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目的了解手足口病合并脑炎病例的临床特点。方法对2011年4月～2012年3月在平顶山市某医院住院的手足口病合并脑炎169例进行描述性分析。结果 169例患儿中多数为男性3岁以下散居儿童,居住于农村。所有病例均为急性起病,出现发热,有皮疹,平均最高体温为(38.8±4.3)℃,皮疹主要为分布在手足口臀部的疱疹和丘疹,95.63%有3个及以上部位皮疹;头痛者占34.67%,呕吐者占31.55%,其中有20.75%为喷射性呕吐;神经系统症状多为精神萎靡、烦躁、表情淡漠和易激惹,脑膜刺激征阳性者占70.83%。1例出现循环衰竭,1例合并肺水肿。71.67%外周血白细胞计数增高,98.51%脑脊液压力增高。53.97%脑电图检查异常;19.72%脑CT检查异常。159例痊愈,9例好转,1例死亡。结论手足口病合并脑炎具有年龄小、起病急的特点,应对高危人群和患儿及早采取预防和诊疗措施,以降低发病和改善预后。
Objective To understand the clinical features of HFMD complicated with encephalitis. Methods A total of 169 hospitalized HFMD encephalitis in a hospital in Pingdingshan from April 2011 to March 2012 were analyzed retrospectively. Results The majority of 169 children were male under 3 years of age living in rural areas living in rural areas. All cases were acute onset, fever, rash, the average maximum body temperature was (38.8 ± 4.3) ℃, the rash mainly herpes and papules located in the buttocks of hands and feet, 95.63% had rash of 3 or more; headache Accounting for 34.67%, vomiting accounted for 31.55%, of which 20.75% for the ejection of vomiting; mostly nervous system symptoms listlessness, irritability, apathy and irritability, meningeal irritation positive accounted for 70.83%. One case had circulatory failure and one case had pulmonary edema. 71.67% peripheral blood leukocyte count increased, 98.51% increased cerebrospinal fluid pressure. 53.97% EEG abnormalities; 19.72% brain CT abnormalities. Of the 159 patients healed, 9 improved and 1 died. Conclusions Hand, foot and mouth disease with encephalitis has the characteristics of young age and acute onset. Early prevention and treatment measures should be taken in high-risk groups and children to reduce the incidence and improve the prognosis.