国际医药卫生导报
國際醫藥衛生導報
국제의약위생도보
INTERNATIONAL MEDICINE & HEALTH GUIDANCE NEWS
2014年
20期
3098-3102
,共5页
手足口病%临床特点%治疗%随访
手足口病%臨床特點%治療%隨訪
수족구병%림상특점%치료%수방
Hand-foot-mouth disease%Clinical features%Treatment%Follow-up
目的 总结手足口病(4期)的临床特点、治疗策略及预后.方法 对我院2010年5月至2011年6月诊断和治疗的危重症手足口病(4期)17例患儿进行临床资料分析及随访.结果 17例患几年龄(19.8±11.1)月,入院时病程(3.180±0.834)天.其中EV71感染15例,COA16感染2例.影像学检查:头颅MRI阳性6例,头颅CT阳性2例,脊髓MRI阳性2例.脑于听觉诱发电位示脑干受损14例.治疗上丙种球蛋白及甲基强的松龙免疫支持,维持血压、血糖及内环境稳定,行呼吸机支持治疗及头部亚低温治疗.家长放弃治疗后死亡5例(放弃时间分别为入院后1、3、7、30、50天).出院时完全治愈4例,遗留斜视(外展神经损伤)3例,面瘫(面神经损伤)2例,吞咽功能障碍(舌咽神经损伤)2例,肢体活动功能障碍4例.结论 手足口病为EV71感染多见,病情进展迅速,年龄为1～3岁为多,经积极综合治疗远期预后良好.
目的 總結手足口病(4期)的臨床特點、治療策略及預後.方法 對我院2010年5月至2011年6月診斷和治療的危重癥手足口病(4期)17例患兒進行臨床資料分析及隨訪.結果 17例患幾年齡(19.8±11.1)月,入院時病程(3.180±0.834)天.其中EV71感染15例,COA16感染2例.影像學檢查:頭顱MRI暘性6例,頭顱CT暘性2例,脊髓MRI暘性2例.腦于聽覺誘髮電位示腦榦受損14例.治療上丙種毬蛋白及甲基彊的鬆龍免疫支持,維持血壓、血糖及內環境穩定,行呼吸機支持治療及頭部亞低溫治療.傢長放棄治療後死亡5例(放棄時間分彆為入院後1、3、7、30、50天).齣院時完全治愈4例,遺留斜視(外展神經損傷)3例,麵癱(麵神經損傷)2例,吞嚥功能障礙(舌嚥神經損傷)2例,肢體活動功能障礙4例.結論 手足口病為EV71感染多見,病情進展迅速,年齡為1～3歲為多,經積極綜閤治療遠期預後良好.
목적 총결수족구병(4기)적림상특점、치료책략급예후.방법 대아원2010년5월지2011년6월진단화치료적위중증수족구병(4기)17례환인진행림상자료분석급수방.결과 17례환궤년령(19.8±11.1)월,입원시병정(3.180±0.834)천.기중EV71감염15례,COA16감염2례.영상학검사:두로MRI양성6례,두로CT양성2례,척수MRI양성2례.뇌우은각유발전위시뇌간수손14례.치료상병충구단백급갑기강적송룡면역지지,유지혈압、혈당급내배경은정,행호흡궤지지치료급두부아저온치료.가장방기치료후사망5례(방기시간분별위입원후1、3、7、30、50천).출원시완전치유4례,유류사시(외전신경손상)3례,면탄(면신경손상)2례,탄인공능장애(설인신경손상)2례,지체활동공능장애4례.결론 수족구병위EV71감염다견,병정진전신속,년령위1～3세위다,경적겁종합치료원기예후량호.
Objective To investigate the clinical characteristics,treatment strategies,and prognosis of severe hand-foot-mouth disease (HFMD).Methods The clinical data of 17 children with HFMD admitted into our hospital form May,2010 to June,2011 were retrospectively analyzed.Results The children' s age was (19.8+11.1) months.Their disease course was (3.180+0.834) days.15 cases were infected by EV71 and 2 by COAl6.6 cases were positive in Cranial MRI Imaging tests,2 CT examination,and 2 spinal MRI.Brain-stem auditory evoked potentials showed that 14 cases had brain-stem injury.In order to maintain blood pressure,blood glucose,and homeostasis,patients were given gamma globulin,ventilator support,methylprednisolone immune support,and head hypothermia treatment.5 cases died because the parents' parents had given up the treatment 1,3,7,30,and 50 days after the children were admitted into the hospital.When discharging from the hospital,4 cases were cured,3 still had legacy of strabismus (outreach nerve damage),2 facial paralysis (facial nerve injury),2 swallowing dysfunction (glossopharyngeal nerve injury),and 4 physical activity dysfunction.Conclusions EV71 is a common virus in HFMD.The disease progress of severe HFMD is rapid.Most of the cases are 1-3 years old children.After active comprehensive treatment,the patients have good long-term prognosis.
