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目的了解重症手足口病的流行学特点及临床特征,探讨危重症手足口病的临床特征及治疗对策。方法回顾性分析佛山妇幼保健院2010年4月至2010年10月份的68例重症手足口病患儿的临床特征及治疗效果。结果发病性别男性明显多于女性,比例为23:11,流动人口占85.3%,发病高峰为6、7、8月份,占63.2%,临床表现主要为发热、肢体抖动、惊跳、呕吐、气促、心率快,血象白细胞.>15×109,占20.6%,危重症患者血象均>20×109,CRP>10mg/L29例(42.6%),IgE>25IU/L39例(57.4%),治愈65例(95.6%),死亡2例占(2.94%),自动出院1例。结论肢体抖动、惊跳是最重症手足口最早期的表现,CRP升高不是应用抗生素的指标,IgE升高,可作为早期判断重症病例的实验室参考指标之一,白细胞明显升高、血糖明显升高、心率快、气促、末梢循环凉(排除发热上升期所致)、精神疲倦伴双眼凝视者是危重症的参考指标。及时综合治疗预后良好。
Objective To understand the epidemiological characteristics and clinical features of severe hand-foot-mouth disease and to discuss the clinical features and treatment strategies of critically ill hand-foot-mouth disease. Methods The clinical features and therapeutic effects of 68 cases of severe hand-foot-mouth disease in Foshan MCH from April 2010 to October 2010 were retrospectively analyzed. Results The incidence of male gender was significantly higher than that of female, with a ratio of 23:11. The floating population accounted for 85.3%. The peak incidence was 6, 7 and 8 months, accounting for 63.2%. The main clinical manifestations were fever, jitter, vomiting, (15.6%), IgE> 25IU / L in 39 cases (57.4%) were cured, the rate of blood leukocytes was higher than that of the control group (> 15 × 109, accounting for 20.6% 65 cases (95.6%), 2 cases died (2.94%), 1 case was discharged automatically. Conclusion Limb jitter and fright are the earliest manifestation of the most severe hand-foot-mouth. Elevated CRP is not an indicator of antibiotic use and IgE is elevated, which can be used as one of the laboratory reference indexes for early judgment of severe cases. Increased, fast heart rate, shortness of breath, peripheral cool circulation (excluding the rise due to fever), mental fatigue with binocular gaze is a critically ill reference index. Prompt comprehensive treatment of good prognosis.