医药前沿
醫藥前沿
의약전연
YIAYAO QIANYAN
2013年
28期
166-167
,共2页
王艳春%黄永坤(通讯作者)%李凌媛%杜曾庆
王豔春%黃永坤(通訊作者)%李凌媛%杜曾慶
왕염춘%황영곤(통신작자)%리릉원%두증경
手足口病%肠道病毒71型%临床分析
手足口病%腸道病毒71型%臨床分析
수족구병%장도병독71형%림상분석
Hand foot mouth disease%Enterovirus 71%Clinical analysis
目的探讨儿童重症手足口病的临床特点及危险因素。方法回顾性分析2012年9月至10月收治的70例确诊重症手足口病患儿的临床资料。结果70例患儿中,年龄<3岁57例(81.4%),均出现皮疹、发热(100%),易惊53例(75.7%),呕吐24例(34.2%),嗜睡14例(20%),肢体震颤20例(28.5%),心率快、血压高43例(61.4%),白细胞>20.0×109/L ,2例(2.8%),>12×109/L ,12例(17.1%),血糖升高21例(30%),脑脊液白细胞增高65例(92.8%)X胸片示单、双侧肺野见渗出39例(55.7%),肺水肿1例(1.4%),肺出血1例(1.4%)。脑电图异常48例(68.5%)。头颅C T:双侧大脑半球脑沟回增宽、加深25例(35.7%),2例行头颅M R I检查,1例示:延髓、右侧颞叶异常信号,考虑脑软化。1例示侧脑室旁白质异常信号。大便病原学检查:EV71型阳性43例(61.4%),CA16阳性9例(12.8%)。其他肠道病毒11例(15.7%),阴性7例(10%)。70例患儿均予甘露醇脱水,43例血压高、心率快患儿均予米力农强心,酚妥拉明降血压治疗,其中24例用酚妥拉明控制血压不满意后改为硝普钠降血压,2例行气管插管机械通气治疗。69例治愈出院,1例好转出院。结论<3岁、肠道病毒71型感染、持续发热、呕吐、肢体抖动、血压升高是重症手足口病的危险因素,尽早行腰穿查脑脊液明确有无中枢神经系统病变,积极脱水,控制血压是抢救成功的关键。
目的探討兒童重癥手足口病的臨床特點及危險因素。方法迴顧性分析2012年9月至10月收治的70例確診重癥手足口病患兒的臨床資料。結果70例患兒中,年齡<3歲57例(81.4%),均齣現皮疹、髮熱(100%),易驚53例(75.7%),嘔吐24例(34.2%),嗜睡14例(20%),肢體震顫20例(28.5%),心率快、血壓高43例(61.4%),白細胞>20.0×109/L ,2例(2.8%),>12×109/L ,12例(17.1%),血糖升高21例(30%),腦脊液白細胞增高65例(92.8%)X胸片示單、雙側肺野見滲齣39例(55.7%),肺水腫1例(1.4%),肺齣血1例(1.4%)。腦電圖異常48例(68.5%)。頭顱C T:雙側大腦半毬腦溝迴增寬、加深25例(35.7%),2例行頭顱M R I檢查,1例示:延髓、右側顳葉異常信號,攷慮腦軟化。1例示側腦室徬白質異常信號。大便病原學檢查:EV71型暘性43例(61.4%),CA16暘性9例(12.8%)。其他腸道病毒11例(15.7%),陰性7例(10%)。70例患兒均予甘露醇脫水,43例血壓高、心率快患兒均予米力農彊心,酚妥拉明降血壓治療,其中24例用酚妥拉明控製血壓不滿意後改為硝普鈉降血壓,2例行氣管插管機械通氣治療。69例治愈齣院,1例好轉齣院。結論<3歲、腸道病毒71型感染、持續髮熱、嘔吐、肢體抖動、血壓升高是重癥手足口病的危險因素,儘早行腰穿查腦脊液明確有無中樞神經繫統病變,積極脫水,控製血壓是搶救成功的關鍵。
목적탐토인동중증수족구병적림상특점급위험인소。방법회고성분석2012년9월지10월수치적70례학진중증수족구병환인적림상자료。결과70례환인중,년령<3세57례(81.4%),균출현피진、발열(100%),역량53례(75.7%),구토24례(34.2%),기수14례(20%),지체진전20례(28.5%),심솔쾌、혈압고43례(61.4%),백세포>20.0×109/L ,2례(2.8%),>12×109/L ,12례(17.1%),혈당승고21례(30%),뇌척액백세포증고65례(92.8%)X흉편시단、쌍측폐야견삼출39례(55.7%),폐수종1례(1.4%),폐출혈1례(1.4%)。뇌전도이상48례(68.5%)。두로C T:쌍측대뇌반구뇌구회증관、가심25례(35.7%),2례행두로M R I검사,1례시:연수、우측섭협이상신호,고필뇌연화。1례시측뇌실방백질이상신호。대편병원학검사:EV71형양성43례(61.4%),CA16양성9례(12.8%)。기타장도병독11례(15.7%),음성7례(10%)。70례환인균여감로순탈수,43례혈압고、심솔쾌환인균여미력농강심,분타랍명강혈압치료,기중24례용분타랍명공제혈압불만의후개위초보납강혈압,2례행기관삽관궤계통기치료。69례치유출원,1례호전출원。결론<3세、장도병독71형감염、지속발열、구토、지체두동、혈압승고시중증수족구병적위험인소,진조행요천사뇌척액명학유무중추신경계통병변,적겁탈수,공제혈압시창구성공적관건。
Objective To analyze the clinic features of children with severe hand-foot-mouth disease from September to October in 2012 in our department to investigate some risk factors with fatal case. Method Al the clinic records and laboratory results of serious patients were col ected. A retrospective study was performed.Result A total 70 serious patients were enrol ed into this study. Al these patients had encephalitis,and 81.4% patients age under 3 years. Fever ,vomiting,and myoclonus were the most frequent symptoms occurred in those serious cases.Hypertension was found to be high risk factor.43(61.4%)cases had hypertension. [(124±9)/(77±10) mm Hg (1 mm Hg=0.133 kPa)].The laboratory confirmed EV17 positive cases were 61.4%.Conclusion Clinicians should give importance to the risk factors.Early recognition of children at risk and timely intervention is the key to reduce acute mortality and morbidity.