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目的分析手足口病(HFMD)危重型的临床特点,为诊断提供线索。方法对本院2010年收治的HFMD危重型78例患儿的发病特点、临床表现、辅助检查结果进行分析。结果病例分布在5-11月,呈2个高峰。59例居住在农村,26/31例为EV71感染,70例为3岁以下,男女比例为1.791.0,61例于病程3 d内出现危重表现。三凹征阳性59例,休克42例,肺部啰音36例,血性泡沫痰23例,昏迷16例,频繁抽搐11例,脑疝4例。尿糖、血糖、血WBC和PLT、心肌酶、ALT、二氧化碳分压、脑压、脑脊液白细胞数和蛋白升高,血氧分压、pH值、二氧化碳结合力降低,胸片、ECG、EEG、MRI等部分患儿出现异常。结论 HFMD危重型以呼吸系统危重表现多见,应动态监测血气、胸片等。
Objective To analyze the clinical features of critically ill hand-foot-mouth disease (HFMD) and provide clues for diagnosis. Methods 78 cases of HFMD critically ill patients admitted to our hospital in 2010 were analyzed for their morbidity, clinical manifestations and auxiliary examinations. Results The cases were distributed from May to November with 2 peaks. 59 cases lived in rural areas, 26 of 31 cases were infected with EV71, 70 cases were under 3 years old, the ratio of male to female was 1.79 1.06, and 61 cases showed critical performance within 3 days of course of disease. Three concave sign positive in 59 cases, shock in 42 cases, pulmonary rales in 36 cases, bloody sputum in 23 cases, coma in 16 cases, frequent convulsions in 11 cases, 4 cases of hernia. Urinary glucose, blood glucose, blood WBC and PLT, myocardial enzymes, ALT, partial pressure of carbon dioxide, intracranial pressure, cerebrospinal fluid leukocyte count and protein increased, partial pressure of oxygen, pH, decreased carbon dioxide binding capacity, Other children with abnormalities. Conclusion HFMD critically ill with respiratory performance more common, blood gas should be dynamically monitored, such as chest X-ray.