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目的探讨儿童重症手足口病的临床特点及危险因素。方法回顾性分析2012年9月至10月收治的70例确诊重症手足口病患儿的临床资料。结果70例患儿中，年龄20.0×109/L ,2例（2.8%），>12×109/L ,12例（17.1%），血糖升高21例（30%），脑脊液白细胞增高65例（92.8%）X胸片示单、双侧肺野见渗出39例（55.7%），肺水肿1例（1.4%），肺出血1例（1.4%）。脑电图异常48例（68.5%）。头颅C T：双侧大脑半球脑沟回增宽、加深25例（35.7%），2例行头颅M R I检查,1例示：延髓、右侧颞叶异常信号，考虑脑软化。1例示侧脑室旁白质异常信号。大便病原学检查：EV71型阳性43例（61.4%），CA16阳性9例（12.8%）。其他肠道病毒11例（15.7%），阴性7例（10%）。70例患儿均予甘露醇脱水，43例血压高、心率快患儿均予米力农强心，酚妥拉明降血压治疗，其中24例用酚妥拉明控制血压不满意后改为硝普钠降血压，2例行气管插管机械通气治疗。69例治愈出院，1例好转出院。结论<3岁、肠道病毒71型感染、持续发热、呕吐、肢体抖动、血压升高是重症手足口病的危险因素，尽早行腰穿查脑脊液明确有无中枢神经系统病变，积极脱水，控制血压是抢救成功的关键。“,”Objective To analyze the clinic features of children with severe hand-foot-mouth disease from September to October in 2012 in our department to investigate some risk factors with fatal case. Method Al the clinic records and laboratory results of serious patients were col ected. A retrospective study was performed.Result A total 70 serious patients were enrol ed into this study. Al these patients had encephalitis,and 81.4% patients age under 3 years. Fever ,vomiting,and myoclonus were the most frequent symptoms occurred in those serious cases.Hypertension was found to be high risk factor.43(61.4%)cases had hypertension. [(124±9)/(77±10) mm Hg (1 mm Hg=0.133 kPa)].The laboratory confirmed EV17 positive cases were 61.4%.Conclusion Clinicians should give importance to the risk factors.Early recognition of children at risk and timely intervention is the key to reduce acute mortality and morbidity.