更新日期9月22日及29日 和台湾健保局现在采行的措施非常大的不同 原文网址请见 http://www.cdc.gov/h1n1flu/guidance/diagnostic_tests.htm http://www.cdc.gov/h1n1flu/recommendations.htm 以下把最重要的重点翻译节录 *Most patients with clinical illness consistent with uncomplicated influenza who reside in an area where influenza viruses are circulating do not require diagnostic influenza testing for clinical management. 大部分非复杂性流感患者不需要接受流感筛检 *Patients who should be considered for influenza diagnostic testing include: 1.Hospitalized patients with suspected influenza 2.Patients for whom a diagnosis of influenza will inform decisions regarding clinical care, infection control, or management of close contacts. 3.Patients who died of an acute illness in which influenza was suspected. 需接受流感筛检的病患包括 1.怀疑流感的住院患者 2.接受流感筛检有助於临床照护,感染控制或对密切接触者的处理 3.怀疑因流感而死亡的病患 *Rapid influenza diagnostic tests (RIDTs) are widely available but have variable sensitivity3 (range 10 – 70%) for detecting 2009 H1N1 influenza when compared with real-time reverse transcriptase polymerase chain reaction (rRT-PCR), and a negative RIDT result does not rule out influenza virus infection4 现在各医院每天报天量的流感快筛敏感性差异很大(10%-70%,原先的研究是40-70%,意思说 原先的敏感性大概比丢铜板好一点点,最新的研究可能比丢铜板还不准.....) 流感快筛阴性不代表可以排除流感感染 *Most healthy persons who develop an illness consistent with influenza, or persons who appear to be recovering from influenza, do not need antiviral medications for treatment or prophylaxis. However, persons presenting with suspected influenza and more severe symptoms such as evidence of lower respiratory tract infection or clinical deterioration should receive prompt empiric antiviral therapy, regardless of previous health or age. 大部分健康的流感患者不需要抗病毒药物(就是克流感)的治疗或预防,然而临床上为重 症者应该积极以抗病毒药物作经验疗法(意思是临床上怀疑就该给),不考虑其之前的健 康状况与年龄 *Early empiric treatment with oseltamivir or zanamivir should be considered for persons with suspected or confirmed influenza who are at higher risk for complications including: 1.Children younger than 2 years old; 2.Persons aged 65 years or older 3.Pregnant women 4.Persons of any age with certain chronic medical or immunosuppressive conditions (see page 3); and, 5.Persons younger than 19 years of age who are receiving long-term aspirin therapy. 下列病患应采用抗病毒药物作经验疗法(同上,临床上怀疑是流感就该给) 1.2岁以下儿童 2.65岁以上老人 3.怀孕妇女 4.慢性疾病或免疫问题之病患 5.19岁以下青年接受长期阿斯匹灵治疗患者 ========================================================================== 其余内容请板上强者继续补充,要说的是以临床医师的立场,到底要遵循这些新 的指引还是遵循台湾健保局甚至台湾媒体的建议,希望我们的政府能指引一盏明灯 --

※ 发信站: 批踢踢实业坊(ptt.cc) ◆ From: 140.112.125.216