems that they are not good, because some people who were both negative in two tests may become positive again in the third test. So now our discharge standard has been increased. If we dont have a fever for more than three days, and the key is the image change of the lung, we need to have a relatively obvious improvement in absorption, respiratory symptoms, and two negative nucleic acid tests before we dare to discharge the patient. Source: Ma Yiyang, editor in charge of Global Times

Now some doctors think that the throat swab can be wiped casually in the pharynx. In fact, the whole jaw bow should be wiped, and the positive rate will be high. If you just wipe it in the throat, the positive rate is very low. If there are errors in the detection, and the sampling is not standardized, the results will show errors.

Reporter: false negative can affect clinical treatment?

Cai Weiping: because of the uncertainty of nucleic acid test, the discharge standard cant be relaxed. At first, it was said that as long as two negative tests were found the next day, they could be discharged from the hospital. Now it seems that they are not good, because some people who were both negative in two tests may become positive again in the third test. So now our discharge standard has been increased. If we dont have a fever for more than three days, and the key is the image change of the lung, we need to have a relatively obvious improvement in absorption, respiratory symptoms, and two negative nucleic acid tests before we dare to discharge the patient.