82例重症手足口病临床诊治体会.doc

82例重症手足口病临床诊治体会[摘要] 目的：了解手足口病的流行特征和临床特点，为手足口病的诊断、治疗及预防提供依据。方法：总结2010年3～7月本院收治的82例重症手足口病患者的临床资料，分析其临床特点、实验室检查和临床治疗的结果。结果：82例患者中，治愈74例，好转6例，自动出院1例，死亡1例。结论：手足口病是由肠道病毒引起的急性传染病，以3岁以下年龄组发病率最高，少数患者可进展为重症手足口病，主要表现为神经系统受累，部分患者出现重症脑干脑炎、神经源性肺水肿（多由EV71感染），多数重症患者预后良好，个别患者会有不同程度的神经系统后遗症。 [关键词] 手足口病；重症；神经系统并发症；临床特点 [中图分类号] R51 [文献标识码] B [文章编号] 1674-4721（2012）01（a）-179-02 The experience of clinical diagnosis and cure of 82 cases with hand-foot-and-mouth disease ZHANG Xiangli, LIU Xiangfei Department of Pediatrics, Maternal and Child Care Service Centre of Boai Country, Henan Province, Jiaozuo 454450, China [Abstract] Objective: To realize the epidemic features and clinical features of hand-foot-and-mouth disease, and provide the basis of diagnosis, treatment and prevention. Methods: To summarize the clinical data of 82 cases of severe hand-foot-and-mouth disease from March to July 2010, and analyze its clinical features, laboratory examinations and the results of clinical treatment. Results: In the 82 cases of patients, 74 cases were cured, progressive in 6 cases, automatic to leave hospital in 1 case and death in 1 case. Conclusion: The hand-foot-and-mouth disease was acute infectious diseases caused by intestinal virus. It has the highest incidence before three years old. Minority patients can progress to severe hand-foot-and-mouth disease. And it is mainly involved nervous system, some severe patients can turn up to severe brainstem encephalitis and neurogenic pulmonary edema (infection by EV71). Most prognosis are good, and individual patients can left different degree of nervous system sequelae. [Key words] Hand-foot-and-mouth disease; Severe; Neurological complication; Clinical features 手足口病是由肠道病毒引起的传染病，多发于学龄前儿童，可引起手、足、口腔等部位的疱疹，部分病例皮疹表现不典型，如单一部位或仅表现为斑丘疹。少数患儿可引起心肌炎、肺水肿 、无菌性脑膜脑炎等并发症。个别重症患儿如果病情发展快，导致死亡。引发手足口病的肠道病毒有20多种（型），柯萨奇病毒A组的16、4、5、9、10型，B组的2、5型，以及肠道病毒71型（EV 71）最为常见。重症脑干脑炎、神经源性肺水肿是本病的死亡原因。 1 资料与方法 1.1 一般资料 随机选取2010年3～7月本院收治的82例重症手足口病患者，其中，男5