摘要
目的探讨亚低温在危重症手足口病中的临床应用价值。方法选取2011年3月～2015年3月在新余市人民医院PICU行亚低温治疗的51例重症手足口病患儿为亚低温组，2009年3月～2015年3月未给予亚低温治疗的52例重症手足口病患儿为对照组。两组常规使用机械通气、甘露醇降颅压、甲强龙和丙种球蛋白免疫调节、循环支持、利巴韦林抗病毒、镇静等综合治疗。对照两组2h后的肛温、心率控制在160／min以下时间、收缩压控制在正常范围时间、肺出血发生率和死亡率。结果亚低温组在2h后的肛温、心率控制〈160／min、收缩压控制在80～110mmHg的时间较对照组有明显的优势。亚低温组肺出血发生率为0．00％，对照组9．62％，第4期中亚低温组死亡率为7．84％，对照组25．00％（均P〈0．05）。结论亚低温对危重症手足口病在降温、降低心率、改善循环等方面有明显的优势。值得临床推广应用。
Objective To explore the clinical application value of mild hypothcrmia in severe hand-foot-and-mouth diseases.Methods From March 2011 to March 2015,51 pediatric patients with severe hand-foot-and-mouth diseases in pediatric intensive care unit （PICU） in our hospital treated with mild hypothcrmia were selected as mild hypothcrmia group,52 pediatric patients with severe hand-foot-and-mouth diseases from March 2009 to March 2015 who were not provided with mild hypothcrmia was classified into control group.In two groups,comprehensive therapies including conventional mechanical ventilation,mannitol for decrease of intracranial pressure,methylprednisolone and gamma globulin for immune regulation,circulatory support,ribavirin for anti-virus and sedation were provided.Rectal temperature after 2 h,time of heart rate within 160/min,time of systolic blood pressure in the normal range,incidence of pulmonary hemorrhage and mortality rate were compared in two groups.Results Rectal temperature after 2 h,time of heart rate within 160/min and time of systolic blood pressure in 80-110 mmHg in the mild hypothcrmia group had obvious advantage than that in the control group respectively.Incidence of pulmonary hemorrhage in the mild hypothcrmia group was 0.00%,with 9.62% in the control group,at the fourth stage of the disease,mortality rate in the mild hypothermia group was 25.00%,with 7.84% in the control group （both P〈0.05）.Conclusion Mild hypothcrmia has great advantages on temperature dropping,heart rate decreasing and circulation improving etc.in severe hand-foot-and-mouth diseases,which is worthy of further promotion and application in clinic.
出处
《中国当代医药》
2016年第21期63-65,共3页
China Modern Medicine
关键词
危重症手足口病
亚低温
高热
循环衰竭
肺出血
Severe hand-foot-and-mouth disease
Mild hypothcrmia
High fever, Circulatory failure
Pulmonary hemorrhage
