东莞地区肠道病毒71型手足口病118例临床分析

目的探讨广东省东莞地区儿童肠道病毒71型手足口病的临床特征。方法归纳分析118例肠道病毒71型手足口病患儿的性别、发病年龄、病情评估、症状与体征、实验室与辅助检查、并发症、治疗经过、转归等临床资料。结果肠道病毒71型手足口病多见于1～5岁婴幼儿(占90.68%),主要症状为皮疹(100%)、发热(82.20%)。重症病例发生率高(占53.39%),多有肢体抖动或惊跳(38.14%)。常见并发症有支气管炎、支气管肺炎、肺炎支原体感染,重症者肺炎支原体感染率(57.14%)较非重症者(38.18%)高。经对症及抗病毒治疗,重症者早期使用免疫球蛋白、短期大剂量糖皮质激素、甘露醇脱水降颅压等治疗,治愈111例(94.07%),好转5例(4.24%),自动出院2例(1.69%),死亡0例。结论肠道病毒71型手足口病多见于婴幼儿,主要症状为发热、皮疹。重症病例发生率高,多有肢体抖动或惊跳。只要早期诊断,识别重症病例,合理治疗,肠道病毒71型手足口病预后良好。

Objective To investigate the clinical characteristics of hand,foot and mouth disease caused by EV71.Methods We collected and analysed clinic data of 118 cases of EV71 infected HFMD,inclouding sex、age、evaluation、symptoms、physical signs、results of laboratory testes、complications、therapies and outcome.Results The incidence was the highest in 1-5-year-old children（accounting for 90.68%）.Rash（100%）and fever（82.20%） were their common signs.the incidence of severe cases （53.39%） is similar to non-severe cases （46.61%） .About 38.14% went with limb shaking or jumping,and they were all severe cases.Common complications include bronchitis,bronchial pneumonia and mycoplasma infection,compared with non-severe cases（38.18%）,the incidence of mycoplasma infection was higher in severe cases（57.14%）.After the symptomatic and anti-viral treatment,early use of immune globulin and short-term high-dose corticosteroids for severe patients,reducing intracranial pressure by mannitol and other treatment,most of the patients（94.07%） were cured,twe patients（1.69%） terminated treatment halfway by themselves,and no one was dead.Conclusion EV71 infected HFMD often happens in infant,characterized by fever and typical rash.,had a high rate of severe cases,which went with limb shaking or jumping frequently.If given early diagnosis、identify of severe cases and reasonable treatment,good prognosis would be gained.