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1、重症EV71感染手足口病13例临床特点及治疗分析任拥军（贵州省沿河县人民医院儿科贵州铜仁565300）【摘要】目的：分析探讨重症手足口病的临床特点及诊断方法。方法：回顾性分析总结14例重症手足口病的临床表现、实验室数据及影像学改变，并学习手足口病相关文献。结果：14例均为小于4岁婴幼儿，以发热、呼吸道感染起病。并发脑炎、消化道出血、肺出血。手足口病病毒检测肠道病毒通用型：阳性，EV71：阳性。肺部有大片炎性实变。10例早期诊断明确，治疗及抢救及时，最终治愈，1例入院时病情较重经抢救无效死亡，2例因早期临床表现不典型，症状较轻，病情突然加重，出现肺出血，虽经积极抢救无效死亡。结论：持续高
2、热，肢体抖动及膝反射亢进对早期发现重型病例有提示意义，白细胞增高、血糖升高患儿病情可能出现加重。详细询问病史、全面体格检查以及必要的辅查（如手足口病病毒肠道病毒：EV71的检测），有助于减少误诊、明确诊断、及早防治严重并发症的发牛及改善预后。【关键词】重症；手足口病；EV71；阳性【中图分类号】R725.1【文献标识码】A【文章编号】2095-1752（2015）14-0046-03Analysisoftheclinicalcharacteristicsandtreatmentof14casesofHFMDsevereEV71infectionRenYongjun.ThePeople'
3、sHospitalofYanheCounty,GuizhouProvionce,Tongren565300,China[Abstract】ObjectiveToanalyzetheclinicalcharacteristicsanddiagnoSticmethodsofseverehandfootmouthdisease.MethodsAretrospectivesummaryof14casesofseverehandfootmouthdiseaseclinicalmanifestations,laboratorydataandimagingchangesandrelatedliter
4、ature,studyofhandfootandmouthdisease.Results14caseswerelessthan4yearsoldinfants,withfever,respiratorytractinfectiononset.Encephalitis,gastrointestinalbleeding,pulmonaryhemorrhage.Handfootandmouthdiseasevirusdetectionofenterovirusuniversaltype:positive,EV71:positive.Alargepulmonaryinflammatorycon
5、solidation.10earlycleardiagnosis,treatmentandtimelyrescue,andultimatelycure,1caseswereseriousconditionafterrescueinvaliddeath,2examplebecausetheearlyclinicalmanifestationisnottypical,thesymptomislighter,theconditionsuddenlyworsened,pulmonaryhemorrhage,althoughaftertherescueinvaliddeathactively.C
6、onclusionPersistentfever,limbshakingkneehyperreflexiaseverecaseshaveimplicationsforearlydetection,leukocytosis,elevatedbloodsugarlevelsinchildrenwiththediseasemayworsen.Adetailedhistory,completephysicalexaminationandnecessaryauxiliaryexamination（suchashandfootandmouthdiseasevirusenterovirus:dete
7、ctionEV71）.Occurreneeandimproveprognosiscanreducemisdiagnosis,diagnosis,earlypreventionandtreatmentofseverecomplications.【Keywords]Severe;Handfootandmouthdisease;EV71;Positive1•临床资料1.1一般资料我院及帮扶本院的台州医院2013年1月至10月收治的确诊为重症手足口病1
