摘要
目的探讨2009年及2010年西安地区危重症手足口病(HFMD)的流行特点。方法对2009年及2010年本院收治的46例(2009年12例,2010年34例)危重症HFMD的一般资料、症状、体征、辅助检查、呼吸机参数以及转归进行比较和回顾性分析。结果 2010年危重症病例数与2009年比较有明显上升趋势,死亡比例自66.7%降至41.2%;皮疹分布较2009年广泛,累及器官数目有所减少;热程、病情转危时间、神经系统受累时间均无明显变化;发生抽搐、脑干脑炎、肺出血及应激性溃疡的比例亦未增加;辅助检查包括血糖、白细胞、CK-MB、心电图及X线影像异常比例差异均无统计学意义,早期行MRI检查阳性率高;呼吸机治疗参数PIP及PEEP值、治愈患儿平均上机时间及住院日、治愈率比较均无统计学意义。结论近2 a西安地区危重症HFMD的流行病学及临床特点及治疗策略均未发生明显变化,对于危重症HFMD患儿,必须采取"关口前移"的预防干预措施才能有效降低病死率。
Objective To explore the clinical characteristics of children with critical hand-foot-and-mouth disease（HFMD）in 2009 and 2010. Methods The clinical data of 46 children with critical HFMD were collected in Xi′an Children′s Hospital between 2009 and 2010,which included general information,symptoms,signs,laboratory test and ventilator parameters,and the outcome between the 2 groups was compared. Results The number of critical HFMD in 2010 was more and the death cases were less compared with those in 2009（66.7% in 2009 and 41.2% in 2010,respectively）.The cumulative number of rash in 2010 was more than that in 2009 and the number of injured organs was lower in 2009.The heat range,time course of the progression and nervous system involved were no significant.The proportion of convulsion,brainstem encephalitis,pneumorrhagia and stress ulceration was not increased.There was no significant difference in laboratory tests which included blood sugar,leukocyte,MB isoenzyme of creatine kinase,electrocardiogram and the abnormal proportion of X-ray.The positive rate of magnetic resonance imaging examination was higher;There was no significant difference in respiratory parameter of peak inspiratory pressure and positive end expiratory pressure,the hours of the ventilator,length of stay and the healing rate. Conclusions The clinical and epidemiological features of critical HFMD have not changed during the 2 years.We should take early preventive interventions of ＂sooner＂ to reduce mortality of critical HFMD.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2011年第18期1420-1422,共3页
Journal of Applied Clinical Pediatrics
关键词
手足口病
危重症
临床分析
机械通气
hand-foot-and-mouth disease
severe disease
clinical analysis
mechanical ventilation
作者简介
雷晋莉，女，副主任医师，硕士学位，研究方向为小儿急救，电子信箱leijinli_2000@163．com。
