小儿手足口病50例临床分析

Clinical analysis on 50 cases of childhood hand-foot-and-mouth disease

目的:总结小儿手足口病的临床特征、诊疗经验,从而提高认识,减少漏诊,识别重症,降低病死率。方法:分析2008年5月在四川省妇女儿童医院诊治的50例手足口病患儿的临床特征和实验室资料,并对其中10例进行了病原学检测,归纳总结其治疗和转归特点。结果:全部病例早期均有手、口皮疹,多数有足部皮疹,部分分布在臀部及肛周、膝关节周围、面部等部位,伴流涎、发热等症。10例取咽拭子予RT-PCR检测肠道病毒核酸:3例EV71阳性、1例肠道病毒通用引物阳性。使用利巴韦林或α-干扰素抗病毒等治疗疗效可靠,无心肌炎、脑炎等并发症发生。结论:手足口病多数是良性的自限性疾病,EV71感染可能更多发生轻症患者,重视早期流行病学调查、病原学检查以及合适的临床评估可预防重症病例发生。

Objective： To summarize the clinical features and therapeutic experience of childhood hand - foot - and - mouth disease （HFMD） , improve cognition, reduce the misdiagnosis rate, recognize the severe cases and lower the mortality. Methods： Clinical features and laboratory data of 50 cases with HFMD were analyzed, and etiologic examination was conducted on 10 cases, the treatment and prognosis were summarized. Results： All the cases had exanthemas of hand and oris mucosa, most of them had exanthemas of foot （92%） , additionally some of them had exanthemas in buttocks, perianal skins, knee joints, faces accompanied with fever and sialorrhea. 10 eases were detected for nucleic acid of intestinal virus by RT - PCR ： 3 cases with positive EV71 and 1 case with positive universal primer of enteric virus. Ribovirin or α - interferon was effective and safe in therapy and there was no complications such as cephalitis and myoearditis. Conclusion： HFMD is a benign, serflimited, viral infected disease. Cases with enterovirus 71 are mild. Early epidemiologieal investigation, etiologic examination and appropriate clinical evaluation can prevent HFMD from deteriorating rapidly and reduce the mortality.