EV71感染手足口病合并病毒性脑炎的临床分析

目的 分析肠道病毒71型（EV71）感染手足口病合并病毒性脑炎的临床特点,总结诊治要点及预后.方法 对我院2011年5月至2013年5月收治的46例EV71感染手足口病合并病毒性脑炎患儿的临床资料进行回顾性分析,包括患儿一般情况、临床表现、辅助检查和治疗、转归情况.结果 年龄分布以小于3岁的婴幼儿为主,均有发热及皮疹,部分患儿有呼吸、循环系统异常体征,46例患儿均有不同程度脑实质损伤表现,尽早治疗可改善危重症患儿症状,治愈或好转42例（91.3％）,死亡4例（8.7％）.结论 EV71感染手足口病合并病毒性脑炎患儿神经系统异常表现与脑实质受累部位有关,其中脑干损害致神经源性肺水肿、肺出血病情最为凶险,及早发现危重病例并予积极治疗可降低死亡率和致残率.

A clinical analysis on hand,foot and mouth disease combined with viral encephalitis infected by EV71

Objective To analyze the clinical characteristics of hand,foot and mouth disease （HFMD） with viral encephalitis infected by EV71,and summarize the key points in diagnosis,treatment and prognosis.Methods Retrospective analysis was carried out to study the clinical data of 46 patients with EV71 HFMD and viral encephalitis,who had been hospitalized during the period from May 2011 to May 2013,including general condition,clinical manifestation,laboratory findings,treatment and outcome.Results Children less than 3 years old were attacked more easily by the disease.All of the patients had fever and rash,part of them showed abnormal signs of respiratory system and circle system.46 patients had varying degrees of injury in cerebral parenchyma,giving timely treatment might relieve patients＇ symptoms.42 cases （91.3％） were cured or better,and 4 cases （8.7％） were dead.Conclusion The nervous system symptoms of patients with EV71 HFMD and viral encephalitis was related to the locations of brain parenchyma lesion.Neurogenic pulmonary edema or pulmonary hemorrhage induced by brainstem encephalitis is the most dangerous.Early diagnosis and treatment can lower the morality rate and disability rate.