重症手足口病心肺功能衰竭前期症状及治疗分析

Symptoms and Treatment of Cardiopulmonary Failure in Severe Hand,Foot and Mouth Disease

目的探究重症手足口病心肺功能衰竭前期的临床症状及治疗分析。方法选取2017年3月—2019年3月期间,云阳县所有医疗卫生机构收治的重症手足口心肺功能衰竭的患儿43例,作为该次探究的主要研究对象,对所有患儿实施目标性救治措施。主要包括:①基本治疗:检测患儿体温、心率、血压、血糖及血氧饱和度等水平,给予米力农、丙种球蛋白、甘露醇等药物治疗。②抢救:将患儿头、肩抬高至30~45°,保持患儿呼吸道畅通及经皮氧饱和度在92%以上。确保血压平均脉压在65 mmHg以上,血糖控制在4.4~11.0 mmol/L,体温控制在38.5℃以下。结果经过治疗预后存活42例,1例死亡,病死率为2.33%。其中有5例患儿病情恶化进展为重症手足口病心肺衰竭期,恶性转化率达11.63%。重症手足口病心肺功能衰竭前期实施目标性救治措施,救治成功率为97.67%。结论对重症手足口病心肺衰竭前期患儿,实施目标性救治措施可明显提高该病的救治成功率。

Objective To explore the clinical symptoms and treatment analysis of pre-cardiopulmonary failure in severe hand-foot-mouth disease.Methods From March 2017 to March 2019,43 children with severe hand-foot-mouth heart-pulmonary failure admitted to all medical institutions in Yunyang County were selected as the main research object of this investigation,and all children were treated with targeted rescue measures.It mainly included:1.basic treatment:measure the children's temperature,heart rate,blood pressure,blood glucose and blood oxygen saturation levels,and give milinone,gamma globulin,mannitol and other drugs to treat.2.rescue:raise the children's head and shoulders to 30-45°,keep the children's airways open and the percutaneous oxygen saturation above 92%.Ensure that the average blood pressure and blood pressure are above 65 mmHg,blood glucose was controlled at 4.4~11.0 mmol/L,and body temperature was controlled below 38.5℃.Results After treatment,42 patients survived and 1 died.The mortality rate was 2.33%.Among them,5 patients had worsening disease and progressed to severe hand-foot-mouth disease heart and lung failure,with a malignant conversion rate of 11.63%.Targeted rescue measures were implemented in the early stage of cardiopulmonary failure for severe hand-foot-mouth disease,and the success rate was 97.67%.Conclusion For children with pre-cardiopulmonary failure of severe hand-foot-mouth disease,the implementation of targeted treatment measures can significantly improve the success rate of treatment of the disease.