81例EV71感染重症手足口病临床特征与护理

Clinical features and nursing of 81 HFMD patients from severe EV71 infections

目的探讨肠道病毒7l型(entemvirns 71,EV71)感染所致重症手足口病的临床特征和护理体会。方法对2011年3月～2012年1月本院PICU收治的81例EV71感染重症手足口病患儿病例资料进行回顾性分析,内容包括起病时间、发热和皮疹出现部位与持续时间、起病至出现神经、呼吸、循环功能受累的时间、病情转归等。结果81例EV71感染重症手足口病患儿中,神经系统受累67例,其中46例早期出现脑干脑炎、脑膜脑炎;36例合并神经源性肺水肿和肺出血。结论 EV71重症主要发生在年龄小于3岁的儿童,以神经系统受累为主。护理重点在于密切观察病情,肺水肿及肺出血和脑炎及脑干脑炎的护理,严格执行各种消毒隔离措施。

Objective To investigate the clinical features and nursing of patients with hand foot mouth disease （HFMD） from severe EV71 infections. Method The histories of 81 HFMD patients from severe EV71 infections in the department of PICU from March 2011 to March 2012 were analyzed retrospectively in regard to the onset time, the location and duration of fever and rash, the interval between the onset and the impairment of nervous, respiratory and circulatory function, and the prognosis. Result Among the 81 patients, 67 had central nervous system infections, 46 of whom contracted with brainstem encephalitis and meningoencephalitis, and 36 had combined neurogenic pulmonary edema and pneumorrhagia. Condusions Children under 3 years old are vulnerable to HFMD by severe EV71 infections, which presents infections in central nervous system. The nursing should focus on close observation of the disease, especially brainstem encephalitis, meningoencephalitis, neurogenic pulmonary edema and pneumorrhagia. Rigid disinfection and isolation measures should be carried out.