手足口病死亡案例临床病理分析及预防保健措施  

Clinicopathological analysis and health preventive measures of hand-foot-mouth disease

作　　者：陈宇[1] 朱惠琴 徐广涛[3] 潘晓燕[3] 林雪平[3] 

机构地区：[1]嘉兴市妇幼保健院儿保科,浙江嘉兴314000 [2]平湖市妇幼保健所儿保科,浙江嘉兴314200 [3]嘉兴学院医学院病理教研室,浙江嘉兴314000

出　　处：《温州医学院学报》2013年第6期394-397,共4页Journal of Wenzhou Medical College

摘　　要：目的:探讨手足口病(HFMD)死亡患儿各脏器的病理特点,分析其死亡原因,结合流行病学特征,探讨保健预防措施。方法:对嘉兴市3例HFMD死亡病例做尸体解剖,分析主要脏器的病理改变与临床症状和体征的关系,探讨导致患儿死亡的病变基础及预防措施。结果:危重型HFMD临床症状典型,病变主要累及脑干的延髓部分和肺。延髓病理改变表现为神经细胞变性坏死、软化灶形成、血管周围淋巴细胞浸润和噬神经细胞现象,呈病毒性脑炎改变;肺呈严重病毒性肺炎和急性肺水肿的病理改变;淋巴结和脾脏的结构遭破坏。结论:危重型HFMD导致肺部的严重病变及延髓的损伤,引起呼吸循环中枢衰竭,是患儿死亡的直接原因。加强HFMD的健康宣传教育和行为干预,消除或减轻危险因素,及早诊治,是控制危重型HFMD发生的关键。Objective： To investigate the pathological features of the various organs of hand-foot-mouth disease （HFMD） patients, and to analyze the causes of death, then to explore health precautions. Methods： There were three death cases of HFMD. The pathological changes of main organs were analyzed through autopsy. The relationship between the pathological changes and clinical symptoms and signs was explored. Results： Pathological changes showed the nerve cell degeneration and necrosis, perivascular infiltration of lymphocytes and macrophages nerve cells phenomenon in the medulla oblongata of brainstem, which were viral encephalitis changes. The pathological changes of the lung were severe viral pneumonia and acute pulmonary edema. The structures of the lymph nodes and spleen were damaged. Conclusion： Critical type of HFMD can induce lung and medulla oblongata injury. Respiratory and circulatory failure is the direct cause of the patient＇s death. Therefore, strength- ening of health education and behavioral intervention, eliminating or reducing risk factors, early diagnosis and treatment are the key to control critical type of HFMD.

关 键 词：手足口病 病理 尸体解剖 预防保健 

分 类 号：R361[医药卫生—病理学]