重症手足口病的临床特征及病原学分析

Clinical features and etiology analysis of severe cases of hand - foot - mouth disease

目的 总结分析重症手足口病的临床特征及其病原学特点.方法 回顾性分析笔者所在医院收治的43例重症手足口病的临床表现、实验室及器械检查、治疗、转归和病原学检测结果.结果 43例重症手足口病例中,发病年龄以3岁以下为主（90.7%）,所有患儿均有发热及皮疹（100%）,其中4例（9.3%）皮疹不典型者（皮疹小且数目少）病情更重且进展快.出现中枢神经系统并发症（CNSC）者38例（88.4%）,此类患儿绝大部分在病程早期即不同程度地表现为精神差或烦躁（97.4%）、肢体抖动（84.2%）等;病原学检测以EV71感染率明显增高,差异有显著性（P〈0.05）.结论 年龄越小,病情越重;皮疹数目少而不典型者病情凶险;重症病例中以中枢神经系统并发症为主,主要为EV71感染引起,早期发现重症病例、早期救治是降低病死率、致残率的关键.

Objective To analysis the severe hand -foot -mouth disease clinical feature and etiology characteristic. Methods 43 severe cases of clinical diagnosis were retrospectively analyzed. Results 43 patients with severe hand, foot and mouth cases, the onset age of 3 , years of age the majority （90. 7% ）. All patients had fever and rash （100%）. 4 cases （9. 3% ） were atypical rash （skin rash of small and smal- ler） sicker and faster progress. 38 eases（88. 4% ） had Central nervous system complication. Most of these children early in the course of disease that is manifested in varying degrees, the spirit of poor or restless（97.4% ）, physical jitter（ 84. 2% ）. Pathogen detection to EV71 infection was significantly higher, the difference was significant （ P 〈 0. 05 ）. Conclusion Younger, more severe illness. The small number of persons without the typical rash dangerous condition. Severe cases with central nervous system complications was mainly caused by the EV71 infection, severe ca- ses of early detection, early treatment is to reduce mortality, morbidity of the key.