149例重症手足口病患儿临床分析

A clinical study of 149 severe cases of hand-foot-mouth disease(HFMD) in children

目的探讨重症手足口病(HFMD)的临床特征、分型和处置方案,提高重症HFMD患者的治愈率和生存率。方法对149例重症HFMD患儿的流行病学、临床表现、病情动态变化、实验室检查及物理检查、治疗及转归进行回顾性分析。结果 149例重症HFMD患儿,男98例(65.8%),女51例(34.2%);年龄5个月～13岁,﹤3岁者92例(61.7%),平均年龄3.3岁。依据临床表现及并发症分为两组:Ⅰ组,并发症以神经系统症状为主要表现者,140例(94%),均存活;Ⅱ组,并发神经、循环、呼吸等系统多器官损害者,9例(6%),3例死亡。存活患儿目前无后遗症出现。结论 HFMD重症病例分为重型和危重型两型,危重型可引起死亡。在临床工作中密切监测,及时发现危重型倾向的病例,正确及时治疗,能提高重症HFMD患儿的生存率,减少并发症和后遗症,改善生存质量。

Objective To discuss the clinical characteristics,classification and treatment of 149 severe HFMD cases at Beijing Ditan Hospital in 2008.Methods The epidemiology,clinical manifestation,disease development,laboratory test,physical examination,therapy and outcome of 149 severe HFMD patients were retrospectively analyzed.Results 149 severe HFMD patients with average age of 3.3,occurred in more male （65.8%） children than female （34.2%） ones,and was more common in the patients under 3 years old.They were classified into 2 types by clinical manifestation and complication.Type Ⅰ：140 （94%） cases predominant by nervous system complication.Type Ⅱ：9 （6%）cases with multi-organ damage including nervous,circulating and respiratory system,etc.146 alive with no sequel.3 dead all from type Ⅱ with multi-organ damage.Conclusions Severe HFMD can be classified into severe case and critical severe case.Critical severe patients,with multi-system damage,is the major cases of death.We should monitor these severe cases closely in clinical work.Correct and early treatment is necessary.