CAJ | 학술논문

回顾性分析120例手足13病重症病例的早期临床特征,并与普通病例进行比较.结果显示,120例重症病例发病主要集中在1～3岁,持续高热(55%)、血压升高(40%)、皮疹稀少(73.3%)是早期重要临床特征;精神萎靡及嗜睡或哭闹(70.8%)是重症病例早期即有的神经精神症状;肢体抖动或肌阵挛(80.0%)、呕吐(30.8%)是其早期中枢神经系统受累表现;血白细胞升高(75.8%)和血糖升高(32.5%)是早期诊断手足13病重症病例的重要检测指标.以上特征与手足口病普通病例相比较均有统计学意义(P<0.01或<0.05).通过20%甘露醇、静脉丙种球蛋白、糖皮质激素为主的早期治疗,患儿无一例死亡,未见不良反应.
회고성분석120례수족13병중증병례적조기림상특정,병여보통병례진행비교.결과 현시,120례중증병례발병주요집중재1～3세,지속고열(55%)、혈압승고(40%)、피진희소(73.3%)시조기중요림상특정;정신위미급기수혹곡료(70.8%)시중증병례조기즉유적신경정신증상;지체두동혹기진련(80.0%)、구토(30.8%)시기조기중추신경계통수루표현;혈백세포승고(75.8%)화혈당승고(32.5%)시조기진단수족13병중증병례적중요검측지표.이상특정여수족구병보통병례상비교균유통계학의의(P<0.01혹<0.05).통과20%감로순、정맥병충구단백、당피질격소위주적조기치료,환인무일례사망,미견불량반응.
The clinical features of 120 severe cases with hand-foot-mouth disease (HFMD) were retrospectively analyzed compared with those of the regular cases. Clinical data showed that the age of mostsevere cases ranged from 1-3 years. Sustained high fever ( 55% ) , hypertension ( 40% ) , fewer rash (73.3%) were important clinical features. Lethargy, somnolence or restlessness (70. 8% ), vomiting (30. 8% ) were early signs of central nervous system ( CNS) ; and the CNS involvement in severe cases was characterized by body trembling or muscle spasm (80% ). High white cell count(75. 8% ) and high blood glucose levels(32. 5% ) were important makers to diagnose the severe HFMD at early stage. There were significant differences in presentation of above features between severe cases and regular cases of HFMD ( P < 0. 01 or P < 0. 05 ) . Early treatment with mannitol, gamma globulin and glucocorticoids were effective, no death was reported and no side effects were found in this case series.