作者：祐红瑞 杨冬冬 郑瑞利 王海建 Hong-rui D...重症病例手足口病临床分析treatmentinterventiontherapy门冬氨酸氨基转移酶clinicaldiagnosis中枢神经系统损伤肌酸激酶同工酶childrenpulmonaryedema神经源性肺水肿干预性治疗阳性空腹血糖升高病死率experiences乳酸脱氢酶分析的方法
摘要：目的 探讨重症手足口病患儿的临床诊断及治疗体会.方法 采用回顾性分析的方法对本院所收治的68例重症手足口病病例的相关信息进行分析.结果 68例重症手足口病大部分发生在2岁以下儿童;发热61例,白细胞升高50例,皮肤黏膜疹发病率100%;部分病例出现天门冬氨酸氨基转移酶(AST)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)和空腹血糖升高;部分病例可并发中枢神经系统损伤,导致神经源性肺水肿和循环衰竭.危重症病例治疗困难,病死率达2.94%(2/68).本组病例中, EV71阳性者23例,CoxA16阳性者2例,其他肠道病毒阳性者18例.结论 重症手足口病发病人群大部分为2岁以下儿童.提高诊断警惕性和及时识别出重症病例的早期临床征象及早期干预性治疗是降低手足口病病死率的关键环节. Abstract： Objective To explore the clinical diagnosis and experiences of treatment of severe patients with HFMD in order to understand HFMD better and accumulate more experience of preventing and treating this disease. Methods Clinical data and treatment of the 68 cases of severe HFMD were analyzed retrospectively. Results In 68 severe cases of HFMD, 58 cases happened children with 2 years lower, fever 61 cases and efflorescence 68 cases (100%). WBC increase in 50 cases rose. AST, CK, CK-MB, LDH and Glu inrease partial cases. Neurogenic pulmonary edema(NPE)and circulation failure could occur on the cases with CNS injure. In 68 cases, 23 cases were EV71-positive, 2 cases were CoxA16-positive, 18 cases were other enterovirus-positive. Treatment of critical cases was difficult, case-fatality rate was high as 2.94%.Conclusions Severe HFMD mostly happened to the children with 2 years lower. Improving diagnosis consciousness and early intervention therapy are critical in reducing the fatality.
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