重症高危手足口病患儿的临床观察与救治

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1、重症高危手足口病患儿的临床观察与救治重症高危手足口病患儿的临床观察与救治［摘要］目的总结手足口病(HFMD)重症高危患儿的临床特点及治疗方案。方法回顾性分析2009年4月〜2011年8月东莞市石龙人民医院3693例HFMD患儿的临床资料，根据疾病严重程度将其分为普通组3608例，重症组85例。比较两组患儿临床表现、实验室检查及治疗效果。结果HFMD高危重症患儿病情较重，更易惊厥和(或)昏迷，皮肤四肢末梢较凉，皮肤多呈花纹状，其发热病程更久，血压及心率较普通HFMD高;普通组白细胞(WBC)［(9.32±3.01)X109/L］、血糖［(7・00土

2、2.98)mmol/L］及乳酸水平［(1.81土0.82)mmol/L_均低于重症组［(10.14±3.65)X109/L.(8.51±4.71)mmol/L.(2.29±1.82)mmol/L］,差异均有统计学意义(t二2.678、4.301、3.582,P=0.0245、0.0096、0.0248)；普通组总有效率为96.4%,明显高于重症组(81.2%),差异有高度统计学意义(x2二49.225,P<0.01)o结论HFMD重症高危患儿病情发展迅速，血糖、血压、WBC均升高，神经系统、呼吸系统及循环系统均受到影响，故临床上应当积极干预，阻止

3、疾病向重症发展。［关键词］手足口病；重症高危型；救治；疗效观察［中图分类号IR725.4［文献标识码］C［文章编号］1673-7210(2014)10(a)-0153-04Clinicalobservationandtreatmentforseverechildrenwithhand-foot-mouthdiseaseCAIDongchunDepartmentofPediatrics,ShilongDongguanPeople'sHospitalofDongguanCity,GuangdongProvince,Dongguan523320,Chi

4、na［Abstract］ObjectiveTodiscusstheclinicalcharacter!sticsandtreatmentoptionsofthehand-foot-mouthdisease(HFMD)・Methods160childrenwithHFMDfromApril2009toAugust2011inShilongDongguanPeople*sHospitalofDongguanCitywereretrospectivelyanalyzed.Allthecasesweredividedintotwogroupsaccord

5、ingtotheseverityofdisease,54casesinthenormalgroup,106casesintheseriousgroup・Theclinicalmanifestations,laboratoryresultsandtreatmenteffectofthetwogroupswerecompared.ResultsTheseriouschildrenwithheavier,moreconvulsionandcoma,skinlimbsendingscooler,andmoredecorativepattern,thehe

6、atingdurationlonger,showedahighbloodpressureandheartratethanordinaryIIFMD・TheWBC,bloodsugar,lacticacidlevelsofseriousgroupwere(9.32±3.01)X109/L,(7.00±2.98)mmol/L,(1.81±0.82)mmol/Lrespectively,lowerthanthoseofthenormalgroup[(10.14±3.65)X109/L,(8.51±4.71)nunol/L,(2.29±1.82)mmol

7、/L],thedifferenceswerestatisticallysignificant(t=2.678,4.301,3.582；P=0.0245,0.0096,0.0248).Thetotaleffectiverateofthenormalgroupwas96.4%,higherthanthatoftheseriousgroup(81.2%),thedifferencewasstatisticallysignificant(x2二49.225,P〈0.001).ConclusionThechildrenwithsevereIIFMDshou

8、ldactivelyintervention,giveactiveintervention,preventdiseasetointens