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目的:探讨手足口病重症危象,提醒临床尽早发现重型病例,提高抢救成功率,降低病死率。方法:对手足口病重症192例患儿的临床资料进行回顾性分析。结果:1～3岁幼儿较多,男孩明显多于女孩;居住在农村和城乡结合部的散居患儿较多;重症病例的临床特点为大多数患儿以发热起病,在病程5d以内,出现反复发热或持续高热不退,常规退热效果不佳,持续时间超过3d;出现精神萎靡、嗜睡、肌阵挛或抽搐、易惊、肢体抖动、共济失调、急性迟缓性麻痹等是发展为重症的早期征象;重症手足口病多为EV71感染引起,外周血白细胞计数增高,除外其他感染因素;出现应激性高血糖;心肌酶增高;胸片异常或动态变化快,这些都是重症危象。结论:早期筛查出有高危因素的患儿,及早干预、正确治疗,是提高抢救成功率、降低病死率的关键。
Objective: To explore the critical crisis of hand, foot and mouth disease, to remind clinical early detection of heavy cases, improve the success rate of rescue and reduce mortality. Methods: The clinical data of 192 cases of severe hand-foot-mouth disease were analyzed retrospectively. Results: There were more children aged 1 to 3 years with significantly more boys than girls. There were more scattered children living in rural areas and urban-rural areas. The clinical features of severe cases were that most of the children had fever onset within 5 days, Recurrence of fever or sustained high fever without retreat, conventional antipyretic effect is poor, duration of more than 3d; appear apathetic, drowsiness, myoclonus or convulsions, easy to shock, limb jitter, ataxia, acute delayed paralysis are the development Severe signs of early signs of severe hand-foot-mouth disease caused by EV71 infection, peripheral blood leukocyte count increased, except for other infectious factors; the occurrence of stress hyperglycemia; myocardial enzymes increased; abnormal or dynamic changes in chest X-ray, these are severe Crisis. Conclusion: Early screening of children with high risk factors, early intervention, the correct treatment is to improve the success rate of rescue and reduce mortality.