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目的提高对重症手足口病的早期诊治率，降低临床死亡率。方法2010年7月1日~2011年7月10日在我院住院并确诊为手足口病（HFMD）的94例患儿为研究组，同期住院并确诊为非手足口病病毒性脑炎的20例患儿作为对照组，常规做血常规、血糖、心肌酶检查，摄胸片，部分行心电图、头颅MRI及脑电图检查，对44例出现惊跳、肢体抖动或无力、精神萎靡、嗜睡的手足口病患儿和20例非手足口病病毒性脑炎的患儿进行早期脑脊液检查。结果手足口病轻症和重症患儿在发热、惊跳、肢体抖动、嗜睡、心率、血糖、WBC计数、L、N分类等体征和检验结果等方面有显著性差异(<0.05)。手足口病重症与非手足口病病毒性脑炎在脑脊液细胞计数方面统计上有显著性差异（<0.05）。一旦出现上述体征和检验结果，早期诊断重症手足口病，在常规治疗基础上，及时给与甘露醇、糖皮质激素、丙种球蛋白和对症治疗，疗效良好，治愈好转率100%，所有病例没有进展成手足口病危重症，无后遗症及死亡病例。结论手足口病（HFMD）轻症患儿，当出现高热不退，心率加快，出现惊跳、肢体抖动、嗜睡等体征时，是临床发生重症手足口病的重要警示信号。及时行脑脊液检查，脑脊液检查提示细胞计数增多，多以单个核细胞为主，WBC和N偏高等利于早期诊断，及时给予治疗效果良好。“,”Objective To increase early diagnosis rate and reduce the clinical mortality rate of severe hand, foot and mouth disease (HFMD).Methods Between 2010/7/1 to 2011/7/10 , 94 cases children diagnosed as HFMD as study group, 20 cases children diagnosed as viral encephalitis as control group. Al cases examined blood routine, blood glucose and the myocardial enzymes, taken chest X-rays, part of the cases did ECG, cranial MRI and EEG. 44 cases HFMD children appearedjumping, imbs shaking or weakness, mental fatigue, hypnosia and 20 cases viral encephalitis children check early CSF. Results Light and severe HFMD children between fever, jumping, body shaking, hypnosia,heart rate, WBC, L, N classification signs and inspection results weresignificant dif erence ( <0.05). Severe HFMD and viral encephalitis children' cel counting in CSF were significant dif erence ( < 0.05). Once appeared above signs and inspection results, was early given diagnosis of severe HFMD. Except antiviral treatment, given timely mannitol, glucocorticoid, gamma globulin and symptomatic treatment, ef ect was good because cure and improvement rate were 100%, no cases progressed into critical HFMD, without sequelae and deaths.Conclusion When occur ence high fever was not retreated, heart rate increased, jumping, body shaking, sleepiness signs and cel counting and mononuclear cel s in CSF increased , high blood sugar, peripheral blood count WBC and N increased etc., which was the important warning signal of the mild HFMD progress severe HFMD.Benefit for early diagnosis. Ef ect of timely treatment was good.