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目的探讨和分析儿童重症手足口病的临床特征、治疗和预后。方法对2008年6月至2010年7月本院PICU收治的36例重症手足口病病例的临床资料进行回顾分析。结果 36例重症手足口病病例的肠道病毒检出阳性率为72.2%(26/36),其中EV71占65.4%(17/26),CA16占23.1%(6/26)。年龄<3岁的患儿占88.9%,平均年龄为2.86岁。神经系统受累32例,发生神经源性肺水肿6例,仅1例神经源性肺水肿抢救成功。误诊3例,均在入院24h内发生神经源性肺水肿死亡。结论儿童重症手足口病多发生在年龄<3岁的患儿,尤其是2岁左右的患儿。EV71感染仍是主要病因。临床表现以神经系统受累最多见,一旦发生神经源性肺水肿,则抢救成功率极低。
Objective To investigate and analyze the clinical features, treatment and prognosis of severe hand-foot-mouth disease in children. Methods The clinical data of 36 cases of severe HFMD treated in our hospital from June 2008 to July 2010 were analyzed retrospectively. Results The positive rate of enterovirus in 36 cases of severe HFMD was 72.2% (26/36), of which 65.4% (17/26) were EV71 and 23.1% (6/26) were CA16. 88.9% of children <3 years of age, with an average age of 2.86 years. Neurological involvement in 32 cases, 6 cases of neurogenic pulmonary edema occurred, only 1 case of neurogenic pulmonary edema rescue success. Misdiagnosis in 3 cases, all within 24 hours of admission occurred in neurogenic pulmonary edema death. Conclusion Children with severe HFMD often occur in children <3 years of age, especially in children aged 2 years and older. EV71 infection is still the major cause. The most common clinical manifestations of nervous system involvement, in the event of neurogenic pulmonary edema, the rescue success rate is very low.