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目的分析重症手足口病(HFM;;DOI:10.3969/j.issn.)并脑干脑炎的临床特征及治疗措施。方法选取重症HFM;;DOI:10.3969/j.issn.并脑干脑炎患儿98例,在常规使用抗病毒药对症处理的基础上,当患儿出现呼吸节律改变,及早行呼吸机辅助呼吸,使用丙种球蛋白和甲泼尼龙,同时配合抑酸剂如奥美拉唑预防消化道出血;均以综合治疗为主,包括予甘露醇脱水降颅压,并感染者予抗生素抗感染治疗,营养脑神经,尽早胃肠内喂养、监测血糖、纠正电解质酸碱平衡紊乱及保肝及营养心肌等治疗。本组患儿手、足、臀的疱疹均予α干扰素凝胶局部涂抹。结果 98例患儿住院时间(8.55±2.38)d。1例出现左侧眼球不能完全回到中线,1例出现吞咽障碍,2例出现肢体瘫痪,1例自动出院,死亡1例,其余92例均无神经系统后遗症。结论肠道病毒71型感染的HFM;;DOI:10.3969/j.issn.发生重症脑干脑炎的机会高,早期发现、早期干预可降低本病病死率及减少后遗症的发生。
Objective To analyze the clinical features and treatment of severe hand-foot-mouth disease (HFM ;; DOI: 10.3969 / j.issn.) And brain stem encephalitis. Methods Select HFM; DOI: 10.3969 / j.issn. 98 cases of children with encephalitis and encephalitis, in the conventional use of antiviral drugs symptomatic treatment, based on when children with respiratory rhythm changes, and early ventilator-assisted breathing , The use of gamma globulin and methylprednisolone, at the same time with acid inhibitors such as omeprazole to prevent gastrointestinal bleeding; are based on comprehensive treatment, including mannitol dehydration reduce intracranial pressure, and infected with antibiotics anti-infective treatment, Nutritional brain, gastrointestinal feeding as early as possible, monitoring of blood glucose, acid-base balance to correct electrolyte imbalance and liver and nutritional heart muscle treatment. The group of children with hands, feet, buttocks of the herpes are alpha interferon gel topical smear. Results The hospitalization time of 98 children was (8.55 ± 2.38) days. One case showed left eyeball can not fully return to the midline, one case of swallowing disorder, two cases of limb paralysis, one case of spontaneous discharge, 1 died, the remaining 92 cases without neurological sequelae. Conclusion HFM of Enterovirus 71 infection is high. It is found that early intervention may reduce the mortality and reduce the incidence of sequelae.