小儿手足口病467例分析

Clinical analysis of 467 cases of infant hand-foot and mouth disease

目的探讨小儿手足口病的发病情况、病原学特点及治疗方法。方法回顾性分析2008年4月至2009年2月本院收治的467例小儿手足口病的临床资料。结果住院病例临床表现都较典型,但有一例重症病例无皮疹;轻症病例5～8d痊愈,各无菌性脑炎、脑脊髓膜炎、心肌损害患儿也均获临床痊愈,但4例脑干脑炎患儿死亡。在加强对重症病例的早期识别,及早使用大剂量丙种球蛋白及激素后未再出现死亡病例。但大剂量丙种球蛋白及激素的使用率过高,腰穿的比例较高,有过度治疗现象。结论早期识别重症病例,加用大剂量丙种球蛋白及激素是重症病例救治成功的关键;EV71导致的手足口病易致脑干脑炎,病情凶险,普及病原体的检测对提高诊治能力,加强疾病的认识很有必要。

Objective To approach the incidence and characteristic of etiology and the remedy of the hand-foot and mouth disease in children. Methods We retrospectively analyzed the clinical data of 467 persons who were suffered from hand-foot and mouth disease between April, 2008 to February, 2009. Results The clinical manifestation of the cases were typical, but one severe case did not have erythras. The mild cases were recovery between 5 to 8 days. The cases of asepsis encephalitis, myeloeneephalitis and myocardial damage got clinical recovery, while 4 cases of brainstem encephalitis died. No one died when we strengthened the prophase recognition of severe case and used large dose of gamma globulin and hormone at an early date. But the high usage of gamma globulin and hormone and lumbar puncture seemed to be over therapy. Conclusions The Prophase recognition of the severe case and the usage of large dose of gamma globulin and hormone are the key to successful rescue of the severe case. The hand-foot-mouth disease caused by EV71 is a dangerous disease that can easily lead to brainstem encephalitis. To make the detection of pathogen known is necessary to improve the ability of diagnosis and therapy and strengthen the realization of the disease.