手足口病分组管理分级治疗164例临床分析  

Clinical analysis of category management and grading treatment in 164 children with hand-foot-mouth disease

作　　者：潘瑞英[1] 肖健楠[1] Pan Ruiying;Xiao Jiannan(Department of Pediatrics,181st Hospital of Chinese PLA,Guilin,Guangxi 541002,China)

机构地区：[1]解放军第一八一医院妇幼中心,广西桂林541002

出　　处：《感染．炎症．修复》2018年第1期19-22,共4页Infection Inflammation Repair

摘　　要：目的:分析不同病情程度手足口病患儿的临床特点,探讨采用病情分组、监护分类、治疗分级的救治方案在手足口病疫情爆发时临床应用中的效果。方法:回顾性分析2010年手足口病疫情爆发时164例住院手足口病患儿的临床资料,根据有无神经系统和其他并发症及其程度,将其分为3型4组,即普通型A组,重型B组、C组和危重型D组。各组给予不同级别的监护和治疗,分析各型性别、年龄分布,临床表现、实验室检查、疗效及预后。结果:手足口病患儿以3岁以下儿童居多(123例,占75%)。除发热和皮疹是常见症状外,89.9%(116/129例)的重症患儿出现四肢抖动;普通型、重型、危重型手足口病患儿在性别、年龄、白细胞计数、肌酸激酶同工酶、C反应蛋白上差异均无统计学意义(P>0.05);普通型与重型、危重型患儿血糖水平存在统计学差异(P<0.05);全部患儿均治愈,其中D组1例遗留神经系统后遗症。结论:四肢抖动是手足口病患儿神经系统受累最常见的表现,重型和危重型患儿的血糖水平较普通型患儿更高。采用病情分组、监护分类、治疗分级的救治方法,可及时发现重症病例并阻止其病情向危重型进展,具体有较好的临床效果。Objective:To analyze the clinical characteristics of children with hand-foot-mouth disease(HFMD),and explore the effects of the strategy of grouping according to patient’s condition,caring according to the disease category and treatment for different grade of the disease when HFMD break out.Methods:Data of 164 HFMD cases were retrospective analyzed and divided into four types(A,B,C and D type)and three groups(group A,group B+C,group D)according to the complications,especially nervous system manifestation,and severity of disease.Different levels of care and treatment were given to corresponding groups,and the sex and age distribution,clinical manifestations,laboratory examinations,curative effect and prognosis were analyzed of each group.Results:Children aged<3 years were the majority in the HFMD patients,accounted for 75%(123 cases).Fever and erythra were the common symptoms,and 89.9%(116/129 cases)severe HFMD cases had myoclonic jerk of limbs.There was no statistical significance among the different groups in sex,age,white blood cell count,creatine kinase MB and C-reactive protein(P>0.05).But statistical significance existed in blood sugar levels between group A and group B+C or group D(P<0.05).All patients were cured finally and only one case in group D got neurological sequela.Conclusions:Myoclonic jerk of limbs is the common symptom of nervous system involvement.Children with severity HFMD have higher level of blood sugar than those with common type HFMD.Treatment of grouping according to patient's condition,caring according to the disease category and treatment for different grade of the disease might have advantages to detect timely and prevent effectively the disease to be worsening,and have a better clinical effect.

关 键 词：手足口病 病情分组 监护分类 治疗分级 

分 类 号：R725.1[医药卫生—儿科]