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目的探讨重症手足口病(HFMD)的临床特征、分型和处置方案,提高重症HFMD患者的治愈率和生存率。方法对149例重症HFMD患儿的流行病学、临床表现、病情动态变化、实验室检查及物理检查、治疗及转归进行回顾性分析。结果 149例重症HFMD患儿,男98例(65.8%),女51例(34.2%);年龄5个月～13岁,﹤3岁者92例(61.7%),平均年龄3.3岁。依据临床表现及并发症分为两组:Ⅰ组,并发症以神经系统症状为主要表现者,140例(94%),均存活;Ⅱ组,并发神经、循环、呼吸等系统多器官损害者,9例(6%),3例死亡。存活患儿目前无后遗症出现。结论 HFMD重症病例分为重型和危重型两型,危重型可引起死亡。在临床工作中密切监测,及时发现危重型倾向的病例,正确及时治疗,能提高重症HFMD患儿的生存率,减少并发症和后遗症,改善生存质量。
Objective To explore the clinical features, classification and treatment of severe HFMD and to improve the cure rate and survival rate of patients with severe HFMD. Methods The epidemiology, clinical manifestation, dynamic changes of disease, laboratory examination, physical examination, treatment and prognosis of 149 severe HFMD children were analyzed retrospectively. Results A total of 149 severe HFMD children, 98 (65.8%) were male and 51 (34.2%) were female, with a mean age of 3.3 years (range, 5 months to 13 years). According to the clinical manifestations and complications, the patients were divided into two groups: group Ⅰ, patients with neurological symptoms as the main complication, and 140 patients (94%) all survived. In group Ⅱ, patients with multiple organ damage including nervous, circulatory and respiratory system , 9 cases (6%) and 3 deaths. Surviving children present no sequelae appear. Conclusion Severe HFMD cases are divided into two types, severe and severe, while those with severe HFMD can cause death. Close monitoring in clinical work, and timely detection of critically ill cases, the correct and timely treatment, can improve the survival rate of children with severe HFMD, reduce complications and sequelae, improve the quality of life.