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目的描述重症手足口病的临床特征,并探究机械通气对重症手足口病患儿的治疗效果。方法回顾性分析2014年3-5月的227例重症手足口病患儿,均采用机械通气进行治疗,并给予静脉丙种球蛋白、乌司他汀及甲基泼尼松加以辅助。观察患儿的临床症状,记录治疗前后患儿的各项指标(白细胞计数,血糖浓度等)。结果治疗前,227例均出现发热、四肢末梢循环欠佳和皮疹,不同患儿伴随神经系统、呼吸系统和心血管系统的功能紊乱。治疗后,227例中2例因医治无效死亡,其余225例均顺利出院,并且几乎所有患儿血糖浓度、白细胞计数、胸片检查等均呈现正常状态。患儿平均住院时间15.2 d,通气时间(85.0±15.2)h。结论重症手足口病患儿常常伴随着呼吸系统和神经系统紊乱,机械通气对重症手足口病有着显著的治疗效果。
Objective To describe the clinical features of severe hand-foot-mouth disease and explore the therapeutic effect of mechanical ventilation on children with severe hand-foot-mouth disease. Methods A total of 227 severe HFMD patients from March to May 2014 were retrospectively analyzed. All of them were treated with mechanical ventilation and were given intravenous gamma globulin, ulinastatin and methylprednisone. Observe the clinical symptoms of children, record the indicators before and after treatment (white blood cell count, blood glucose concentration, etc.). Results Before treatment, all of the 227 patients experienced fever, poor circulation of the extremities, and rash. Different children had neurological, respiratory and cardiovascular disorders. After treatment, 2 of 227 patients died of medical failure, and the other 225 patients were discharged smoothly. Almost all children had normal blood glucose concentration, white blood cell count and chest radiography. The average length of hospital stay was 15.2 days and the duration of ventilation was (85.0 ± 15.2) h. Conclusions Children with severe hand-foot-mouth disease are often accompanied by respiratory and nervous system disorders. Mechanical ventilation has a significant therapeutic effect on severe hand-foot-mouth disease.