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目的探索重症手足口病(HFMD)患儿合并心衰的危险因素及治疗方法。方法选取2012年5月至2013年3月本院收治的120例重症手足口病患儿的临床资料,分析重症HFMD患儿合并心肺功能衰竭的危险因素并探讨丙种球蛋白联合地塞米松及利巴韦林治疗的有效性。结果与未合并心肺功能衰竭组比较,合并心衰患儿的意识障碍、呼吸急促和EV71感染发生率更高,差异有统计学意义(P<0.01)。丙种球蛋白、地塞米松及利巴韦林三联治疗未合并心肺功能衰竭组的疗效明显好于合并心肺功能衰竭组(P<0.05)。结论重症HFMD合并心肺功能衰竭的主要危险因素包括呼吸急促、意识障碍及EV71感染。给予丙种球蛋白、地塞米松及利巴韦林联合治疗可以降低病死率。
Objective To explore the risk factors and treatment of heart failure in children with severe hand-foot-mouth disease (HFMD). Methods The clinical data of 120 severe HFMD patients admitted to our hospital from May 2012 to March 2013 were analyzed to analyze the risk factors of HFMD complicated with cardiopulmonary failure and to explore the relationship between gamma globulin and dexamethasone The effectiveness of ribavirin therapy. Results Compared with patients without cardiopulmonary failure group, the incidence of disturbance of consciousness, shortness of breath and EV71 infection were significantly higher in children with heart failure (P <0.01). The efficacy of gamma globulin, dexamethasone and ribavirin triple therapy in patients without cardiopulmonary failure was significantly better than that in patients with cardiorespiratory failure (P <0.05). Conclusions The main risk factors for HFMD complicated with cardiopulmonary failure include shortness of breath, disturbance of consciousness and EV71 infection. Given gamma globulin, dexamethasone and ribavirin combination therapy can reduce mortality.