重症高危手足口病患儿的临床观察与救治重症高危手足口病患儿的临床观察与救治［摘要］目的总结手足口病(HFMD)重症高危患儿的临床特点及治疗方案。方法回顾性分析2009年4月〜2011年8月东莞市石龙人民医院3693例HFMD患儿的临床资料，根据疾病严重程度将其分为普通组3608例，重症组85例。比较两组患儿临床表现、实验室检查及治疗效果。结果HFMD高危重症患儿病情较重，更易惊厥和(或)昏迷，皮肤四肢末梢较凉，皮肤多呈花纹状，其发热病程更久，血压及心率较普通HFMD高;普通组白细胞(WBC)［(9.32±3.01)X109/L］、血糖［(7・00土2.98)mmol/L］及乳酸水平［(1.81土0.82)mmol/L_均低于重症组［(10.14±3.65)X109/L.(8.51±4.71)mmol/L.(2.29±1.82)mmol/L］,差异均有统计学意义(t二2.678、4.301、3.582,P=0.0245、0.0096、0.0248)；普通组总有效率为96.4%,明显高于重症组(81.2%),差异有高度统计学意义(x2二49.225,P<0.01)o结论HFMD重症高危患儿病情发展迅速，血糖、血压、WBC均升高，神经系统、呼吸系统及循环系统均受到影响，故临床上应当积极干预，阻止疾病向重症发展。［关键词］手足口病；重症高危型；救治；疗效观察［中图分类号IR725.4［文献标识码］C［文章编号］1673-7210(2014)10(a)-0153-04Clinicalobservationandtreatmentforseverechildrenwithhand-foot-mouthdiseaseCAIDongchunDepartmentofPediatrics,ShilongDongguanPeople'sHospitalofDongguanCity,GuangdongProvince,Dongguan523320,China［Abstract］ObjectiveTodiscusstheclinicalcharacter!sticsandtreatmentoptionsofthehand-foot-mouthdisease(HFMD)・Methods160childrenwithHFMDfromApril2009toAugust2011inShilongDongguanPeople*sHospitalofDongguanCitywereretrospectivelyanalyzed.Allthecasesweredividedintotwogroupsaccordingtotheseverityofdisease,54casesinthenormalgroup,106casesintheseriousgroup・Theclinicalmanifestations,laboratoryresultsandtreatmenteffectofthetwogroupswerecompared.ResultsTheseriouschildrenwithheavier,moreconvulsionandcoma,skinlimbsendingscooler,andmoredecorativepattern,theheatingdurationlonger,showedahighbloodpressureandheartratethanordinaryIIFMD・TheWBC,bloodsugar,lacticacidlevelsofseriousgroupwere(9.32±3.01)X109/L,(7.00±2.98)mmol/L,(1.81±0.82)mmol/Lrespectively,lowerthanthoseofthenormalgroup[(10.14±3.65)X109/L,(8.51±4.71)nunol/L,(2.29±1.82)mmol/L],thedifferenceswerestatisticallysignificant(t=2.678,4.301,3.582；P=0.0245,0.0096,0.0248).Thetotaleffectiverateofthenormalgroupwas96.4%,higherthanthatoftheseriousgroup(81.2%),thedifferencewasstatisticallysignificant(x2二49.225,P〈0.001).ConclusionThechildrenwithsevereIIFMDshouldactivelyintervention,giveactiveintervention,preventdiseasetointensivedevelopment[Keywords]Iland-foot-and-mouthdisease；Severehigh-risktype；Treatment；Curativeeffectobservation手足口病(handfootmouthdisease,HFMD)是国家法定报告丙类传染病，系多种肠道病毒引起，常见柯萨奇病毒病毒A16型、肠道病毒71型。以发热和手、足、口等部位皮疹、疱疹为主要特征，部分患儿伴发心肌炎、肺水肿等。重症患儿病情发展迅速，若加控制可致死亡[1]。在我国，小儿手足口病呈现“早、快、重”的特点，且发病率逐年上升，威胁到儿童的健康成长。木研究对广东省东莞市石龙人民医院(以下简称“我院”)收治的手足口病患儿进行临床观察,通过总结发病特征、治疗方案的研究，为该疾病的诊断与治疗提供依据。现报道如下：<!--endprint--><!--startprint-->1资料与方法1.1一般资料回顾性分析2009年4月〜2011年8月我院3693例手足口病患儿的临床资料,其中男2382例，女1311例，年龄3个月〜5岁，其中〈3岁2982例，3〜5岁711例。按照病程严重程度分为：普通组3608例，男2315例，女1293例；＜3岁2934例，3〜5岁674例，平均年龄(4.3±1.6)岁；发热3530例，体温37.6—38.5°C者2997例，＞38.5〜39.0°C...
