常规剂量静注人免疫球蛋白治疗重症早期手足口病的临床观察

The clinical observation of treatment for initial severe hand-foot-mouth disease with conventional dose IVIG

目的探讨静注人免疫球蛋白治疗重症早期手足口病的疗效。方法对该院收治35例重症早期手足口病的患儿均在监护条件下给予抗病毒、退热等处理,由外院转入17例患儿未在重症早期使用常规剂量静注人免疫球蛋白,治疗组(18例)采取加强治疗,包括:(1)静脉注射常规剂量免疫球蛋白(IVIG)2.5～5.0 g,分1～2 d给予;(2)常规剂量地塞米松每天0.2～0.3 mg.kg-1,IVIG前用;(3)有肢体无力、易惊或肢体抖动5例,加用20%甘露醇。结果 35例病人均治愈出院,没有1例出现重症危重型。治疗组平均住院日6 d,对照组平均住院日9 d,治疗组体温降至正常时间短于对照组。结论对重症早期手足口病患儿早期应用常规剂量静注人免疫球蛋白治疗可缩短住院日,明显改善手足口病的症状及预后。

Aim To investigate the clinical effect of human intravenous immunoglobulin（IVIG） treatment for initial severe hand-foot-mouth disease（HFMD）.Methods 35 initial severe HFMD inpatients were cured by antiviral therapy and antipyretic therapy with intensive therapy simultaneously,17 cases transferred from other hospitals were not cured by IVIG early.Treatment group（18 cases） was cured by intensive therapy,to include：（1）Intravenous injected by conventional dose IVIG 2.5～5.0 g in one or two days,（2）Conventional dose dexamethasone used before IVIG everyday for 0.2～0.3 mg·kg-1,（3）20% mannitol was used for 5 patients with muscle weakness,limb-shaking or scared easily.Results All of the 35 inpatients were cured,no one emerged as severe critical case,the treatment group temperature drop to normal time is shorter than the control group.The average length of stay in treatment group is 6 days,while in control group is 9 days.The time of temperature drop to normal in treatment group is shorter than the control group.Conclusion Early IVIG therapy for children with initial severe HFMD can significantly shorten length of stay and improve the syptom and prognosis.