作者johnliou (豬神)
看板medache
標題美國疾病管制局對於H1N1流感的最新建議
時間Wed Sep 30 10:29:44 2009
更新日期9月22日及29日
和台灣健保局現在採行的措施非常大的不同
原文網址請見
http://www.cdc.gov/h1n1flu/guidance/diagnostic_tests.htm
http://www.cdc.gov/h1n1flu/recommendations.htm
以下把最重要的重點翻譯節錄
*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.
大部分非複雜性流感患者不需要接受流感篩檢
*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.
需接受流感篩檢的病患包括
1.懷疑流感的住院患者
2.接受流感篩檢有助於臨床照護,感染控制或對密切接觸者的處理
3.懷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
現在各醫院每天報天量的流感快篩敏感性差異很大(10%-70%,原先的研究是40-70%,意思說
原先的敏感性大概比丟銅板好一點點,最新的研究可能比丟銅板還不準.....)
流感快篩陰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藥物(就是克流感)的治療或預防,然而臨床上為重
症者應該積極以抗病毒藥物作經驗療法(意思是臨床上懷疑就該給),不考慮其之前的健
康狀況與年齡
*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.
下列病患應採用抗病毒藥物作經驗療法(同上,臨床上懷疑是流感就該給)
1.2歲以下兒童
2.65歲以上老人
3.懷孕婦女
4.慢性疾病或免疫問題之病患
5.19歲以下青年接受長期阿斯匹靈治療患者
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其餘內容請板上強者繼續補充,要說的是以臨床醫師的立場,到底要遵循這些新
的指引還是遵循台灣健保局甚至台灣媒體的建議,希望我們的政府能指引一盞明燈
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1F：推 oneders:沒辦法啊 台灣人體質特異啊... 國情不同啊... ><" 09/30 10:31
2F：推 DrBear:昨天不是還有一個說快篩陰性就快要害了他的命的？ 09/30 10:31
3F：推 Arieta:政府有燈??說實話，黑暗道找照世明燈可能性都比較大!! 09/30 11:27
4F：推 ChienLijen:八卦版吧~媽媽說有人黃金三天沒檢查出來就掛了~~~~ 09/30 12:41
5F：推 ulcer:台灣人的治療不是依照guideline的 是照媒體和病人自己的想法 09/30 15:13
6F：→ madguy:醫海冥燈… 09/30 21:50
7F：→ EasonA:悲哀的台灣 10/02 00:26
8F：推 racemic:"3.懷疑因流感而死亡的病患"===>台灣人 10/02 01:29