摘要
目的总结危重型手足口病(HFMD)的临床诊治经验及病原学分析。方法选择昆明市儿童医院感染科2008年4月至2017年12月收治的HFMD患儿3452例,所有患儿均出现高血压症状,根据发病时间分为3组,A组12例,因对高血压认识不足,未给予降压治疗;B组1 257例,主要给予酚妥拉明治疗高血压;C组2183例,给予硝普钠治疗高血压。所有患儿均给予并发脑炎的常规治疗,2249例(65.15%)患儿加用静脉丙种球蛋白治疗。结果A组12例,上机11例(91.67%),死亡5例(41.67%);B组1257例,上机46例(3.66%),死亡13例(1.03%);C组2183例,上机35例(3.66%),死亡5例(0.23%)。病原以EV71为主。结论危重型HFMD的病原以EV71为主。HFMD患儿的高血压严重程度与病情呈正比。同时积极治疗高血压是抢救危重型HFMD最重要措施之一,是最大限度降低危重型HFMD病死率、致残率的关键。
Objective To summarize the clinical experience and etiological analysis of critical hand,foot and mouth disease(HFMD).Methods A total of 3 452 children with HFMD admitted to the Department of Infection of Children’s Hospital of Kunming from April 2008 to December 2017 were selected,all children expressed hypertension symptoms.According to the onset time of hypertension,all children were divided into 3 groups.Twelve children in group A did not receive antihypertensive treatment for insufficient knowledge of hypertension;1 257 children in group B were treated with phentolamine;2 183 children in group C were treated with valproate sodium for hypertension.All children were given routine treatment for encephalitis,and 2 249 children(65.15%)were treated with intravenous gamma globulin.Results Of the 12 children in group A,11 cases(91.67%)used ventilation and 5 cases(41.67%)died.Among the 1 257 children in group B,46 cases(3.66%)used ventilation,and 13 cases(1.03%)died.Thirty-five cases(3.66%)of 2 183 children in group C used ventilation,however,5 cases(0.23%)died.The pathogen mainly was EV71.Conclusions EV71 is the main pathogen of severe HFMD.The severity of hypertension in children with HFMD is positively correlated with their disease condition.At the same time,active treatment of hypertension is one of the most important measures to rescue severe HFMD,and is the key to minimize the mortality and disability rate of severe HFMD.
作者
杜曾庆
罗云娇
王美芬
甘泉
杜丽江
蒋鸿超
马薇
刘麟晶
Du Zengqing;Luo Yunjiao;Wang Meifen;Gan Quan;Du Lijiang;Jiang Hongchao;Ma Wei;Liu Linjing(Department of Infection,Kunming Children’s Hospital,Kunming 650034,China)
出处
《中国实用医刊》
2019年第9期9-12,共4页
Chinese Journal of Practical Medicine
基金
昆明市科技局重点项目(2017-1-S-15381).
关键词
儿童手足口病
危重型
高血压
病原学
治疗
Hand foot and mouth disease in children
Severe
Hypertension
Etiology
Treatment
