169例并发神经系统损害的手足口病患儿的临床特点及危险因素分析雷且且审胜绉本地  

The Clinical Features of 169cases of Hand-foot-mouth Disease Complicated with Nervous System Damage and the Analysis for its Risk Factors

作　　者：霍丹丹[1] 宋保德[1] 李浩[1] HUO Dan-dan,SONG Bao-de,LI Hao （Department of Infectious Diseases ,the People＇s Hospital of sihong,Sihong 223900,China）

机构地区：[1]泗洪县人民医院感染科,江苏泗洪223900

出　　处：《医学信息》2011年第23期255-256,共2页Journal of Medical Information

摘　　要：目的分析手足口病患儿（Hand—foot—mouthdisease，HFMD）并发神经系统损害的临床特点，探讨其危险因素。方法分析我院自2008年1月至2011年8月所收治2100例HFMD资料，总结临床特点，并采用Logistic回归分析危险因素。结果2100例手足口病患儿中并发神经系统损害的HFMD患儿共169例（8．04％），男女性别比207：1。平均年龄（16±04）岁，略低于普通的HFMD患儿（P〈005），高热发生率为899％，高于普通的HFMD患儿（P〈0.05）。患儿神经损害的临床症状有精神差、呕吐、易惊、嗜睡、查体多有颈抵抗、少数出现头痛、肢体抖动、肌阵挛等。在169例有神经系统损害患儿中，外周血白细胞（WBC）升高者为124例，降低11例，末梢血糖（GLU）异常这为56例，均要高于普通的HFMD患儿（P〈0．05）。死亡1例，遗留左上肢无力2例。危险因素分析显示患儿年龄小，由爷爷奶奶或其他人（非父母亲）照看、家庭月平均收入低．是HFMD并发神经系统损害的独立危险因素。结论并发神经系统损害的手足口病患儿有一定的临床特点．年龄较小的手足口病患儿，当出现高热、易惊、呕吐，肢体抖动时，要高度怀疑并发神经系统损害；而对于年龄越小、平时由爷爷奶奶或其他人（非父母亲）照看、家庭月平均收入低这类患儿．更应该引起足够重视。Objective To summarize the clinical features ofhand-foot-mouth disease （HFMD）complicated with central nervous systemdamageo and analysis its risk factot＇s. Methods We summarized the clinical features by retrospective analysis of 2100 cases of HFMD in our hospital.as well as risk factors analysis by Logistic regression. Results A total of 169 children complicated with central nervous system damage in 1931 HFMD patents （8.04%）.The sex ratio was 2.1 ：l.The average age was （1.6±0.4） year,lower than normal HFMD patients （P〈0.05）.Heat rate was 89.9%.higherthan normal HFMD patients （P〈0.05）.The typical symptoms of nervous system damagewere vomiting , headache,easily frightened,lethargy,neck resistance, body shake ,myoelonus,weakness or paralysis and ataxia and so on.124 children have abnormal white blood cell count,56 children have higher blood sugar. which were higher than normal HFMD children（P〈0.05）.166 cases were cured,2 cases left over the left upper limb weakness, 1 patients died of cardiac arrest.Mortality is also higher than normal HFMD patients （P〈0.05）.Risk factor analysis showed that the smaller children.Usually grandparents care.low average monthly household income,are the independent risk factor for central nervous system damage in HFMD.Conelusion HFMD children with high fever,in a daze,shaking time are suspected to be a high degree of central nervous system damage;smaller age of months,cared by grandparents,low income families are the independent risk factor for central nervous system damage inHFMD.whieh should be paid more attention to.

关 键 词：手足口病 神经系统损害 临床特点 危险因素 

分 类 号：R593.241[医药卫生—临床医学;医药卫生—内科学]