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目的:探讨危重症手足口病的临床特征、病程特点及早期干预措施。方法:对住院危重症HFMD患儿的相关临床资料进行回顾性分析。结果:危重症手足口病13例中男女比例12∶1,年龄集中在1～3岁,主要来自农村,10例皮疹稀少,主要分布在手足心及臀部。13例患儿热程持续2～5天,神经系统症状出现后早期未予治疗于18～72 h迅速进入呼吸循环衰竭期,血白细胞、血糖在Ⅲ期患儿均明显增高。结论:年龄分布主要集中在1～5岁,尤其是1～3岁。男童多,病例主要来自农村,皮疹少,不典型,病程中出现持续发热。应严密监测心率、呼吸、血压等生命体征变化,同时结合血象,血糖、胸片的检查,尽早发现呼吸循环衰竭早期患儿,及时给予呼吸机支持治疗,可以降低病死率及致残率。
Objective: To explore the clinical features, course of disease and early intervention of critically ill hand-foot-mouth disease. Methods: The clinical data of HFMD in critically ill children were retrospectively analyzed. Results: In 13 cases of critically ill hand-foot-and-mouth disease, the ratio of male to female was 12: 1, and the age ranged from 1 to 3 years old. Most of them came from rural areas. Rash was rare in 10 cases, mainly distributed in hands and feet and buttocks. 13 cases of children with fever continued 2 to 5 days, the nervous system symptoms early after no treatment at 18 to 72 h into the respiratory failure, blood leukocytes, blood glucose in patients with stage Ⅲ were significantly higher. Conclusion: The age distribution mainly concentrated in 1 ~ 5 years old, especially 1 ~ 3 years old. More boys, mainly from rural areas, less rash, atypical, sustained fever during the course of the disease. Should be closely monitored heart rate, respiration, blood pressure and other vital signs, combined with blood, blood glucose, chest X-ray examination, early detection of early respiratory failure in children with ventilator support timely treatment can reduce mortality and morbidity.