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目的分析手足口病(HFMD)危重型的影响因素,有针对性进行预防治疗,减少HFMD患儿的死亡率。方法对郑州市儿童医院2015年1—12月收治的12例HFMD危重型病例的临床资料进行回顾性分析。结果危重型HFMD患儿主要集中在3~6月份,年龄为8月~1岁2个月,且以农村为主。危重表现发生的频率由多到少依次为四肢末梢凉、呼吸节律不齐、惊颤、呕吐、皮肤颜色改变、双眼上翻、站立不稳、肢体抖动。白细胞明显升高,且以中性比例为主,损伤部位主要集中在延髓,淋巴细胞亚群T细胞及TH细胞降低。结论手足口病危重型主要和炎症反应、机体免疫功能、损伤部位有密切关系,积极地应用静注人血免疫球蛋白针、呼吸机、改善循环能显著降低死亡率。
Objective To analyze the influencing factors of critically ill hand-foot-mouth disease (HFMD), and to prevent and treat HFMD in order to reduce the mortality of children with HFMD. Methods The clinical data of 12 HFMD critically ill patients admitted to Zhengzhou Children’s Hospital from January to December 2015 were retrospectively analyzed. Results The children with severe HFMD mainly concentrated in March to June, and the age ranged from August to 1 year and 2 months, and mainly in rural areas. The frequency of critical manifestations from more to less in order for the limbs cold, irregular respiratory rhythm, chaos, vomiting, skin color changes, eyes upturn, standing instability, limb jitter. Leukocytes were significantly increased, and the proportion was mainly in the neutral, the lesion mainly in the medulla oblongata, lymphocyte subsets T cells and TH cells decreased. Conclusion HFMD is mainly associated with inflammatory reaction, immune function and injury site. Active intravenous injection of human immunoglobulin pin and ventilator improves the circulation and significantly reduces the mortality rate.