980例手足口病临床分析

Clinical analysis of 980 cases with the hand,foot and mouth disease

目的探讨本地区手足口病的临床诊断及治疗措施,为手足口病的防治提供理论依据。方法以对本院接诊的居家观察病例家访和回顾性分析的方法对所收治病例的相关信息进行分析。结果手足口病多发生于4岁以下儿童(87%),大多数病例临床表现轻,愈后良好,部分病例可出现ALT、AST和血糖升高。在住院病例中约59%出现心肌酶谱异常,提示存在心肌损害。重症病例可并发中枢神经损害,导致神经源性肺水肿、治疗困难、病死率高。2008年本地区手足口病流行的主要病原体可能为肠道病毒EV71。结论手足口病是一种多发生于学龄前儿童的常见传染病,可出现多脏器功能损害的全身性疾病,既有隐性感染,也有显性感染,既有轻型感染,也有重型感染病例,应提高及时识别重症病例早期临床征象的意识,并积极治疗以降低手足口病的病死率。

Objective To study the clinical diagnosis and treatment of the hand, foot and mouth disease in Taiyuan and provide a theoretical basis for the prevention and treatment of the disease. Methods Home visits were paled to cases receipted in the hospital and observed at home now and relevant information of the cases were analyzed by retrospective analysis. Results The hand, foot and mouth disease occur in children under the age of 4 （87%）. The clinical manifestation of the major cases is light and some cases have elevated ALT, AST and blood sugar. Fifty nine percent of hospitalization cases have abnormal myocardial enzymes, which suggested the existence of myocardial damage. Severe cases may be complicated by central nervous system damage, which results in neutrogena pulmonary edema, with difficult treatment and high mortality rate. Intestinal virus EV71 is possibly the main pathogen of the hand, foot and mouth disease in this region in 2008. Conclusions The hand, foot and mouth disease is an infectious disease which occurs more commonly in preschool children and cause multiple organ damage. Some cases are hidden infection and some are overt. Some cases belong to light infection and some are heavy. To improve the awareness of identification to early clinical manifestations of severe cases timely and treat actively in order to reduce the mortality of the hand, foot and mouth disease.