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目的探讨重症手足口病(HFMD)的早期临床特点与治疗方法,降低危重型的病死率。方法对感染病科2010年4月-2011年8月收住的168例重症HFMD患儿临床资料进行回顾性分析。结果 168例中以12～36个月为高发年龄,多在病程2～4 d进展为重症,发热161例(95.83%)、易惊或肢体抖动153例(91.07%)、精神差和/或嗜睡99例(58.93%)、呕吐98例(57.74%)、脑膜刺激征阳性和(或)病理反射阳性69例(41.07%)、高血压58例(34.52%)。血白细胞升高71例(42.26%)、血糖升高61例(36.30%)。早期应用人血免疫球蛋白,大剂量甲基强的松龙,甘露醇、呋塞米治疗可以阻止病情进展,治愈166例,好转1例,死亡1例。结论 3岁以内HFMD患者多在2～4 d进展为重症,早期干预可提高治愈率。
Objective To investigate the early clinical features and treatment of severe hand-foot-mouth disease (HFMD) and to reduce the critical mortality rate. Methods The clinical data of 168 cases of severe HFMD admitted to Department of Infectious Diseases from April 2010 to August 2011 were retrospectively analyzed. Results Of the 168 cases, 12 to 36 months were the high-incidence age, and most of them progressed to severe disease from 2 to 4 days. 161 cases (95.83%) were fever, 153 cases (91.07%) were jittery or jittery, with poor psychosis and / or Ninety-nine cases (58.93%) were drowsiness, 98 cases (57.74%) vomited, 69 cases (41.07%) were positive and / or pathological reflection of meningeal irritation and 58 cases (34.52%) were hypertension. Blood leukocytes increased in 71 cases (42.26%), elevated blood sugar in 61 cases (36.30%). Early application of human blood immunoglobulin, high-dose methylprednisolone, mannitol, furosemide treatment can prevent the progression of the disease, cured 166 cases, 1 case of improvement, 1 case of death. Conclusion HFMD patients within 3 years of age mostly progressed to severe disease from 2 to 4 days, and early intervention could improve the cure rate.