【摘要】 目的探讨重症手足口病(HFMD)的临床表现及治疗情况,为其防治提供依据。方法回顾性分析镇江市第一人民医院2012年5～9月收治的55例重症HFMD患儿的临床资料。结果 55例均出现发热伴手、足、口、臀部皮疹,半数以上患儿出现惊跳、肢体抖动、精神差和(或)嗜睡,部分患儿出现惊厥,危重型2例,均发生神经源性肺水肿、心肺功能衰竭、顽固性休克。应用利巴韦林、甘露醇、免疫球蛋白、甲基泼尼松龙等综合治疗,治愈38例,好转15例,2例死亡。结论 3岁以内HFMD患儿在病程的第3～5天易发展成重症,出现持续高热、惊跳、肢体抖动、抽搐、嗜睡多提示病情危重;出现频繁抽搐、昏迷、脑疝、呼吸困难、发绀、血性泡沫痰、休克则认为为危重型病例。重症手足口病起病凶险,须早期发现危重征象,并及早给予相关的治疗,以改善患儿预后,降低病死率。更多还原

【Abstract】 Objective To discuss the clinical feature, treatment of severe HFMD cases, and provide the basis for the control of the disease. Methods To analyze the clinical data of 55 cases with severe HFMD in Zhenjiang First People’s Hospital from May to September 2012 retrospectively. Results All 55 cases appeared fever with hand, foot and mouth, hip rash, more than half of the children appear jumping, body shaking, spirit not good enough and (or) sleepiness, some children appeared convulsions, 2 critical severe cases happened neurogenic pulmonary edema, cardiorespiratory failure, persistent shock. With comprehensive treatment including ribavirin, mannitol, immunoglobulin, methyl prednisolone, 38 cases were cured and 15 cases were improved, 2 cases died. Conclusion HFMD children within 3 years old in the course of the third to fifth day were easily developed into severe cases. Severe cases usually had persistent high fever, jumping body shaking, convulsions, sleepiness. When appeared frequently twitching, coma, cerebral hernia, difficulty breathing, cyanosis, hemorrhagic foam phlegm and shock were regarded as critical cases. Severe HFMD cases usually appeared dangerous onset that must be found early signs of critical, and given early relevant treatment that can improved the prognosis and mortality.更多还原