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[目的]探讨重症手足口病(Hand foot mouth disease,HFMD)的流行特征与临床分析,及早发现危重症,提高抢救成功率,降低病死率。[方法]分析聊城市人民医院2009年3～8月收住院的487例重症手足口病的流行特征及临床特点。总结重症患儿的特点及降低病死率的方法。[结果]发病特点以4岁以内为多,病死率及死亡率高。重症患儿常有易惊、四肢抖动、惊厥、昏迷、皮肤有皮疹或大理石纹、四肢发凉、发热时间长、心率快、血压高、WBC高、血糖高、血乳酸高。有上述重症表现有向危重症转化的可能,应尽早机械通气。[结论]HFMD重症患儿高热﹥3d、WBC﹥12.8×109/L、血糖﹥9.8mmol/L、血乳酸﹥3.2mmol/L,表示有转化为危重症的可能,应住ICU,早期机械通气降低患儿死亡率。
[Objective] To explore the epidemiological characteristics and clinical analysis of severe foot-foot-mouth disease (HFMD), early detection of critically ill patients, improve the success rate of rescue and reduce the mortality rate. [Methods] The prevalence and clinical features of 487 severe hand-foot-mouth disease admitted to Liaocheng People’s Hospital from March to August in 2009 were analyzed. Summarize the characteristics of critically ill children and reduce mortality. [Results] The incidence characteristics of more than 4 years old, high mortality and mortality. Children with severe panic often easy to shock, limbs jitter, convulsions, coma, skin rash or marbling, cold limbs, fever, long time, fast heart rate, high blood pressure, high WBC, high blood sugar, high blood lactate. The above-mentioned severe manifestations may be transformed into critically ill patients, mechanical ventilation should be as soon as possible. [Conclusion] HFMD patients with severe HFMD severe fever> 3d, WBC> 12.8 × 109 / L, blood glucose> 9.8mmol / L, blood lactate> 3.2mmol / L, indicating the possibility of conversion to critical illness should live in ICU, early mechanical ventilation Reduce child mortality.