危重型手足口病临床特点与预后分析

Clinical features and prognosis analysis about severe Hand-Foot-and-Mouth Disease

目的分析危重症手足口病临床特点与预后,以提高对重症手足口病上机时机的把握。方法选择本院ICU 2012年1月至2014年12月收治并进行机械通气的危重症手足口病75例进行回顾性分析。结果 75例危重症手足口病患儿中,存活组55组,死亡组20例;年龄在1~3岁占多数。死亡组不典型皮疹、意识障碍、肺部啰音、肺出血、心率增快、应激性溃疡、CRT>5 s、白细胞计数>15×10~9/L、血糖增高,血糖>9 mmol/L及血乳酸增高的发生率均显著高于存活组,差异有统计学意义(P<0.05)。结论上机时的多种因素如不典型皮疹、意识障碍、肺部罗音、肺出血、心率增快、应激性溃疡、CRT>5 s、白细胞计数增高、血糖增高,血乳酸增高是影响预后的危险因素。

Objective To analyze the clinical features and prognosis about Severe Hand-Foot-and-Mouth Disease when mechanical ventilation was given. Methods We retrospectively analyzed 75 cases of Severe Hand- Foot-and-Mouth Disease of clinical features treated in our hospital from March 2012to August 2014 when the mechanical ventilation was given. And according to the prognosis, they were divided into the death group and the survival group, and then investigated the factors influencing prognosis by comparing the clinical features.Results Among the clinical features, the incidence rate of death group was higher than that of the survival group significantly including Atypical rashes, disturbance of consciousness, lung rales, empsyxis, heart rates increasing, stress ulcer, CRT〉 5s, white blood cell count 〉 15 x 109/L, blood glucose increasing, hyperglycemia 〉9mmol/L, and blood lactic acid increasing, and the difference had statistical significance （P 〈 0. 05 ）. Conclusions Typical rashes, disturbance of consciousness, lung tales, empsyxis, heart rates increasing, stress ulcer, CRT〉5s, white blood cell count increasihg . hyperglycemia, and blood lactic acid increasing, all of theese are risk factors that affect prognosis.n.