危重型手足口病168例临床治疗及病原学分析

Analysis of clinical therapy and etiology of 168 cases with severe hand foot and mouth disease

目的:总结危重型手足口病(HFMD)病例的临床诊治经验及对病原学进行分析。方法:2011年6-12月收治危重型手足口病患者168例,对其临床资料进行回顾性分析。结果:168例危重型患儿经积极抢救治疗,其中1例肺出血患儿入院11 h死亡,1例高热、昏迷患儿家长放弃治疗自动出院外,166例全部治愈出院。全部病例均行粪便RT-PCR核酸检测:阳性147例(87.50%),其中EV71 143例(85.12%),Cox A16 4例(2.38%),阴性21例(12.50%)。结论:HFMD危重型患儿病情危重,临床应高度重视。EV71是危重型手足口病的主要病原。早期发现、诊断、治疗HFMD危重型,是最大限度降低HFMD死亡率、致残率的关键。

Objective:To summarize the clinical experience of diagnosis and treatment of patients with severe hand foot and mouth disease and analyze the etiology.Methods:168 patients with severe hand foot and mouth disease were selected from June to December 2011.The clinical data was retrospectively analyzed.Results:168 cases with severe hand foot and mouth disease were given positive rescue and treatment.1 case with pulmonary hemorrhage was death after in hospital of 11 hours;1 case with high fever and coma was automatically discharged with giving up treatment;166 cases were cured and discharged.All patients were given the fecal RT-PCR nucleic acid detection:147 cases(87.50%) was positive,143 cases(85.12%) of EV71,4 cases(2.38%) of Cox A16;21 cases(12.50%) was negative.Conclusion:Pathogenetic condition of patients with severe hand foot and mouth disease was severe.Patients should be given high attention.EV71 was the main pathogen of severe hand foot mouth disease.Early discovery,diagnosis,treatment for patients with severe hand foot and mouth disease was the key to farthest minimizing the mortality and disability rate.