医药前沿
醫藥前沿
의약전연
YIAYAO QIANYAN
2015年
14期
46-47,48
,共3页
重症%手足口病%EV71%阳性
重癥%手足口病%EV71%暘性
중증%수족구병%EV71%양성
Severe%Hand foot and mouth disease%EV71%Positive
目的：分析探讨重症手足口病的临床特点及诊断方法。方法：回顾性分析总结14例重症手足口病的临床表现、实验室数据及影像学改变，并学习手足口病相关文献。结果：14例均为小于4岁婴幼儿，以发热、呼吸道感染起病。并发脑炎、消化道出血、肺出血。手足口病病毒检测肠道病毒通用型：阳性，E V71：阳性。肺部有大片炎性实变。10例早期诊断明确，治疗及抢救及时，最终治愈，1例入院时病情较重经抢救无效死亡，2例因早期临床表现不典型，症状较轻，病情突然加重，出现肺出血，虽经积极抢救无效死亡。结论：持续高热，肢体抖动及膝反射亢进对早期发现重型病例有提示意义，白细胞增高、血糖升高患儿病情可能出现加重。详细询问病史、全面体格检查以及必要的辅查（如手足口病病毒肠道病毒：E V71的检测），有助于减少误诊、明确诊断、及早防治严重并发症的发生及改善预后。
目的：分析探討重癥手足口病的臨床特點及診斷方法。方法：迴顧性分析總結14例重癥手足口病的臨床錶現、實驗室數據及影像學改變，併學習手足口病相關文獻。結果：14例均為小于4歲嬰幼兒，以髮熱、呼吸道感染起病。併髮腦炎、消化道齣血、肺齣血。手足口病病毒檢測腸道病毒通用型：暘性，E V71：暘性。肺部有大片炎性實變。10例早期診斷明確，治療及搶救及時，最終治愈，1例入院時病情較重經搶救無效死亡，2例因早期臨床錶現不典型，癥狀較輕，病情突然加重，齣現肺齣血，雖經積極搶救無效死亡。結論：持續高熱，肢體抖動及膝反射亢進對早期髮現重型病例有提示意義，白細胞增高、血糖升高患兒病情可能齣現加重。詳細詢問病史、全麵體格檢查以及必要的輔查（如手足口病病毒腸道病毒：E V71的檢測），有助于減少誤診、明確診斷、及早防治嚴重併髮癥的髮生及改善預後。
목적：분석탐토중증수족구병적림상특점급진단방법。방법：회고성분석총결14례중증수족구병적림상표현、실험실수거급영상학개변，병학습수족구병상관문헌。결과：14례균위소우4세영유인，이발열、호흡도감염기병。병발뇌염、소화도출혈、폐출혈。수족구병병독검측장도병독통용형：양성，E V71：양성。폐부유대편염성실변。10례조기진단명학，치료급창구급시，최종치유，1례입원시병정교중경창구무효사망，2례인조기림상표현불전형，증상교경，병정돌연가중，출현폐출혈，수경적겁창구무효사망。결론：지속고열，지체두동급슬반사항진대조기발현중형병례유제시의의，백세포증고、혈당승고환인병정가능출현가중。상세순문병사、전면체격검사이급필요적보사（여수족구병병독장도병독：E V71적검측），유조우감소오진、명학진단、급조방치엄중병발증적발생급개선예후。
ObjectiveTo analyze the clinical characteristics and diagnostic methods of severe hand foot mouth disease. Methods A retrospective summary of 14 cases of severe hand foot mouth disease clinical manifestations, laboratory data and imaging changes and related literature, study of hand foot and mouth disease.Results 14 cases were less than 4 years old infants, with fever, respiratory tract infection onset. Encephalitis, gastrointestinal bleeding, pulmonary hemorrhage. Hand foot and mouth disease virus detection of enterovirus universal type: positive, EV71: positive. A large pulmonary inflammatory consolidation. 10 early clear diagnosis, treatment and timely rescue, and ultimately cure, 1 cases were serious condition after rescue invalid death, 2 example because the early clinical manifestation is not typical, the symptom is lighter, the condition suddenly worsened, pulmonary hemorrhage, although after the rescue invalid death actively.Conclusion Persistent fever, limb shaking knee hyperreflexia severe cases have implications for early detection, leukocytosis, elevated blood sugar levels in children with the disease may worsen. A detailed history, complete physical examination and necessary auxiliary examination (such as hand foot and mouth disease virus enterovirus: detection EV71). Occurrence and improve prognosis can reduce misdiagnosis, diagnosis, early prevention and treatment of severe complications.
