重症重型手足口病37例临床救治研究

目的 探讨重症危重型手足口病患儿的临床特点、救治经验和转归.为重症危重型手足口病的救治积累经验.方法 对2010年3月至2011年12月入住本院重症监护病房的37例危重型手足口病患儿进行临床回顾性分析.结果 危重型手足口病发病季节主要集中在5～7月份,以5月为主,持续高热伴精神萎靡、惊跳、呕吐、是神经系统受损的早期临床症状.呼吸急促,X线改变要警惕神经性肺水肿.主要治疗药物为甘露醇、甲基泼尼松龙、静脉丙种球蛋白,有肺水肿先兆者尽早机械通气.结论 重症手足口病患儿起病急、变化快,除对症治疗外,酌情应用糖皮质激素和丙种球蛋白治疗,有肺水肿先兆及呼吸功能障碍者尽早正压机械通气.

37 cases of clinical treatment of a critical type of hand,foot and mouth disease

【Objective】 To investigate the clinical features,experience of treatment and outcome of severe critical HFMD children.Accumulate experience for the treatment of severe critical HFMD.【Methods】 Clinical data of 37 cases of critically ill patients with hand,foot and mouth children were admitted to the intensive care unit in March 2010 to December 2011 were retrospectively analyzed.【Results】 The season of the critical type of hand,foot and mouth disease is mainly concentrated in July to May,mainly sustained high fever with listlessness,startle,vomiting,early clinical symptoms of nervous system damage.Shortness of breath,X-ray changes should be wary of neurogenic pulmonary edema.It is to study the main treatment for mannitol,methylprednisolone,intravenous gamma globulin,a sign of pulmonary edema and mechanical ventilation as soon as possible.【Conclusion】 The rapid onset of severe hand,foot and mouth disease children,changes quickly,in addition to symptomatic treatment,as appropriate,glucocorticoids and gamma globulin treatment,pulmonary edema aura and respiratory dysfunction early positive pressure mechanical ventilation.