重症手足口病并发心肺衰竭321例临床分析

发布时间：2018-05-18 15:23

  本文选题：手足口病 + 心肺衰竭　； 参考：《临床儿科杂志》2017年04期

【摘要】：目的分析重症手足口病(HFMD)并发心肺衰竭患儿的临床及流行病学特点,并寻找重症相关危险因素。方法回顾分析2014年1月至2014年12月因手足口病住院,且临床分期为2期及以上患儿的临床资料。结果共入选321例重症手足口病住院患儿,普通组(临床分期2期)306例,无死亡病例;心肺衰竭组(临床分期3、4期)15例,7例死亡,两组病死率差异有统计学意义(P0.001)。心肺衰竭组中位年龄9个月(6~20月龄),低于普通组的24月龄(3月龄~12岁),差异有统计学意义(P0.01)。心肺衰竭组患儿热峰(39.44±0.23)℃、热程(5.01±0.94)d,高于普通组的(39.12±0.20)℃、(3.93±0.47)d,差异有统计学意义(P均0.05)。心肺衰竭组呕吐、意识障碍、外周循环障碍、呼吸节律不齐以及肺水肿的发生率均高于普通组,差异有统计学意义(P均0.001)。心肺衰竭组肠道病毒71型(EV71)阳性率85.7%,高于普通组的61.4%,差异有统计学意义(P0.01);心肺衰竭组N末端脑钠肽前体(NT-pro BNP)水平均增高(100.0%),普通组35.3%增高,差异有统计学意义(P0.001)。结论儿童HFMD出现呕吐、意识障碍、循环障碍、呼吸节律紊乱,以及EV71阳性和NT-pro BNP水平升高,存在发生心肺衰竭的风险,需重点监测病情变化。
[Abstract]:Objective to analyze the clinical and epidemiological characteristics of severe HFMD complicated with heart and lung failure and to find out the risk factors of severe HFMD. Methods from January 2014 to December 2014, the clinical data of children with hand-foot-mouth disease were retrospectively analyzed. Results A total of 321 hospitalized children with severe hand-foot-mouth disease were enrolled in this study. There were 306 cases in the general group and 7 cases in the group of cardiopulmonary failure (15 cases died in stage 3 or 4). The difference of mortality between the two groups was statistically significant (P 0.001). The median age of cardiopulmonary failure group was 9 months and 20 months, which was lower than that of 24 months old and 3 months old and 12 months old. The difference was statistically significant (P 0.01). In the heart and lung failure group, the heat peak temperature was 39.44 卤0.23 鈩，

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