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目的分析探讨手足口病致下肢迟缓性麻痹的临床特点。方法回顾性分析42例手足口病所致下肢急性迟缓性麻痹患儿的临床资料,所有患儿均给予丙种球蛋白、利巴韦林、神经生长因子及弥可保等治疗,观察其临床表现,并行病原学检查、头颅和脊髓磁共振检查、脑脊液检查、脑电图、肌电图、神经电图等检查及心肌酶检测。结果手足口病所致下肢急性弛缓性麻痹患儿,麻痹前期均有典型手足口病的皮疹症状,瘫痪前驱期多伴有单峰热;76.2%(32/42)的患儿脑脊液压力、生化或细胞数异常;咽拭子EVPCR和血清免疫学检查均显示有17例患儿肠道病毒EV71阳性;88.1%的患儿在病程的3～8d患肢肌力开始恢复,病程2个月时,69.0%(29例)的患儿达到痊愈标准。结论手足口病致下肢急性弛缓性麻痹主要由EV71感染所致,经积极治疗后患儿肌力恢复较快,预后良好。
Objective To analyze the clinical characteristics of slow-limb paralysis caused by hand-foot-mouth disease. Methods A retrospective analysis of 42 cases of hand, foot and mouth disease in children with acute delayed paralysis clinical data, all children were given gamma globulin, ribavirin, nerve growth factor and miconazole treatment, to observe the clinical manifestations , Parallel etiological examination, cranial and spinal magnetic resonance imaging, cerebrospinal fluid examination, electroencephalogram, electromyography, electromyography and other tests and myocardial enzyme detection. Results Children with acute flaccid paralysis caused by hand-foot-mouth disease had typical rash symptoms of hand-foot-mouth disease in the early stage of paralysis and single peak fever in the prodromal stage of paralysis. In 76.2% (32/42) of children with cerebrospinal fluid pressure and biochemical Or cell number abnormality; throat swab EVPCR and serum immunological examination showed that 17 cases of children with enterovirus EV71 positive; 88.1% of children in the course of 3 ~ 8d limb muscle strength began to recover, duration of 2 months , 69.0% (29 cases) of children reached the standard of recovery. Conclusion Foot and mouth disease caused by acute flaccid paralysis lower extremity EV71 infection caused by the active treatment of children with rapid recovery of muscle strength, the prognosis is good.