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目的总结重症手足口病的临床特点、治疗时机、治疗方法及高危因素。方法回顾2010年1月-2011年8月收治的27例重症手足口病患儿,分析其基本资料、主要症状、体征、辅助检查结果及治疗方案,并对其临床特点、治疗时机、治疗方法及重症发生的高危因素进行总结。结果 27例重症病例中26例治愈出院,未遗留明显并发症,1例合并肺部感染好转后转门诊治疗,无死亡病例。结论在夏季,由于空气湿度大、气温高,手足口病容易集中发生。家庭经济条件、卫生条件差的儿童,较容易发生手足口病并进展为重症。手足口病重症病例大多数为EV71感染。重症病例早期识别是治疗的关键,应把握好糖皮质激素、丙种球蛋白的治疗时机,加强护理,在神经源性肺水肿出现的早期及时采取机械通气,能有效地提高重症手足口病治愈率。
Objective To summarize the clinical features, treatment timing, treatment and risk factors of severe HFMD. Methods From January 2010 to August 2011,27 cases of severe hand-foot-mouth disease were analyzed. The basic information, main symptoms and signs, auxiliary examination results and treatment regimen were analyzed. The clinical characteristics, treatment timing, treatment methods And the risk factors for severe disease are summarized. Results Twenty-seven cases of severe cases were cured and discharged, no obvious complications were left, and one case of complicated pulmonary infection was transferred to outpatient treatment without death. Conclusion In summer, hand-foot-mouth disease easily occurs due to high humidity and high temperature. Family economic conditions, poor health conditions of children, more prone to hand-foot-mouth disease and progress to severe. The majority of HFMD cases are EV71 infections. Severe cases of early identification is the key to treatment, glucocorticoid and gamma globulin should be good timing of treatment, and strengthen care in the early emergence of neurogenic pulmonary edema in a timely manner to take mechanical ventilation, can effectively improve the cure rate of severe HFMD .