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 参见附件。

  【摘要】 目的：探讨小儿重症手足口病的早期识别及早期干预对其预后的影响。方法：回顾性分析2009年6月至2011年2月本院收治的98例重症手足口病的临床资料。观察分析患者的临床特征以及经过积极的临床干预后对患者的预后影响。结果：重症手足口病多发生于3岁以下患儿，该病病情进展快，患儿体温的异常，手、足皮疹，精神差、易惊、肢体抖动多见，呼吸频率及节律改变、心率增快，血压增高或降低，WBC升高，血糖升高，危重患者可出现神经源性肺水肿和循环衰竭；经过临床鉴别诊断及积极的临床治疗，98例患儿经早期识别和干预，此98例患者的临床疗效结果为：显效：56例；好转：34例；无效：8例。总体有效率高达92%。结论：重症手足口病早期识别是治疗的关键，治疗上除使用丙种球蛋白及激素外，尽早气管插管呼吸机机械通气，可提高抢救成功率、降低死亡率。

 【关键词】 手足口病；重症；机械通气；早期诊断

 Severe hand, foot and mouth disease in the early identification and intervention of its prognosis

 Zeng Xuefei He Yinghui Zou Li Yu Rong Liu Xiufang Lin Junrong Fang Xing Wang Kaipping Liu Liangan Zheng Rutian, Huizhou People’s Central Hospital

 Pediatrics 1Department of Infectious Diseases2, Huizhou 516001, Guangdong, China

 【Abstract】 Objective: To evaluate children with severe hand, foot and mouth disease in the early identification and early intervention on prognosis. Methods: A retrospective analysis from June 2009 to February 2011 our hospital 98 patients with severe hand, foot and mouth disease in clinical data. Observe and analyze the clinical characteristics of patients and the clinical intervention after a positive prognosis for patients. Results: Severe HFMD occurred in children under 3 years old, the disease has a rapid progression in children with abnormal body, hand, foot rashes, mental difference, easy to panic, limb shaking more common, respiratory rate and rhythm changes, faster heart rate, blood pressure increased or decreased, WBC increased blood sugar, can occur in critically ill patients with neurogenic pulmonary edema and circulatory failure; through the clinical differential diagnosis and clinical treatment of positive, 98 cases of children through early identification and intervention, The 98 patients with the clinical efficacy results are as follows: markedly: 56 cases; improved: 34 cases; invalid: 8 cases. 92% overall efficiency. Conclusion: Early recognition of severe hand, foot and mouth disease is the key to the treatment, the treatment of gamma globulin and other than using hormones, the breathing machine early intubation mechanical ventilation, can improve the success rate and reduce mortality.

 【Key words】 Hand-Foot-and-Mouth Disease Severe Mechanical ventilation Early stage Diagnosis

 手足口病(Hand-foot-and-mouth disease)是由多种肠道病毒感染引起的急性传染病 ......