118例危重症儿童手足口病的临床特征分析(1)
[摘要] 目的 总结分析危重症手足口病(HFMD)患儿的临床表现特点，研究早期干预治疗措施。 方法 选择2011年8月～2014年1月广州市妇女儿童医疗中心儿童医院院区收治的118例危重症HFMD患儿作为研究对象，回顾性分析所有患儿的临床表现特征，对其进行血生化、血常规、心电图、胸片、头颅MRI或CT、EEG、脑干听觉诱发电位检查(BAEP)等辅助检查，以及积极的早期干预治疗措施，必要时给予机械通气；随访1年，观察并记录其转归情况。 结果 危重症HFMD临床特征：大部分患儿年龄小于3岁，发热严重；神经系统病症方面，主要表现有：精神差、肢体震颤、烦躁和惊跳，伴随高血糖和高血压等现象；BAEP和头颅MRI检查表现异常；110例患儿需给予呼吸机机械通气治疗。转归率为89.0%(105/118)，随访1年后，好转患儿均未发现显著的智力衰退、肢体瘫痪或者继发性癫痫；13例患儿死亡，其中2例为家属放弃治疗。 结论 严密观察HFMD患儿的病情变化过程，通过对患儿的临床表现特点归纳分析及施行相关的辅助检查，及早识别该疾病的高危因素并采取积极的早期干预治疗措施，对缩减危重症HFMD患儿严重后遗症、最大限度降低致残率和死亡率，以及改善其预后起着关键作用。
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[关键词] 危重症；手足口病；儿童；临床特征；脑干听觉诱发电位
[中图分类号] R725.1 [文献标识码] A [文章编号] 1673-7210(2015)10(b)-0059-04
Analysis of clinical feature of 118 children with critical illness hand foot and mouth disease
LIANG Yufeng YANG Yiyu
Children's Hospital District， Guangzhou Women and Children's Medical Center， Guangdong Province， Guangzhou 510120， China
, http://www.100md.com
[Abstract] Objective To explore clinical features and treatment protocols of children with critical hand foot and mouth disease (HFMD). Methods 118 patients with HFMD who were treated in Children's Hospital District of Guangzhou Women and Children's Medical Center from August 2011 to January 2014 were chosen as research objects. Their symptomatic features were analyzed retrospectively. A lot of auxiliary examinations including blood routine， blood biochemistry， chest film， electrocardiogram， cranial MRI or CT， EEG， BAEP were carried among the research objects. They were treated with positive early intervention measures and given mechanical ventilation when necessary. The long outcomes were observed and recorded for 1 year. Results The clinical features of critical HFMD： most of the patients aged under three and had high fever； they had neurological manifestations like limbs tremor， short of vigour， dysphoria and pavor and often accompanied with increased blood glucose and blood pressure， pulmonary edema and pulmonary hemorrhage； BAEP and cranial MRI showed abnormal； 110 patients received mechanical ventilation. 105 cases were cured or discharged from hospital with improvement with obsolete mental retardation， secondary epilepsy and limb paralysis after 1 year follow-up. Of 13 death cases， 2 cases of patients died from withdrawing breathing machine because their family members gave up treatment. Conclusion The changes of condition in children with HFMD should be closely monitored. Analyzing of the symptomatic characteristics of patients and related auxiliary examination is helpful for identify the high risk factors of children with critical HFMD and take positive early intervention measures. All these have critical effect on reducing severe sequela of children with critical HFMD， decreasing disability rate and death rate to the upmost and improving the prognosis., http://www.100md.com(梁宇峰 杨鎰宇)
, http://www.100md.com
[关键词] 危重症；手足口病；儿童；临床特征；脑干听觉诱发电位
[中图分类号] R725.1 [文献标识码] A [文章编号] 1673-7210(2015)10(b)-0059-04
Analysis of clinical feature of 118 children with critical illness hand foot and mouth disease
LIANG Yufeng YANG Yiyu
Children's Hospital District， Guangzhou Women and Children's Medical Center， Guangdong Province， Guangzhou 510120， China
, http://www.100md.com
[Abstract] Objective To explore clinical features and treatment protocols of children with critical hand foot and mouth disease (HFMD). Methods 118 patients with HFMD who were treated in Children's Hospital District of Guangzhou Women and Children's Medical Center from August 2011 to January 2014 were chosen as research objects. Their symptomatic features were analyzed retrospectively. A lot of auxiliary examinations including blood routine， blood biochemistry， chest film， electrocardiogram， cranial MRI or CT， EEG， BAEP were carried among the research objects. They were treated with positive early intervention measures and given mechanical ventilation when necessary. The long outcomes were observed and recorded for 1 year. Results The clinical features of critical HFMD： most of the patients aged under three and had high fever； they had neurological manifestations like limbs tremor， short of vigour， dysphoria and pavor and often accompanied with increased blood glucose and blood pressure， pulmonary edema and pulmonary hemorrhage； BAEP and cranial MRI showed abnormal； 110 patients received mechanical ventilation. 105 cases were cured or discharged from hospital with improvement with obsolete mental retardation， secondary epilepsy and limb paralysis after 1 year follow-up. Of 13 death cases， 2 cases of patients died from withdrawing breathing machine because their family members gave up treatment. Conclusion The changes of condition in children with HFMD should be closely monitored. Analyzing of the symptomatic characteristics of patients and related auxiliary examination is helpful for identify the high risk factors of children with critical HFMD and take positive early intervention measures. All these have critical effect on reducing severe sequela of children with critical HFMD， decreasing disability rate and death rate to the upmost and improving the prognosis., http://www.100md.com(梁宇峰 杨鎰宇)