儿童重症手足口病56例临床特征剖析.docVIP

儿童重症手足口病56例临床特征剖析 　　【摘要】目的分析儿童重症手足口病的临床特征、治疗及预后状况，为临床诊断和治疗提供参考。方法选择2012年6月～2014年6月重症手足口病患儿56例，收集患儿临床资料并进行分析。结果危重患儿中，患儿年龄3岁、体温≥38.5℃、发热持续时间≥72 h、病原体为EV71、WBC≥12×109/L、血糖≥9 mmol/L的构成比较高。重症病例的早期临床特征主要表现为高热持续不退、精神萎靡、肢体震颤、烦躁不安等。采用综合治疗措施进行救治，1例患儿死于神经源性肺水肿，其余患儿均治愈。结论3岁以下为危重症手足口病患儿高危年龄，以EV71和 Cox A 16感染为主要病原体，患儿病情进展迅速，早期诊断重症病例、及时进行救治可以减少患儿死亡，改善预后。 　　【关键词】儿童；重症手足口病；临床特征 　　中图分类号：R725.1 文献标识码：ADOI：10.3969/j.issn2015.04.019 　　【Abstract】ObjectiveTo analyze clinical features，treatment and prognosis of severe handfootmouth disease （HFMD） in children，so as to provide reference for clinical diagnosis and treatment of this disease.Methods56 cases of severe HFMD from June，2012 to June，2014 were selected，and the clinical data of these cases were collected and analyzed.Results A high proportion of children with severe HFMD appeared in those under the age of three，with temperature at 38.5℃ or above，got fever more than 72 hours，with enterovirus type 71（EV71） as the pathogen，with white blood cell（WBC）more than 12×109/L and blood sugar higher than 9 mmol/L.And main early clinical manifestations of severe HFMD were persistent high fever，listlessness，limb tremor and dysphoria.After being treated with comprehensive treatment measures，1 case died of neurogenic pulmonary edema and the others were cured.ConclusionChildren under the age of three are the high risk group of severe HFMD，and the main pathogens are EV71 and Cox A16 infection.HFMD can develop very rapidly，so early diagnosis and timely rescue are vital to reduce the death and improve the prognosis. 　　【Key words】children；HFMD；clinical features 　　手足口病是由肠道病毒71型（EV71）、柯萨奇病毒（Cox）A 16 型等为主的多种肠道病毒引起的一种常见传染病，多发生在5 岁以下的婴幼儿。严重患儿可引起肺水肿、心肌炎、无菌性脑炎等并发症，少数重症患儿起病急、病情发展迅速，常使神经系统受累，并迅速发生肺水肿或循环功能衰竭，导致患儿死亡，早期识别重症患儿并进行积极的治疗，对减少后遗症、改善患儿预后具有重要临床意义[1～2]。本研究旨在分析儿童重症手足口病的临床特征、治疗及预后状况，为临床诊断和治疗提供客观依据。 　　1资料与方法1.1一般资料选择2012年6月～2014年6月在我院诊治的重症手足口病患儿56例，男29例，女27例，年龄9个月～8岁，平均（3.43±2.81）岁。 　　1.2研究方法 　　1.2.1诊断标准入选病例均符合卫生部制定的《手足口病诊疗指南（2010 年版）》诊断标准，重症病