肠道病毒71型感染重症手足口病33例随访分析.docVIP

肠道病毒71型感染重症手足口病33例随访分析 　　[摘要] 目的 对肠道病毒EV71感染重症手足口病患儿进行随访分析，了解预后情况。 方法 对2011年3～12月新乡市中心医院收治的33例确诊为肠道病毒EV71感染的重症手足口病患儿出院后3个月进行跟踪随访，观察预后情况。 结果 肠道病毒EV71感染重症手足口病33例患儿入院时均有不同程度的嗜睡、精神状态的改变（萎靡和烦躁）以及四肢抖动、惊跳等中枢神经系统表现，经治疗后有2例遗留有不同程度的后遗症，余均预后良好。 结论 肠道病毒EV71更易致中枢神经系统损害及AFP且具有发病年龄小，病情凶险，病死率高的特点，及早发现、及时干预治疗可减轻其预后。 　　[关键词]肠道病毒71型；手足口病；预后 　　[中图分类号] R725.1 [文献标识码] B [文章编号] 2095-0616（2013）13-211-02 　　Follow-up analysis of 33 patients with enterovirus 71 infected severe hand-foot-mouth disease 　　LOU Ying JING Huijuan LIANG Peng 　　Department of Pediatrics，Xinxiang Central Hospital，Xinxiang 453011，China 　　[Abstract] Objective To follow up the children with Enterovirus 71 （EV71） infected severe hand-foot-mouth disease in order to understand the prognosis. Methods Thirty-three children diagnosed with EV71 infected severe hand-foot-mouth disease treated in the Xinxiang Central Hospital from March to December 2011 were followed up 3 months after discharge and the prognosis was observed. Results On admission to the hospital， all the 33 children with EV71 infected severe hand-foot-mouth disease had varying degrees of lethargy， mental status changes （malaise and irritability） and central nervous system manifestations such as limb shake and startle. After the treatment， 2 children were left with different degrees of sequelae and the rest had a good prognosis. Conclusion EV 71 is more prone to causing central nervous system damage and AFP and has the characteristics such as low age of disease onset， dangerous conditions and high mortality. Early detection and timely intervention can improve the prognosis. 　　[Key words] EV71；HFMD；Prognosis 　　手足口病（hand- foot-mouth disease，HFMD）是一种由多种肠道病毒感染引起的急性传染性疾病，以柯萨奇病毒A16型和肠道病毒71型最常见，EV71多导致重症及危重症病例的发生[1]，病情进展迅速，短期内危及生命，部分可遗留神经系统后遗症。3岁以下的婴幼儿是严重并发症的高危人群，目前尚无安全有效的疫苗用于预防。因EV71感染所致的无菌性脑炎病情发展迅速，导致周围神经损伤发生率已越来越高并且这种损伤致残率极高。2011年3～12月期间对我院收治33例确诊为肠道病毒EV71感染的重症手足口病患儿出院后3个月进行跟踪随访，对其临床预后特点分析如下。 　　1 资料与方法 　　1.1 一般资料 　　2011年3～12月我院收治重症手足口病经粪便病毒分离确诊为EV71感染患儿