手足口病重症病例的早期临床特征分析  

Early clinical features of severe cases with hand-foot-mouth disease

作　　者：阎振武[1] 陈建红[1] 李淑花[1] 高海英[1] 王万鹏[1] 于贤杰[1] 

机构地区：[1]潍坊市人民医院传染科,山东261041

出　　处：《中华全科医师杂志》2011年第5期343-345,共3页Chinese Journal of General Practitioners

摘　　要：回顾性分析120例手足口病重症病例的早期临床特征，并与普通病例进行比较。结果显示，120例重症病例发病主要集中在1～3岁，持续高热（55％）、血压升高（40％）、皮疹稀少（73．3％）是早期重要临床特征；精神萎靡及嗜睡或哭闹（70．8％）是重症病例早期即有的神经精神症状；肢体抖动或肌阵挛（80．0％）、呕吐（30．8％）是其早期中枢神经系统受累表现；血白细胞升高（75．8％）和血糖升高（32．5％）是早期诊断手足口病重症病例的重要检测指标。以上特征与手足口病普通病例相比较均有统计学意义（P〈0．01或〈0．05）。通过20％甘露醇、静脉丙种球蛋白、糖皮质激素为主的早期治疗，患儿无一例死亡，末见不良反应。The clinical features of 120 severe cases with hand-foot-mouth disease （HFMD） were retrospectively analyzed compared with those of the regular cases. Clinical data showed that the age of most severe cases ranged from 1 - 3 years. Sustained high fever （ 55% ）, hypertension （ 40% ）, fewer rash （73. 3% ） were important clinical features. Lethargy, somnolence or restlessness （ 70. 8% ）, vomiting （30. 8% ） were early signs of central nervous system （CNS） ; and the CNS involvement in severe cases was characterized by body trembling or muscle spasm （ 80% ）. High white cell count （ 75.8% ） and high blood glucose levels（32. 5% ）were important makers to diagnose the severe HFMD at early stage. There were significant differences in presentation of above features between severe cases and regular cases of HFMD （ P 〈 0. 01 or P 〈 0. 05 ）. Early treatment with mannitol, gamma globulin and glucocorticoids were effective, no death was reported and no side effects were found in this case series.

关 键 词：手足口病 诊断 

分 类 号：R725.1[医药卫生—儿科]