重症手足口病患儿中枢神经系统感染的临床分析  

Clinical analysis of children with severe hand-foot-mouth disease complicated with central nervous system infections

作　　者：申远方[1] 王芳[1] 乔平云[1] 

机构地区：[1]郑州市儿童医院感染性疾病科,河南郑州450053

出　　处：《中华医院感染学杂志》2014年第14期3610-3612,共3页Chinese Journal of Nosocomiology

基　　金：河南省科技攻关基金资助项目(200905056)

摘　　要：目的探讨重症手足口病并发中枢神经系统感染患儿的临床特点及其救治措施,为临床治疗重症手足口病患儿中枢神经系统感染提供依据。方法回顾性分析2012年2月-2013年2月医院收治的手足口病并发中枢神经系统感染患儿243例,对患儿的年龄、实验室检查、临床症状以及病程转归进行重点分析;采用SPSS 19.0对数据进行分析。结果 243例患儿发病年龄<3岁的患儿占83.95%;主要临床表现为发热、嗜睡、肢体抖动、易惊、皮疹、口腔疱疹等;经粪便及咽拭子病原菌检查,均为EV71病毒感染;69.14%患儿出现白细胞升高,93.00%出现脑脊液细胞数升高;治疗后232例患儿治疗效果较为理想,未出现后遗症,5例患儿死亡,病死率为2.06%。结论重症手足口病合并神经系统感染主要以<3岁儿童发病率较高,且男孩的发病率高于女孩,以精神差、易惊、肢体痉挛等为主要临床特征,及时发现和有效的治疗是减少病残率以及病死率的关键。OBJECTIVE To explore the clinical characteristics of the children with severe hand-foot-mouth disease（HFMD）complicated with central nervous system infections and propose treatment measures so as to provide guidance for clinical treatment of central nervous system infections in the children with severe HFMD.METHODS A total of 243HFMD children complicated with central nervous system infections who were treated in the hospital from Feb 2012to Feb 2013were retrospectively reviewed,then the age,laboratory examinations,clinical symptoms,and treatment outcomes were analyzed,and the statistical analysis was performed with the use of SPSS 19.0software.RESULTS Of the 243HFMD children complicated with central nervous system infections,83.95% were aged less than 3years old.The major clinical manifestations included the fever,lethargy,limb shaking,easily frightened,rash,and oral herpes.The results of culture of feces and throat swab showed that all the children were infected with EV71;leukocytosis occurred in 69.14%of the children,the increase of cerebrospinal fluid cell counts in 93.00%of the children.Totally 232children achieved ideal therapeutic effect,and the sequelae did no occur;5children died with the mortality rate of 2.06%.CONCLUSIONThe severe HFMD children with less than three years of age are the major population at high risk of central nervous system infections,and the incidence of the infections is higher in the males than in the females.The poor mental status,easily frightened,and limb spasms are the predominant clinical characteristics.It is the key to perform the diagnosis and effective treatment in a timely manner so as to minimize the morbidity as well as the mortality rate.

关 键 词：手足口病 中枢神经系统感染 临床特点 

分 类 号：R752[医药卫生—皮肤病学与性病学]