中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2013年
4期
10-12
,共3页
王美芬%柳琼%杜曾庆%王明英%廖亚彬%王艳春
王美芬%柳瓊%杜曾慶%王明英%廖亞彬%王豔春
왕미분%류경%두증경%왕명영%료아빈%왕염춘
手足口病%危重型%病原%机械通气%神经源性肺水肿%高血压
手足口病%危重型%病原%機械通氣%神經源性肺水腫%高血壓
수족구병%위중형%병원%궤계통기%신경원성폐수종%고혈압
Hand-foot and mouth disease%Critical ills%Pathogens%Mechanical ventilation%Neurogenic pulmonary edema%Hypertension
目的 探讨危重型手足口病的临床特点及病原学,为临床诊断、治疗提供依据.方法 总结昆明市儿童医院2010年1月至2011年12月行机械通气的32例危重型患儿的临床资料,分析临床特征、病原学资料及其救治效果.主要救治措施为机械通气、甘露醇脱水、酚妥拉明降血压及激素、静脉丙种球蛋白.结果 32例机械通气患儿除均有神经系统受累的临床表现外,还有下肢凉、心率、呼吸明显增快或呼吸衰竭、高血压.发病年龄7个月～8岁10月,其中年龄≤3岁占81.25％.14例神经源性肺水肿、肺出血,死亡7例,病死率为21.88％.大便病原学检查EV71阳性31例,占96.88％.结论 EV71是引起危重型手足口病及死亡最主要的病原.危重型手足口病患儿发病年龄小,部分患儿病情进展快,出现高血压、呼吸循环衰竭、神经源性肺水肿、脑功能衰竭,病死率较高.危重型早期识别及治疗至关重要.
目的 探討危重型手足口病的臨床特點及病原學,為臨床診斷、治療提供依據.方法 總結昆明市兒童醫院2010年1月至2011年12月行機械通氣的32例危重型患兒的臨床資料,分析臨床特徵、病原學資料及其救治效果.主要救治措施為機械通氣、甘露醇脫水、酚妥拉明降血壓及激素、靜脈丙種毬蛋白.結果 32例機械通氣患兒除均有神經繫統受纍的臨床錶現外,還有下肢涼、心率、呼吸明顯增快或呼吸衰竭、高血壓.髮病年齡7箇月～8歲10月,其中年齡≤3歲佔81.25％.14例神經源性肺水腫、肺齣血,死亡7例,病死率為21.88％.大便病原學檢查EV71暘性31例,佔96.88％.結論 EV71是引起危重型手足口病及死亡最主要的病原.危重型手足口病患兒髮病年齡小,部分患兒病情進展快,齣現高血壓、呼吸循環衰竭、神經源性肺水腫、腦功能衰竭,病死率較高.危重型早期識彆及治療至關重要.
목적 탐토위중형수족구병적림상특점급병원학,위림상진단、치료제공의거.방법 총결곤명시인동의원2010년1월지2011년12월행궤계통기적32례위중형환인적림상자료,분석림상특정、병원학자료급기구치효과.주요구치조시위궤계통기、감로순탈수、분타랍명강혈압급격소、정맥병충구단백.결과 32례궤계통기환인제균유신경계통수루적림상표현외,환유하지량、심솔、호흡명현증쾌혹호흡쇠갈、고혈압.발병년령7개월～8세10월,기중년령≤3세점81.25％.14례신경원성폐수종、폐출혈,사망7례,병사솔위21.88％.대편병원학검사EV71양성31례,점96.88％.결론 EV71시인기위중형수족구병급사망최주요적병원.위중형수족구병환인발병년령소,부분환인병정진전쾌,출현고혈압、호흡순배쇠갈、신경원성폐수종、뇌공능쇠갈,병사솔교고.위중형조기식별급치료지관중요.
Objective To explore the clinical features of criticall ill of severe hand-foot and mouth disease and provide the basis for clinical diagnosis and treatment.Methods Summary the clinical data of 32 critical patients of severe hand-foot and mouth disease with mechanical ventilation in children' s hospital of Kunming from January 2010 to December 2011,analysis clinical characteristics and etiology,and its treatment effect.The main treatment measures were mechanical ventilation,mannitol,phentolamine to lower blood pressure and steroids,intravenous immunoglobulin.Results Thirty-two patients with mechanical ventilation not only had clinical manifestation of nervous system involvement,but also had lower extremity cold,apparent heart rate and faster breathing or breathing rate changes and hypertension.The age from 7 month to 8 years and 10 months.The age under 3 years accounted for 81.25％,14 patients with neurogenic pulmonary edema,pulmonary hemorrhage,7 patients died,the fatality rate was 21.88％,fecal pathogenic test of EV71,the positive were 31cases,accounted for 96.88％.Conclusions EV71 was the main pathogens of severe hand-foot-mouth disease and death.The critical ills of severe hand-foot and mouth disease with EV71 infection were age of small,rapid progression and higher fatality rate,occured respiratory failure,circulatory failure,neuerogenic pulmonary edema and brain dysfunction or failure,it was crucial to early recognition and treatment and early application of mechanical ventilation for the treatment.
