重症手足口病患儿临床分析

Clinical analysis of children with severe hand, foot and mouth disease

目的探讨重症手足口病的临床特征及治疗情况，为其防治提供依据。方法对60例重症手足口病患儿的临床资料进行分析。结果60例均出现发热伴手、足、口、臀部皮疹，部分患儿出现惊跳、肢体抖动、精神差和／或嗜睡，甚至出现惊厥，危重型2例，均发生神经源性肺水肿、肺出血、心肺功能衰竭。给予利巴韦林、甘露醇、人免疫球蛋白、甲泼尼龙等综合治疗，治愈43例，好转15例，2例死亡。结论重症手足口病病情危急，须早期发现危重征象，给予正确有效的临床治疗，促进患儿康复，降低病死率。

Objective To discuss the clinical feature and the treatment of severe hand, foot and mouth disease （HFMD）, and provide the basis for control of the disease. Methods The clinical data of 60 children with severe HFMD were retrospectively analyzed. Results All the 60 cases appeared fever and the erythra in hand, foot, mouth and gluteal region. Part of the children appeared jumping, body shaking, poor spirit and/or sleepiness. Some children appeared convulsion, and neurogenic pulmonary edema, pulmonary hemorrhage, cardiorespiratory failure happened in 2 critical severe cases. The children were given the comprehensive treatment including ribavirin, mannitol, human immunoglobulin and methylprednisolone. Forty-three cases were cured, 15 cases were improved, and 2 cases died. Conclusions Severe HFMD children usually appear critical condition. Early detection of critical signs and correct and effective clinical treatment can promote children＇s recovery and reduce the mortality rate.