626例手足口病临床分析

发布时间：2018-05-23 12:13

  本文选题：普通手足口病 + 重症手足口病　； 参考：《重庆医科大学》2012年硕士论文

【摘要】：目的：探讨不同类型手足口病临床特征差异，以早期识别重症及危重症手足口病，及时治疗，防止并发症，，改善预后。 方法：以2011年3-9月重庆医科大学附属儿童医院收治的626例手足口病为研究对象，其中普通手足口病102例、重症手足口病499例、危重症手足口病25例，采用卡方检验（或秩和检验）比较普通组、重症组、危重症组在临床特征方面的差异。 结果：各型手足口病在年龄和性别构成比上无显著差异，均好发于三岁以下男性儿童，危重症组中年龄小于3岁（80%）所占比例比重症组（67。9%）及普通组（67。7%）高。危重症死亡率（40%）显著高于重症及普通组。重症组持续高热（体温≥39℃或发热时间≥3天）、呕吐、神萎、嗜睡或昏睡、惊跳、肢体抖动、无力、抽搐、颈阻阳性发生率显著高于普通组；危重症组持续高热、不典型皮疹、神萎、昏迷、烦躁、反复抽搐、瞳孔改变、颈阻阳性、肌张力改变（增高或降低）、巴氏征阳性、气促、呼吸困难、呼吸节律改变、肺部罗音、心率增快(心率≥160次/分)、心音改变、末梢循环改变率显著高于重症组。辅助检查方面，重症组及危重症组粪便肠道病毒EV71检出率均显著高于普通组；危重症组血糖（血糖≥10mmol/L）及白细胞（WBC≥16×109/L）显著增高、肝功能异常发生率、脑电图阳性率、脑MRI阳性率、脑CT阳性率、胸片渗出性改变显著高于重症组。 结论：对临床诊断的手足口病患儿，应尽快完善手足口病病原学检查，高度重视小于3岁、持续高热、皮疹不典型、EV71感染的患儿，密切观察有无惊跳、肢体抖动、无力等神经系统受累表现，同时监测呼吸、心率、末梢循环等生命体征，早期完善外周血白细胞计数、血糖、胸片检查，必要时做脑电图及头颅影像学检查，有助于早期发现重症、危重症患儿，积极治疗，改善预后。
[Abstract]:Objective: to explore the difference of clinical characteristics of different types of hand, foot and mouth disease in order to identify severe hand, foot and mouth disease in early stage, treat it in time, prevent complications and improve prognosis. Methods: from March to September 2011, 626 cases of hand, foot and mouth disease, including 102 cases of hand, foot and mouth disease, 499 cases of severe hand, foot and mouth disease and 25 cases of critical hand, foot and mouth disease, were studied. Chi-square test (or rank sum test) was used to compare the clinical characteristics of common group, severe group and critical group. Results: there was no significant difference in age and sex composition of all types of hand, foot and mouth diseases, which occurred in male children under three years of age, and the proportion of patients with severe diseases younger than 3 years old was higher than that of patients with severe hand, foot and mouth diseases (67.9%) and 67.7% (normal group). The critical death rate was significantly higher than that in the severe group and the general group. The incidence of persistent high fever (body temperature 鈮

本文编号：1924676