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目的探讨225例重症手足口病患儿的临床特点及诊治体会。方法分析了255例重症手足口病住院病例临床资料,总结了7例危重症患儿临床特点及诊治情况。结果危重症患儿特点是,年龄小,持续高热,皮疹不典型,数量少、陈旧,呼吸快、心率快、手脚凉,精神差、嗜睡、肌震颤,三高即高血压、高血糖、高白细胞。7例危重病人均出现了神经原性肺水肿,5例抢救成功,2例死亡。结论对危重手足口病患儿要早期甄别、早期干预,积极降颅压,掌握早期气管插管指征,大剂量甲泼尼龙冲击等积极治疗可以阻止病情进展,降低危重症的病死率。
Objective To investigate the clinical features, diagnosis and treatment of 225 cases of severe hand-foot-mouth disease in children. Methods The clinical data of 255 cases of severe HFMD inpatients were analyzed and the clinical features and diagnosis and treatment of 7 critically ill children were summarized. The results of critically ill children is characterized by age, high fever, rash is not typical, the number of small, stale, fast breathing, fast heart rate, cold hands and feet, poor spirit, lethargy, muscle tremor, that is, three high blood pressure, leukocyte. Neurogenic pulmonary edema occurred in 7 critically ill patients, 5 patients were successfully treated, and 2 patients died. Conclusion Early screening, early intervention, positive intracranial pressure reduction, early indications for tracheal intubation and high dose methylprednisolone in children with critical hand-foot-mouth disease can prevent the progress of disease and reduce the mortality of critically ill patients.