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呼吸道合胞病毒感染：治疗

Authors
Frederick E Barr, MD
Barney S Graham, MD, PhD
Section Editors
Morven S Edwards, MD
George B Mallory, MD
Deputy Editor
Mary M Torchia, MD

引言

呼吸道合胞病毒(respiratory syncytial virus, RSV)可引起任何年龄个体的急性呼吸道疾病。几乎所有的儿童在2岁之前都会感染该病毒，再感染也较常见[1]。临床表现随着年龄、健康状况及感染是原发性还是继发性而不同。

RSV感染的治疗将在此讨论。RSV感染的流行病学、微生物学、临床表现、诊断和预防将单独讨论。 (参见“呼吸道合胞病毒感染：临床特征和诊断”和“呼吸道合胞病毒感染：预防”)

概述

下文的讨论假定患者的疾病已经严重到需住院治疗或者寻求病因学诊断，因为轻度呼吸道感染但其他方面健康的同门诊患者一样接受对症治疗的患者，通常不追求特异的病因学诊断。 (参见“呼吸道合胞病毒感染：临床特征和诊断”，关于‘诊断’一节)

无特异微生物学诊断的上呼吸道感染、毛细支气管炎或肺炎患者的门诊治疗将单独讨论。 (参见“婴儿及儿童毛细支气管炎的治疗、结局及预防”和“儿童社区获得性肺炎的门诊治疗”，关于‘经验性治疗’一节和“儿童普通感冒：治疗与预防”，关于‘治疗’一节)

下呼吸道RSV感染的治疗主要是支持性治疗。支气管扩张剂可能有助于缓解一些患者的下气道阻塞，但是对未能显示快速改善的患者不应继续使用。有可用的抗病毒药物，但大多数患者并不需要使用这些药物。正如下文所述，免疫功能受损的患者可能需要采用更积极的治疗措施，包括免疫治疗、抗病毒药物联合免疫治疗，或者抗病毒药物联合免疫治疗并联合皮质类固醇治疗。 (参见下文‘利巴韦林’和‘被动免疫治疗’和‘联合治疗’)

                  

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Literature review current through: 2017-06 . | This topic last updated: 2017-05-16.
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