重症手足口病31例临床分析(1)
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【摘要】 目的 分析手足口病重症病例的临床特点,以助于提高对该病的早期识别。方法 对31例重症手足口病患儿临床资料进行回顾性分析。结果 31例重症手足口病患儿,3岁以内占96.8%,前3 d重症发生率90.3%;发热及皮疹100%,不典型皮疹35.5%;呕吐71.0%;精神差74.2%,嗜睡61.3%,易激惹41.9%,肌阵挛64.5%,心率异常61.3%,呼吸异常32.3%,血压异常19.4%;合并神经系统症状83.9%,后遗症12.9%,死亡9.7%。结论 重症手足口病以神经系统并发症为主,6个月~2岁多见;精神差、嗜睡、呕吐症状突出,不典型皮疹多见;呼吸、心率、血压异常是手足口病极重症的信号,死亡率高。
【关键词】 儿童;手足口病;重症
Clinical analysis of 31 cases with Hand-foot -mouth disease
SUN Xiao-qian,WU Jing-cai.Department of Zaozhuang Children Health Care Hospital of Shandong,Zaozhuang 277102,China
【Abstract】 Objective To analyse the clinical features of the severe hand-foot-mouth disease(HFMD),in order to identify the early incidence of the HFMD.Methods Retrospectively analyzed clinical dataof 31 severe children cases ofHFMD.Results 31 cases of children with severe HFMD,under 3 years old accounted for 96.8%of all;90.3%of the severe cases were found in the first 3 days of the onsets; All the severe cases were with fever and eruption,atypical rash 35.5%; vomiting 71%; bad spirit 74.2%; drowsiness 61.3%,Irritability 41.9%, muscular Paroxysmal Spasm 64.5%;Abnormal heart rate 61.3%, abnormal breathing 32.3%,abnormal blood pressure 19.4%;83.9%with the nervous symptoms,12.9%with thesequelae,and the mortality was 9.7%.Conclusion Severe HFMDwere often occurred at the age of 6 months to 2-year-old children,neurological complications were the main clinical manifestasions.Poor spirit,drowsiness,vomiting were the prominent symptoms.Atypical rashes were often found.It’s the severe signal of HFMD that abnormality of breathing,heart rate and blood pressure.The mortality was high.
【Key words】Children;Hand-foot-mouth disease;Severe cases
手足口病(hand-foot-mouth disease,HFMD) 自1957年首次报道以来,在世界上多次流行,此病传染性强,传播快,短期内在儿童中即可造成大流行,主要由柯萨奇病毒A16(CoxAl6)和肠道病毒71(EV71)引起的以发热和手足口部皮疹为临床特征的儿童传染病。重症病例可并发无菌性脑膜脑炎、脑干脑炎、心肌炎、神经源性肺水肿、肺出血、呼吸循环衰竭,病情进展快,病死率高。我院2008年5月至2009年4月收治重症手足口患者31例,报告如下。
1 一般资料
全部病例均为我院2008年5月至2009年4月收治的手足口病重症患儿,男17例,女14例,男女比例1.2:1;农村28例(90.3%),城市3例(9.7%);散居25例(80.6%),群居6例(19.4%);最小年龄5个月,最大年龄4岁8个月,平均1岁7个月,5个月~1岁12例(38.7%),1~3岁18例(58.1%),3~5岁1例(3.2%);重症发生时间1~3 d 28例(90 ......
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