重症手足口病的临床表现与治疗分析

Clinical Characteristics and Treatment of Severe Hand-Foot-Mouth Disease

目的探讨重症手足口病的临床特征与治疗措施。方法选择2008年4月至2012年7月收入我院确诊为重症手足口病的56例患儿,对其临床表现及治疗方法进行回顾性分析。结果 56例重症手足口病的患儿中,年龄最大6岁,最小4月龄,其中2岁半(含)以下50例,占89.3%。男42例(75.0%),女14例(25.0%)。本地常住儿童21例(37.5%),非本地儿童35例(62.5%)。治愈50例(89.3%),好转2例(3.57%),自动出院2例(3.57%),死亡2例(3.57%)。住院时间最长23d,最短7d,平均时间(6.8±4.4)d。结论重症手足口病好发于2岁半以下男性儿童。治疗上应当强调早期发现和早期治疗;一旦确诊即予加强指标监测,积极预防和治疗并发症,有效控制感染,提高免疫力并减轻全身严重免疫应激反应,可有效降低重症患儿的死亡率并改善预后。

Objective To study the clinical features and find out the therapeutic measures of severe hand-foot-mouth disease （HFMD）. Methods We retrospective analyzed the clinical features and the therapeutic measures of 56 hospitalized cases of severe HFMD from April 2008 to July 2012. Results Among 56 patients with severe HFMD, the oldest was 6 years old, the youngest was 4-month-old. 50 cases （89.3%） attacked by severe HFMD were less than 2 and a half years old. Male patients accounted for 75.0% （42 cases） and female patients accounted for 25.0% （14 cases）. The percentage of local resident children in all cases was 37.5% （21 cases）, the rest cases （35 patients, 62.5%） were non-local children. 50 cases （89.3%） were cured, 2 cases （3.57%） discharged from the hospital and 2 deaths accounted for 3.57%. The median length of hospital stay was （6.8 ± 4.4） d, the longest one was 23 d, the shortest one was 7 d. Conclusions HFMD tends to occur in younger male children less than 2 and a half years old. It is of vital importance for physicians to take early diagnosis and early treatment. Once the diagnosis is confirmed, we should strengthen the monitoring for the relevant indicators, actively prevent and treat cerebral edema, pulmonary edema, heart and lung failure and other complications. Meanwhile, we need strengthen laboratory, prevention and treatment of cerebral edema, pulmonary edema, heart and lung failure. We need control the infection effectively, enhance immunity and relieve the whole severe systematic immune response in order to reduce the mortality rate of children with severe hand-foot-mouth disease and improve the curative rate and prognosis.