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目的:探讨重症、危重症手足口病患儿的临床特点。方法:回顾性分析资料完整的168例重症、危重症手足口患儿临床表现、实验室检查及治疗效果。结果:168例患儿多有发热、手足口等部位皮疹、呼吸及神经系统异常等表现;部分患儿病情进展迅速,表现为呼吸困难,咳粉红色或血性泡沫痰,嗜睡、精神差;实验室检查:白细胞计数正常、较低或较高,危重症患儿均有血糖升高,多伴有肝功能及心肌酶、X线片异常;均给予抗病毒、改善呼吸、循环等治疗,危重症患儿给予降血糖、降颅压、静脉丙种球蛋白、甲泼尼龙冲击治疗;53例予机械通气,6例死亡,9例放弃治疗。结论:重症手足口患儿病情凶险,进展迅猛,死亡风险高,早发现、早诊断、早治疗可能对阻止重症病例向危重状态发展和降低危重病例病死率有益。
Objective: To investigate the clinical features of critically ill and critically ill children with hand-foot-mouth disease. Methods: A retrospective analysis of 168 cases of complete and critically ill children with hand, foot and mouth clinical manifestations, laboratory tests and treatment. Results: 168 cases of children with fever, hand, foot and mouth and other parts of the rash, respiratory and nervous system abnormalities and other performance; some patients progressed rapidly, manifested as dyspnea, cough pink or bloody sputum, lethargy, poor spirit; experiment Room examination: normal white blood cell count, lower or higher, critically ill children have elevated blood sugar, often accompanied by liver function and myocardial enzymes, X-ray abnormalities were given antiviral to improve breathing, circulation and other treatment, Severe children were given hypoglycemic, intracranial pressure, intravenous gamma globulin, methylprednisolone impact treatment; 53 cases were given mechanical ventilation, 6 died, 9 patients to give up treatment. Conclusion: Children with severe foot and mouth disease are in dangerous condition, with rapid progress and high risk of death. Early detection, early diagnosis and early treatment may be helpful to prevent the development of severe cases to critical state and reduce the mortality of critical cases.