重症肠道病毒71型感染患儿胃肠功能损害的诊治

Diagnosis and treatment of gastrointestinal dysfunction in children with severe enterovirus 71 infection

危重手足口病患儿可出现脑干脑炎、脑脊髓炎、肺水肿／肺出血和心血管功能衰竭等严重合并症。部分患儿合并严重胃肠功能损害，表现为腹胀、肠麻痹、便血、呕血等胃肠动力学障碍或消化道出血等症状。“儿茶酚胺风暴”和病毒性炎症反应可能是胃肠功能障碍的主要原因，应重视对胃肠损害的监测。胃肠功能障碍的防治以预防为主，并应注意避免医源性损害。

Severe hand, foot and mouth disease （HFMD） may lead to the high mortality due to brainstem encephalitis, encephalomyelitis, pulmonary edema/pulmonary hemorrhage and cardiopulmonary failure in children. Some patients are complicated with severe gastrointestinal dysfunction, manifested as abdominal distension, intestinal paralysis, bleedy stool, haematemesis. ＂Catecholamine storm＂ and viral systemic inflammatory response syndrome may be the main mechanisms for gastrointestinal dysfunction. It is important to focus on the monitoring of gastrointestinal dysfunction of severe HFMD. Preventing and avoiding iatrogenic damage of ~astrointestinal dvsfunction are main treatment strategies.