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目的:探讨机械通气治疗小儿危重症手足口病(HFMD)的临床疗效。方法:2010年5月至2013年5月来我院就诊的危重症HFMD患儿73例,在综合治疗的基础上采用机械通气进行辅助治疗。监测治疗前、通气24 h、撤机前三个时间点患儿收缩压、心率变化情况;描述分析患儿的机械通气时间、并发症发生及转归情况。结果:治疗前、机械通气24 h、撤机前,患儿收缩压分别为(114.38±12.82)mm Hg、(101.32±6.74)mm Hg、(94.85±4.87)mm Hg,心率分别为(175.38±17.64)次/分、(147.36±13.92)次/分、(124.29±7.67)次/分,患儿收缩压、心率分别与治疗前比较明显下降,差异均有统计学意义(P<0.05),且撤机前各项指标与通气24 h相比改善更显著。患儿使用呼吸机机械通气时间为3~16 d,平均(7.34±3.08)d,最终所有患儿均治疗好转出院。结论:对危重症HFMD患儿及时采用机械通气治疗后,有利于患儿尽早康复,从而改善预后,提高其生活质量。
Objective: To investigate the clinical efficacy of mechanical ventilation in the treatment of pediatric critical HFMD. Methods: From May 2010 to May 2013, 73 cases of HFMD in our hospital were treated with mechanical ventilation on the basis of comprehensive treatment. The changes of systolic blood pressure and heart rate were monitored before treatment, ventilation for 24 h and at the three time before weaning. The mechanical ventilation time, complications and outcome of children were described and analyzed. Results Before treatment, the systolic blood pressure of patients before and after mechanical ventilation were (114.38 ± 12.82) mm Hg, (101.32 ± 6.74) mm Hg and (94.85 ± 4.87) mm Hg, respectively, and the heart rates were (175.38 ± (P <0.05). The systolic blood pressure and heart rate were significantly lower than those before treatment (P <0.05), and the difference was statistically significant (P <0.05) And before weaning, each index improved more significantly than ventilation 24 h. Mechanical ventilation in children with ventilator time was 3 ~ 16 d, an average of (7.34 ± 3.08) d, and finally all children were treated and discharged. Conclusion: The prompt treatment of critically ill HFMD children with mechanical ventilation is conducive to early rehabilitation of children, thus improving the prognosis and improving their quality of life.