重症手足口病合并神经源性肺水肿的诊治进展

Diagnosis and treatment progress of severe hand-foot-mouth disease combined with neurogenic pulmonary edema

手足口病(HFMD)是近年来婴幼儿常见的急性流行性传染病,重症患儿可引发神经系统受累,并发神经源性肺水肿(NPE),其是导致患儿死亡的重要原因。重症HFMD合并NPE患儿的预后与救治措施、脑损伤程度及其他并发症密切相关,因此,医护人员应该早期通过结合患儿的临床表现,准确识别神经系统是否受累,一旦确诊,则采取正确的处置方法,降低颅内压、控制液体负荷、抑制交感神经功能,同时给予呼吸支持、保护心脏功能、加强呼吸道管理等,可提高治疗效果和改善预后。

The hand-foot-mouth disease （HFMD） is a common acute infectious disease in infants and young children in recent years,severe patients can cause nervous system involvement and complicate with neurogenic pulmonary ede- ma （NPE）,the NPE is also the important cause of death in children.The prognosis of the patients with severe HFMD combined with NPE are closely related to treatment measures,degree of brain injury and other complications,therefore, the medical staff should accurately identify whether the nervous system involvement by clinical manifestation in chil- dren in the early stage,if the disease is diagnosed,the medical staff should adopt the correct methods to improve the treatment effect and prognosis,the measures includes reducing intracranial pressure,controlling of the liquid load,in- hibiting the sympathetic nerve function,and at the same time,giving the respiratory support,protecting function of heart and strengthening the respiratory management.