中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2012年
18期
11-13
,共3页
杜曾庆%王美芬%柳琼%王明英%王艳春%邓成俊%廖亚彬%罗云娇%甘泉
杜曾慶%王美芬%柳瓊%王明英%王豔春%鄧成俊%廖亞彬%囉雲嬌%甘泉
두증경%왕미분%류경%왕명영%왕염춘%산성준%료아빈%라운교%감천
手足口病%危重型%高血压%神经源性肺水肿%治疗
手足口病%危重型%高血壓%神經源性肺水腫%治療
수족구병%위중형%고혈압%신경원성폐수종%치료
Hand-foot and mouth disease%Critical case%Hypertension%Neurogenic pulmonary edema%Therapy
目的 探讨儿童手足口病(HFMD)危重型的临床特点,为临床诊治提供依据.方法 回顾性分析昆明市儿童医院2010年6月至10月住院的558例重症患儿中的142例危重型患儿的临床资料.结果 142例危重型患儿经积极抢救治疗,除1例肺出血患儿入院不足10 h,上呼吸机60 h,肺出血止住,患儿高热、昏迷,家长放弃治疗自动出院外,其余141例(其中2例瘫痪患儿)临床症状消失,全部治愈出院.141例粪便RT-PCR核酸检测:阳性129例,其中EV71 125例,CoxA16 4例.结论 HFMD危重型患儿病情危重,严重威胁儿童的健康.HFMD危重型早期识别及治疗至关重要,本研究患儿均有高血压,均积极给予酚妥拉明及少部分改用硝普钠降压治疗控制了高血压,积极治疗了神经源性肺水肿,提高了抢救成功率,仅13例应用了呼吸机治疗,取得了满意疗效.早期发现、诊断、治疗HFMD危重型,可明显减少静脉丙种球蛋白治疗及机械通气的应用,是提高治愈率减少后遗症的关键.
目的 探討兒童手足口病(HFMD)危重型的臨床特點,為臨床診治提供依據.方法 迴顧性分析昆明市兒童醫院2010年6月至10月住院的558例重癥患兒中的142例危重型患兒的臨床資料.結果 142例危重型患兒經積極搶救治療,除1例肺齣血患兒入院不足10 h,上呼吸機60 h,肺齣血止住,患兒高熱、昏迷,傢長放棄治療自動齣院外,其餘141例(其中2例癱瘓患兒)臨床癥狀消失,全部治愈齣院.141例糞便RT-PCR覈痠檢測:暘性129例,其中EV71 125例,CoxA16 4例.結論 HFMD危重型患兒病情危重,嚴重威脅兒童的健康.HFMD危重型早期識彆及治療至關重要,本研究患兒均有高血壓,均積極給予酚妥拉明及少部分改用硝普鈉降壓治療控製瞭高血壓,積極治療瞭神經源性肺水腫,提高瞭搶救成功率,僅13例應用瞭呼吸機治療,取得瞭滿意療效.早期髮現、診斷、治療HFMD危重型,可明顯減少靜脈丙種毬蛋白治療及機械通氣的應用,是提高治愈率減少後遺癥的關鍵.
목적 탐토인동수족구병(HFMD)위중형적림상특점,위림상진치제공의거.방법 회고성분석곤명시인동의원2010년6월지10월주원적558례중증환인중적142례위중형환인적림상자료.결과 142례위중형환인경적겁창구치료,제1례폐출혈환인입원불족10 h,상호흡궤60 h,폐출혈지주,환인고열、혼미,가장방기치료자동출원외,기여141례(기중2례탄탄환인)림상증상소실,전부치유출원.141례분편RT-PCR핵산검측:양성129례,기중EV71 125례,CoxA16 4례.결론 HFMD위중형환인병정위중,엄중위협인동적건강.HFMD위중형조기식별급치료지관중요,본연구환인균유고혈압,균적겁급여분타랍명급소부분개용초보납강압치료공제료고혈압,적겁치료료신경원성폐수종,제고료창구성공솔,부13례응용료호흡궤치료,취득료만의료효.조기발현、진단、치료HFMD위중형,가명현감소정맥병충구단백치료급궤계통기적응용,시제고치유솔감소후유증적관건.
Objective To investigate the clinical characterics of critical hand-foot-mouth disease (HFMD),and to provide basis for clinical diagnosis and treatment.Methods The clinical data of 142 cases of critical HFMD in 558 cases hospitalized children with severe HFMD were retrospectively analyzed admitted in our hospital from June to October in 2011 were retrospectively analyzed admitted.Results Through the active and effective treatment,141 patients(including 2 cases with acute flaccid paralysis)were cured and discharged from hospital except 1 patients with pulmonary hemorrhage after admission for less than 10 hours,by mechanical ventilation for 60 hours,pulmonary hemorrhage had stopped,but the children persisted with the status of high fever and coma,the parents abandoned treatment and automatically discharged from hospital.The stool specimens RT-PCR detection and nucleic acid sequencing of the 141 cases showed:129 cases were positive,in which EV71 were 125 cases,CoxA16 were 4 cases.Conclusions The cendition of patients with critical HFMD were critical,and it is a serious threat to the health of children.It was important to early diagnose and treatment of critical HFMD.In the study,patients all suffered from hypertension,and were actively given phentolamine and small part of sodium nitroprusside depressor therapy,then hypertension was controled,the neurogenic pulmonary edema was actively treated,and the success rate of rescue was improved.Only 13 cases obtained ventilator therapy.The curative effect was satisfactory.Early detection,diagnosis and treatment of critical HFMD can reduce the intravenous immunoglobulin treatment and application of mechanical ventilation and improve the cure rate and reduce the sequelae.
