中国医学创新
中國醫學創新
중국의학창신
MEDICAL INNOVATION OF CHINA
2013年
35期
82-83,84
,共3页
手足口病%危重型%肠道病毒(EV71)%临床分析
手足口病%危重型%腸道病毒(EV71)%臨床分析
수족구병%위중형%장도병독(EV71)%림상분석
HFMD%Serious type%Enterovirus EV71%Clinical analysis
目的：分析总结15例重症危重型手足口病患儿的临床特征。方法：回顾性分析2010年5月-2013年7月本院儿科住院的15例重症危重型手足口病患儿的临床资料。结果：（1）15例患者中，男12例，女3例；发病年龄6~52个月：其中≤1岁者4例，1~3岁者9例，3~5岁者2例，平均21个月。治愈好转11例，死亡4例（26.7%）。（2）15例危重型患儿在起病0~3 d内以精神萎靡、呕吐、惊跳为主要临床特征，发生率分别为100%、73.0%、86.7%；在起病3~5 d内以循环功能障碍、呼吸功能障碍、抽搐、死亡为主要病情改变，发生率分别是85.7%、42.9%、50.0%、21.4%。（3）死亡组白细胞计数、嗜中性粒细胞比率、血糖水平，死亡组均明显高于存活组，比较差异均有统计学意义（P<0.05）；死亡组C反应蛋白、肝功能、心肌酶检查改变不明显（P>0.05）。结论：危重型手足口病患儿病情进展迅猛，死亡率高。精神萎靡、呕吐、惊跳是危重型手足口病早期主要临床表现，可作为早期迅速判断危重病情的指标；白细胞计数、嗜中性粒细胞比率、血糖水平异常增高提示患儿死亡风险高。
目的：分析總結15例重癥危重型手足口病患兒的臨床特徵。方法：迴顧性分析2010年5月-2013年7月本院兒科住院的15例重癥危重型手足口病患兒的臨床資料。結果：（1）15例患者中，男12例，女3例；髮病年齡6~52箇月：其中≤1歲者4例，1~3歲者9例，3~5歲者2例，平均21箇月。治愈好轉11例，死亡4例（26.7%）。（2）15例危重型患兒在起病0~3 d內以精神萎靡、嘔吐、驚跳為主要臨床特徵，髮生率分彆為100%、73.0%、86.7%；在起病3~5 d內以循環功能障礙、呼吸功能障礙、抽搐、死亡為主要病情改變，髮生率分彆是85.7%、42.9%、50.0%、21.4%。（3）死亡組白細胞計數、嗜中性粒細胞比率、血糖水平，死亡組均明顯高于存活組，比較差異均有統計學意義（P<0.05）；死亡組C反應蛋白、肝功能、心肌酶檢查改變不明顯（P>0.05）。結論：危重型手足口病患兒病情進展迅猛，死亡率高。精神萎靡、嘔吐、驚跳是危重型手足口病早期主要臨床錶現，可作為早期迅速判斷危重病情的指標；白細胞計數、嗜中性粒細胞比率、血糖水平異常增高提示患兒死亡風險高。
목적：분석총결15례중증위중형수족구병환인적림상특정。방법：회고성분석2010년5월-2013년7월본원인과주원적15례중증위중형수족구병환인적림상자료。결과：（1）15례환자중，남12례，녀3례；발병년령6~52개월：기중≤1세자4례，1~3세자9례，3~5세자2례，평균21개월。치유호전11례，사망4례（26.7%）。（2）15례위중형환인재기병0~3 d내이정신위미、구토、량도위주요림상특정，발생솔분별위100%、73.0%、86.7%；재기병3~5 d내이순배공능장애、호흡공능장애、추휵、사망위주요병정개변，발생솔분별시85.7%、42.9%、50.0%、21.4%。（3）사망조백세포계수、기중성립세포비솔、혈당수평，사망조균명현고우존활조，비교차이균유통계학의의（P<0.05）；사망조C반응단백、간공능、심기매검사개변불명현（P>0.05）。결론：위중형수족구병환인병정진전신맹，사망솔고。정신위미、구토、량도시위중형수족구병조기주요림상표현，가작위조기신속판단위중병정적지표；백세포계수、기중성립세포비솔、혈당수평이상증고제시환인사망풍험고。
Objective:To analyze and summarize the clinical features of 15 children who suffered from serious hand-food-mouth disease(HFMD). Method:Clinical data of 15 hospitalized children with serious hand-food-mouth disease(HFMD)in our hospital from May 2010 to July 2013 were analyzed retrospectively.Result:(1)In 15 patients,had 12 males and 3 females;age at onset:from 6 months to 52 months:there were 4 cases≤1 year old,9 cases whose age were 1-3 years old,2 cases of 3-5 years old,the average age was 21 months.11 cases were cured,4 cases died(26.7%). (2)Fifteen children who were critically ill began to present listlessness,vomiting,startle as their main clinical features during onset time of 0-3 days, the occurrence rates were 100%,73.0%,86.7%;During the onset time of 3-5 days,the main transformations of illness were convulsions,respiratory dysfunction,circulatory dysfunction and death,transformation rates were 85.7%,42.9%,50.0%,21.4%.(3)In terms of white blood cell count, neutrophil percentage and blood glucose level,the death group was higher than the survival group,the differences were statistically significant(P<0.05);The changes of C-reactive protein,liver function and myocardial enzymes in the death group were not significant(P>0.05).Conclusion:The state of illness of serious HFMD progress rapidly,the mortality rate is high.Listlessness,vomiting,startle are the main clinical manifestations in the early days of HFMD,which could be considered as indicators to judge serious HFMD early and quickly;the dramatic increase of white blood cell count,neutrophil percentage and blood glucose levels indicate that children may be in the high risk of death.
