Brighton PEWS在重型手足口病并发神经功能损害患儿中的应用价值

Application of Brighton PEWS in Children with Severe Hand-Foot-and-Mouth Disease Complicated with Neurological Impairment

【目的】探讨Brighton儿童早期预警评分(Brighton PEWS)在重型手足口病并发神经功能损害患儿中的应用价值。【方法】回顾性分析2018年6月至2020年5月宝鸡市千阳县妇幼保健院收治的98例重型手足口病合并神经功能损害患儿的临床资料,根据干预方法的不同将其分为对照组(常规干预)和观察组(在常规干预的基础上应用Brighton PEWS),每组49例。比较两组患儿干预前后中性粒细胞及血清肌酸激酶(CK)、特异性神经元烯醇化酶(NSE)、肌酸激酶同工酶(CK-MB)水平,比较两组退热时间、疱疹消退时间、口腔溃疡愈合时间以及神经受损持续时间。记录两组肺水肿、重症脑炎及循环衰竭发生率。【结果】观察组退热时间、疱疹消退时间、口腔溃疡愈合时间及神经受损持续时间均短于对照组(P<0.05)。干预后,两组中性粒细胞、CK、NSE及CK-MB水平均低于干预前,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率为4.08%(2/49),低于对照组的14.29%(7/49),差异有统计学意义(χ^(2)=4.009,P<0.05)。【结论】对重型手足口病并发神经功能损害患儿在常规干预的基础上给予Brighton PEWS干预,可有效缩短临床症状消失时间,减轻心肌细胞、脑细胞损伤,降低并发症发生率。

【Objective】To explore the application value of Brighton Pediatric Early Warning Score for Children(Brighton PEWS)in children with severe hand-foot-and-mouth disease complicated with neurological impairment.【Methods】A retrospective analysis was conducted on the clinical data of 98 children with severe hand-foot-and-mouth disease complicated with neurological impairment admitted to our hospital from June 2018 to May 2020.They were divided into a control group(with routine intervention)and an observation group(Brighton PEWS application in addition to routine intervention)based on different intervention methods,with 49 cases in each group.The levels of neutrophils,serum Creatine kinase(CK),specific neuron Enolase(NSE),and Creatine kinase Isozyme(CK-MB)were compared before and after the intervention in the two groups.And the antipyretic time,herpes regression time,aphthous stomatitis healing time,and the duration of nerve damage were compared between the two groups.The incidence of pulmonary edema,severe encephalitis and circulatory failure were recorded.【Results】The antipyretic time,herpes regression time,aphthous stomatitis healing time and nerve damage duration in the observation group were shorter than those in the control group(P<0.05).After intervention,the levels of neutrophils,CK,NSE,and CK-MB in both groups were lower than those before intervention.And these parameter's levels of the observation group was lower than those of the control group with a statistically significant difference(P<0.05).The incidence of complications in the observation group was 4.08%(2/49),which was lower than the control group's 14.29%(7/49)with a statistically significant difference(χ2=4.009,P<0.05).【Conclusion】Brighton PEWS intervention on the basis of routine intervention can effectively shorten the disappearance time of clinical symptoms,effectively reduce the damage of myocardial cells and brain cells,and reduce the incidence of complications in children with severe hand-foot-and-mouth disease complicated with neurological damage.