摘要
目的:探讨重症手足口病(HFMD)的临床特点及治疗措施,为重症手足口病的防治提供理论依据。方法:回顾性分析收治112例重症手足口病病例的临床资料进行分析。结果:重症病例的临床特点是多发生于3岁以下患儿,病情进展快,均有体温的异常,手、足皮疹、精神差、易惊、肢体抖动多见,呼吸频率、心率增快,血压增高,WBC和PLT升高,血糖升高,脑脊液呈无菌性脑炎或脑膜炎的改变,脑脊液葡萄糖水平增高,危重患者可出现神经源性肺水肿和循环衰竭;本组患儿采用综合治疗措施的治愈102例,死亡4例,转院6例。结论:HFMD患儿病情进展快,早期筛查出重症病例是降低病死率,提高救治水平的关键;重症病例治疗原则是以脱水降颅压、大剂量激素和静脉用丙种球蛋白冲击,以及呼吸循环支持治疗为主的综合治疗措施。
Objective： To analyze the clinical symptoms of patients with hand - foot - mouth disease （HFMD） in Fuyang, and to provide basis for prevention and control of HFMD. Methods：The medical record data of 112 patients with HFMD were collected to analyze clinical symptoms and diagnostic situation. Result： Most patients with HFMD were found below the age of three and had a fast pathogenesis. Fever occurred in all the patients. Patients always behaved as herpes on hands and feet, lassitude, convulsion and jitter. HR and respiratory rate accelerated. BP, WBC, PLT and Blood Glucose raised up. CSF trended to aseptic meningitis or meningitis with higher glucose lever. Patients with severe HFMD behaved as neurogenic pulmonary edema and respiratory failure. 102 patients were cured, 4 were dead and 6 got Hospital Referral. Conclusion：Patients with HFMD have a fast pathogenesis.Screening for severe patients is the key point to reduce death rate and raise therapeutic level. The combined treatments including reducing the intracranial pressure by dehydration,ictus treatment with high -dose glucocorticoid and Gammaveniu and respiratory circulatory support are the therapeutic principles.
