嚴重急性呼吸道症候群的診斷及治療

Severe Acute Respiratory Syndrome Diagnosis and Management

嚴重急性呼吸道症候群是一種進行非常快且嚴重的呼吸道疾病。在短短的六星期就在世界各地爆發流行，根據世界衛生組織(WHO)的統計全球有超過八千個可能病例並且有超過九百人死亡，其最可能的傳染途徑為飛沫傳染。適當的支持性療法及審慎的使用雷巴威靈(ribavirin)及類固醇可以使約九成的病人恢復，但是這些治療仍須要進一步的研究及更多的臨床試驗來確認其角色。要能成功的控制這個疾病有賴於早期的確認疑似病例，適當的隔離以及嚴密的感染控制措施。長期接受透析的病人是屬於免疫不全的慢性疾病，經常出入醫療院所，對於SARS的預防尤其不應疏忽，各個透析醫療院所的感染控制相形之下更是重要。

SARS is a serious respiratory illness that frequently runs a rapidly progressive downhill course. In just six weeks this past Spring, it spread to all continents of the globe. According to statistics compiled by the World Health Organization, more than 8,000 probable cases have been reported worldwide with more than 900 deaths. The primary mode of transmission appears to be aerosol droplets. Good supportive care and the judicious use of ribavirin and steroids result in recovery in nearly 90% of patients, but randomized controlled trials are needed to define the respective roles of these treatments. Success in controlling the disease relies on early identification of suspect cases, proper isolation, and meticulous infection control measures. Patients who receive long-term dialysis are immunocompromise and are frequently hospitalized. Because of this, stringent infection control measures within dialysis clinics are particularly important to prevent SARS.