重症手足口病病情进展的预测探讨

Predict Clinical Investigation for Severe Hand-foot-and-mouth Disease Progress

目的:观察总结重症手足口病患儿的临床特征,探讨能够识别手足口病患儿病情进展的一些预测因素。方法:回顾性分析2010年10月至2011年5月期间我院重症监护病房住院的重症手足口病患儿50例,通过患儿住院期间的临床表现、体征、辅助检查、治疗措施等不同方面的分析与研究,预测病情进展。结果:45例患儿的年龄在3岁以下,辅助检查中白细胞计数增高的有46例;血糖增高的有40例;脑脊液异常的有43例。持续高热、呼吸心率增快、食欲不振、神经系统受累发生率为70%(35/50),X线胸片显示肺纹理明显增多、模糊的发生率为68%(34/50)。重症手足口病可并发中枢神经系统损伤,导致神经性肺水肿和循环衰竭。结论:加强对重症手足口病患儿病情的观察,及时发现重症手足口病患儿早期的临床特征,对于病情轻重、发展与预后有着不可替代的重要作用,能够明显降低危重率以及死亡率,是成功治愈重症手足口病患儿的关键。

Objective： To observe and summarize the puerile patients＇ clinical features of severe hand-foot-and-mouth disease,also discuss about the prediction factors which can able to identify the disease progression of puerile patients.Method： Retrospective analysis： From October 2010 to May 2012,there were fifty cases of puerile patients with severe hand-foot-and-mouth disease who were taken to critical care ward in our hospital.We predicted the disease progression through different aspects of the analysis and research,like the clinical manifestations of patients,physical sign,auxiliary examinations,and treatment measures and so on during hospitalization.Result：The ages of the puerile patients in 45 cases＇ are all under 3 years,while 46 patients＇ WBC count increase in auxiliary examinations and 40 cases blood sugar increase and cerebrospinal fluid anomaly has 43 cases.The involvement rate for continuous high fever,fast breathing and heart rate,loss of appetite,and tired nervous system is 70%（35/50）.X-ray radiograph shows that the incidence for a significant increase or fuzzy in lung texture was 68%（34/50）.Severe hand-foot-and-mouth disease is complicated by central nervous system damage,leading to nerve pulmonary edema and circulatory failure.Conclusion： Strengthen observation on patient＇s illness for severe hand-foot-and-mouth disease and timely find its early clinical features in order to reduce the critical rate and mortality and also play an irreplaceable role in mild or severe,development and prognosis.It is the key of curing severe hand-foot-and-mouth disease successfully.