以植物神经功能紊乱为主要表现的手足口病六例诊治分析

Analysis of Hand-Foot-Mouth Disease in 6 Patients with Vegetative Nerve Functional Disturbance

目的探讨重症手足口病的临床特点,以提高诊治水平。方法回顾性分析我院2011年2月—2012年7月收治的以植物神经功能紊乱为主要表现的重症手足口病6例的临床资料。结果 6例发病初期均表现为呕吐、多汗、高血压、四肢抖动、肌张力增高及皮肤颜色潮红、苍白交替出现等植物神经功能紊乱症状,病原学检查肠道病毒71型均阳性,确诊重症手足口病。经脱水、降颅压及减轻肺水肿等治疗后,均康复出院。结论手足口病临床表现复杂,当出现植物神经功能紊乱时应及时脱水、降低颅内压及体肺循环阻力,减少回心血量,以阻断神经源性肺水肿,改善预后。

Objective To explore clinical manifestations of severe hand-foot-mouth disease to improve the diagnosis and treatment.Methods Clinical data of severe hand-foot-mouth disease in 6 patients with vegetative nerve functional disturbance during February 2011 and July 2012 in our hospital were retrospectively analyzed.Results In the initial stage,6 patients had vegetative nerve functional disturbance signs such as vomiting,hidrosis,hypertension,four limbs trembling,hypermyotonia,alternate blush and pale face.Enterovirus 71 of aetiology examination was positive,and the hand-foot-mouth disease was confirmed.All patients were cured and discharged after dehydration treatment and reducing intracranial hypertension and pulmonary edema treatment.Conclusion The clinical manifestation of severe hand-foot-mouth disease is complex,so treatment of dehydration and reducing intracranial hypertension,pulmonary vascular resistance and returned blood volume should be performed when patients suffer from vegetative nerve functional disturbance,in order to obstruct neurogenic pulmonary edema and improve prognosis.