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目的:探讨儿童手足口病(HFMD)合并急性驰缓性麻痹(AFP)的临床特点。方法:2009年1月至2012年1月郑州市儿童医院康复中心收治的HFMD合并AFP患儿79例,对其临床表现、影像学、神经电生理、综合康复治疗等资料进行回顾性分析。结果:单侧上肢瘫痪29例,单侧下肢瘫痪26例,单侧肢体瘫痪7例,双下肢瘫痪11例,四肢瘫痪6例。影像学检查结果示病变多位于第2～7颈椎和(或)第12胸椎至第1腰椎。周围神经功能检查结果示上、下肢神经损伤最多。经过综合康复治疗后,瘫痪预后下肢好于上肢,单下肢好于双下肢,四肢瘫痪者预后最差。结论:对于HFMD合并AFP患儿,进行MRI和周围神经功能检测可对其病变程度和范围进行早期预测及评估,以便及时进行早期康复治疗,减少瘫痪的发生,降低致残率。
Objective: To investigate the clinical features of children with HFMD complicated with acute flaccid paralysis (AFP). Methods: From January 2009 to January 2012, 79 children with HFMD and AFP admitted to Zhengzhou Children’s Hospital Rehabilitation Center were retrospectively analyzed for clinical manifestations, radiology, neuroelectrophysiology and comprehensive rehabilitation. Results: Unilateral upper limb paralysis in 29 cases, unilateral lower limb paralysis in 26 cases, unilateral limb paralysis in 7 cases, double lower limb paralysis in 11 cases, quadriplegia in 6 cases. Imaging findings showed lesions in the 2nd to 7th cervical vertebra and (or) 12th thoracic to the first lumbar. Peripheral neurological examination showed that the lower limb nerve injury up. After comprehensive rehabilitation, the prognosis of paralyzed lower limbs better than the upper limbs, single lower limbs better than double lower limbs, limbs paralysis, the worst prognosis. Conclusion: For children with HFMD complicated by AFP, MRI and peripheral nerve function tests can be used to predict and assess the extent and extent of the disease in order to make early rehabilitation treatment in time and reduce the incidence of paralysis and reduce the morbidity.