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目的:分析重症儿童手足口病的临床特点。方法:回顾性分析2011年2月至2012年10月收治的50例重症手足口病病例的临床资料,总结其临床特点及诊治情况。结果:重症手足口病患儿的特点为年龄小,持续高热,皮疹不典型、数量少、陈旧,呼吸快、心率快、手脚凉,精神差、嗜睡、肌震颤,高血压、高血糖、高白细胞。5例危重患儿均出现神经源性肺水肿,2例抢救成功、3例死亡。结论:手足口病重症病例多数为EV71感染,对危重手足口病患儿要早期甄别、早期干预,掌握早期插管指征,积极降颅压,剂量丙种球蛋白、甲泼尼龙冲击等积极治疗可以阻止病情进一步进展。
Objective: To analyze the clinical features of HFMD in critically ill children. Methods: The clinical data of 50 cases of severe HFMD treated in our hospital from February 2011 to October 2012 were analyzed retrospectively. The clinical features, diagnosis and treatment were summarized. Results: Children with severe hand-foot-mouth disease were characterized by small age, persistent fever, atypical rashes, small number, old age, fast breathing, fast heart rate, cold hands and feet, poor spirit, drowsiness, tremor, hypertension, hyperglycemia, leukocyte. Neuropathic pulmonary edema occurred in all five critically ill children, with two successfully salvaged and three with death. Conclusion: The majority of HFMD cases are EV71 infection. Early screening and early intervention are needed in critically ill children with hand-foot-mouth disease. Early indications for intubation, aggressive intracranial pressure, gammaglobulin, and methylprednisolone should be mastered actively Can stop further progression of the disease.