27例重症手足口病诊治体会

Clinical Analysis of 27 Children with Severe Hand-Foot-Mouth Disease

目的总结重症手足口病的临床特点、治疗时机、治疗方法及高危因素。方法回顾2010年1月-2011年8月收治的27例重症手足口病患儿,分析其基本资料、主要症状、体征、辅助检查结果及治疗方案,并对其临床特点、治疗时机、治疗方法及重症发生的高危因素进行总结。结果 27例重症病例中26例治愈出院,未遗留明显并发症,1例合并肺部感染好转后转门诊治疗,无死亡病例。结论在夏季,由于空气湿度大、气温高,手足口病容易集中发生。家庭经济条件、卫生条件差的儿童,较容易发生手足口病并进展为重症。手足口病重症病例大多数为EV71感染。重症病例早期识别是治疗的关键,应把握好糖皮质激素、丙种球蛋白的治疗时机,加强护理,在神经源性肺水肿出现的早期及时采取机械通气,能有效地提高重症手足口病治愈率。

Objective To summarize the manifestation,treatment opportunity,therapy methods and risk factors of severe hand-foot-mouth disease（HFMD）.Methods Retrospective review the data of children who suffering from severe HFMD from January,2010-August,2011,and analyze the basic information,main symptoms,signs,laboratory tests and therapeutic regimen,made a summary on the manifestation,treatment timing,treatments and risk factors for severe occurrence.Results In 27 severe HFMD cases,26 were cured and discharged without complications,1 case was combined with pulmonary infection and transferred to ambulatory treatment,no case died.Conclusion HFMD is easy to occur in the summer.The children in families those with economic difficulties and poor sanitation are easy to be attacked and get worse easily.Most cases of HFMD were infected by EV71,EV71 has great damage of nervous system,in clinic,we should pay close attention to children,recognize the children who are dangerous early,use glucocorticoid and immunoglobulin in time,use mechanical ventilation in a early time when neurogenic pulmonary edema occurred,and effectively improve the cure rates in children who suffer from severe hand foot and mouth disease.