手足口病二次复发的临床特点分析

Clinical Features of the First Relapse of Hand-foot-mouth Disease in Children

目的探讨手足口病二次复发的临床特点及诊治体会。方法回顾性分析资料完整的50例手足口病患儿二次复发的临床表现、实验室检查及影像学资料。结果 50例患儿均急性起病,均有呼吸道感染症状。首发症状为流涎、流涕、咳嗽、低热,手掌及足底部皮肤出现散在斑丘疹,部分为小水疱。继而口腔、臀部、躯干部及膝部出现数个至数十个斑丘疹及水疱,色泽灰暗,部分脱屑。实验室检查:以白细胞计数升高为主。病毒阳性率低。X线胸片显示肺纹理增粗,边缘欠清。结论与第一次发病相比,手足口病患儿二次复发时临床表现不典型,并发症多,病毒检出率低;早期识别和早期诊断是治疗关键。

Objective To explore the clinical features and treatment of the first relapse of hand-foot-mouth disease（HFMD） in children. Methods Clinical data,laboratory results and radiological findings of 50 pediatric patients with the first relapse of HFMD were retrospectively analyzed. Results All the 50 patients presented acute onset of symptoms,especially respiratory symptoms.The initial symptoms included salivation,snuffles,cough and fever.Spotted papula and/or water blisters appeared on the palm and foot bottom.Subsequently,dark gray spot papula and water blister appeared on mouth,hip,trunk and knee.Some of them showed scaling.Laboratory examinations showed increased white blood cells.The positive rate of virus was low.Chest X-ray showed thickened pulmonary markings with unclear edges. Conclusion Compared with the first onset,the first relapse of HFMD tends to be more atypical,with more complications and lower detection rate of virus.Early identification and diagnosis are the key sfor the successful treatment of HFMD.