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目的探讨儿童重症手足口病的早期临床表现,总结分析诊治经验及预后因素。方法回顾性分析30例重症手足口病病例的临床表现、辅助检查及治疗、预后。结果 30例重症病例中治愈出院21例,好转5例,死亡4例,其中后遗症5例。发现早期皮疹不典型导致误诊、误治未及时综合治疗而导致死亡的病例增多;经及早应用丙球(2g/kg,分1或2次)和甲强龙冲击治疗3d(10～20mg/kg.d分3次),早期呼吸机支持及内科综合治疗均存活,预后良好。结论重症手足口病的早期识别非常重要,早期呼吸机支持、监测心血管功能及对症治疗是抢救成功的关键。
Objective To explore the early clinical manifestations of severe hand-foot-mouth disease in children and to summarize the diagnosis and treatment experience and the prognostic factors. Methods Retrospective analysis of 30 cases of severe hand foot and mouth disease cases of clinical manifestations, auxiliary examination and treatment, prognosis. Results In 30 cases of severe cases, 21 cases were cured, 5 cases improved and 4 cases died, of which 5 cases were sequelae. Found that early rashes caused by atypical misdiagnosis, mistreatment is not timely and comprehensive treatment led to an increase in the number of deaths; early use of corticosteroid (2g / kg, 1 or 2 times) and methylprednisolone therapy 3d (10 ~ 20mg / kg . D points 3 times), early ventilator support and comprehensive medical treatment survived, the prognosis is good. Conclusion Early recognition of severe HFMD is very important. Early ventilator support, monitoring of cardiovascular function and symptomatic treatment are the keys to successful treatment.