重症手足口病并发病毒性脑炎154例临床剖析.docVIP

重症手足口病并发病毒性脑炎154例临床剖析 　　[摘要] 目的 探讨重症手足口病（HFMD）合并病毒性脑炎的临床特征及疗效。 方法 回顾性分析我院2011年1月～2015年7月收治的重症HFMD并发病毒性脑炎患儿154例，重点分析患儿的年龄、实验室检查、临床表现及病程转归情况。 结果 154例患儿中，男104例（67.5%），女50例（32.5%），发病年龄3岁的124例，占80.5%，主要临床表现有发热、嗜睡、易惊、肢体抖动、呕吐、手足皮疹、口腔疱疹等；EV71病毒感染112例，占72.7%，脑脊液呈无菌性脑炎或脑膜炎改变。154例患儿中5例死亡，病死率为3.2%；2例遗留急性驰缓性麻痹。 结论 重症HFMD合并病毒性脑炎主要以3岁的儿童发病率较高，男孩多于女孩，主要临床表现为精神差、易惊、肢体抖动等，及时识别及有效治疗是降低病残率及病死率的关键。 　　[关键词] 手足口病；病毒性脑炎；临床表现 　　[中图分类号] R725.1 [文献标识码] A [文章编号] 1674-4721（2016）02（b）-0071-03 　　Clinical analysis of severe hand-foot-mouth disease combined with viral encephalitis in 154 cases 　　LI Ying-fei WANG Yan-rong WANG Xian-feng 　　Department of Pediatrics，the Third People′s Hospital of Shenzhen City，Shenzhen 518112，China 　　[Abstract] Objective To explore the clinical features and efficacy of severe hand-foot-mouth disease （HFMD） combined with viral encephalitis. Methods From January 2011 to July 2015，154 pediatric patients with HFMD combined with viral encephalitis received by our hospital were retrospectively analyzed.The age，laboratory test，clinical manifestation，and prognosis of course of disease was analyzed respectively in emphasis. Results 104 cases （67.5%） were male，50 cases （32.5%） were female，and age of onset being lower than 3 years old was in 124 cases among 154 ones accounting for 80.5%.The primary clinical manifestation was fever，somnolence，being easy to be frightened，limb shaking，vomiting，hand-foot skin rashes，and herpes of mouth and so on.There were 112 cases infected by EV71 accounting for 72.7%.The cerebrospinal fluid was displayed in non-bacterial meningitis or meningitis.5 out of 154 pediatric cases were death，and the fatality rate was 3.2%. There were 2 cases with the sequela of acute flaccid paralysis. Conclusion The morbidity of severe HFMD combined with viral encephalitis is high in pediatric patients under 3 years old.Boys are more than girls.The main clinical manifestation includes listlessness，being easy to be frightened，and limb shaking and so on.Prompt rec