重症手足口病合并脑炎30例临床分析

Clinical analysis of 30 cases severe Hand-Foot-Mouth disease complicated with cephalitis

目的了解重症手足口病合并脑炎的临床特点、诊断方法、治疗方案及预后。方法总结分析2008年6月～2010年6月于本院治疗的重症手足口病合并脑炎患者30例的临床特点、治疗方案及预后。结果手足口病多发于儿童,合并神经系统症状者于发病后约3 d出现。临床特点为发热、手足口部位皮疹、疱疹,合并精神萎靡、呕吐、醉酒样步态、肌肉震颤、抽搐、肌无力和头痛等神经系统症状。经血常规、脑脊液检查、胸片、CT、MRI等进行诊断,治疗主要进行抗病毒治疗,同时控制补液量、并给予小剂量糖皮质激素治疗,预后良好。结论重症手足口病合并脑炎患者明确诊断、适当治疗后预后良好。

Objective To study the clinical characteristics, diagnosis method, treatment programs and prognosis of severe Hand - Foot - Mouth disease complicated with cephalitis. Methods Take 30 cases of severe Hand - Foot - Mouth disease complicated with cephalitis during June 2008 to June 2010 in our hospital into research. Analysis their clinical characteristics, diagnosis method, treatment programs, and prognosis. Results Hand - Foot - Mouth disease mainly threaten children. The cephalitis appeared about 3 days after the Hand - Foot - Mouth disease clinical manifestation occurs. The clinical characteristics of severe Hand - Foot - Mouth disease complicated with cephalitis were patients had a fever, skin eruption of hand, foot and mouth, together with the nervous system manifestation such as cachexia, vomit, drinking man gait, amyostasia, twitch, myasthenia, headache and so on. After routine blood test, CSF examination, X - ray, CT and MRI, the dignosis could be decided. The patients of severe Hand - Foot - Mouth disease complicated with cephalitis could be cured after antivirus therapy, fluid infusion control, glucocorticoid treatment. And the patients had no recurrence nervous system manifestation after follow - up survey for 6 mouths. Conclusion Patients of severe Hand - Foot - Mouth disease complicated with cephalitis can be cured after proper diagnosis and treatment. And they can have fine prognosis.