急性神经源性肺水肿型手足口病患儿1例救治报告

Acute neurogenic pulmonary edema caused by hand,foot and mouth disease:a case report

本文报道急性神经源性肺水肿型手足口病1例。该患儿发热伴特征性手、足、臀部皮疹和口腔疱疹,继发呼吸困难、严重高血压、肺水肿、颅内高压,伴外周循环衰竭等症状。经过气管插管,正压机械通气,大剂量丙种球蛋白封闭,大剂量肾上腺皮质激素冲击,甘露醇、甘油果糖控制肺水肿和颅内高压,磷酸肌酸营养心肌,利巴韦林抗病毒等治疗,转危为安。

A case of acute neurogenic pulmonary edema caused by hand,foot and mouth disease was reported in this paper. The child presented with fever and characteristic rashes in hands,feet,mouth and buttocks. Respiratory difficulties,serious hypertension,pulmonary edema,and intracranial pressure were secondary to fever and rashes,complicated with peripheral circulatory failure. Intubation,positive pressure ventilation,high-dose intravenous γ-globulin,and short-term high-dose cortin were effective measures to prevent disease progression. After administration of mannitol and glycerol and fructose,pulmonary edema and intracranial pressure were controlled. Furthermore,in combination with nutrition of myocardium by creatine phosphate and antiviral therapy by ribavirin,the child was rescued.