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[目的]回顾性分析26例重症手足口病(11例合并神经源性肺水肿(NPE))的临床表现及救治体会。[方法]回顾性分析我院儿科2008年2月～2011年2月收治的重症手足口病(11例合并神经源性肺水肿(NPE))26例患儿的临床救治过程,记录分析患者主要临床表现,记录患者治疗效果及预后,分析影响预后的相关风险因素。[结果]所有患儿均有发热,皮疹,呼吸困难,其中肺部湿啰音并粉红色泡沫痰11例,持续高热(≥39℃,持续3d)6例,持续低血压≥48h7例、入院时GCS评分≤5分7例。经积极治疗,存活19例,死亡7例,经Logistic回归分析,持续高热、持续低血压≥48h、入院时GCS评分≤5分,是影响患者死亡预后的独立影响因素。[结论]重症手足口病合并神经源性肺水肿起病急骤,发展迅速,病死率高,需积极行综合治疗,持续高热、持续低血压≥48h、入院时GCS评分≤5分是影响导致患儿死亡的独立影响因素。
[Objective] To retrospectively analyze the clinical manifestations and treatment of 26 cases of severe hand-foot-mouth disease (11 cases with neurogenic pulmonary edema (NPE)). [Methods] A retrospective analysis of pediatric patients in our hospital from February 2008 to February 2011 admitted to severe hand-foot-mouth disease (11 cases with neurogenic pulmonary edema (NPE)) in 26 cases of clinical treatment of patients with records of major patients Clinical manifestations, records of patients with treatment and prognosis, analysis of prognosis related risk factors. [Results] All patients had fever, rash and breathing difficulties. Among them, 11 cases were accompanied by pulmonary araucosis with pink foamy sputum, 6 cases sustained high fever (≥39 ℃, continuous 3d), 7 cases with persistent hypotension ≥48h and admission When GCS score ≤ 5 points in 7 cases. After active treatment, 19 cases were alive and 7 died. Logistic regression analysis showed that persistent high fever, sustained hypotension ≥48h and GCS score ≤5 at admission were independent influencing factors for prognosis of patients. [Conclusion] Severe hand-foot-mouth disease complicated with neurogenic pulmonary edema, the rapid onset, rapid development, high mortality, the need for aggressive comprehensive treatment, sustained high fever, sustained hypotension ≥ 48h, admission GCS score ≤ 5 points is the impact of lead The independent influencing factors of child death.