目的 探讨早期识别神经系统受累重症手足口病的临床特点及早期干预方法.方法 对2010年6-10月我院50例神经系统受累重症手足口病患儿临床特征、治疗及预后情况进行回顾性分析.结果 50例患儿纳入研究,<3岁33例(66%);临床表现:发热50例(100%)、皮疹50例(100%);神经系统主要表现:精神差46例(92%)、惊跳39例(78%)、肢体抖动36例(72%)、呕吐25例(50%);实验室榆查:血白细胞增高21例(42%)、脑脊液白细胞增高33例(66%)、CRP增高12例(24%)、血糖增高10例(20%)、EV71阳性33例(66%);50例患儿经治疗后48例治愈,2例死亡.结论 精神差、惊跳、肢体抖动、呕吐为手足口病神经系统受累早期诊断依据,及时给予甘露醇降颅压、大剂量丙种球蛋白及甲基泼尼松龙早期干预可明显改善重症手足口病预后.%Objective To explore the clinical features and early intervention methods of severe hand, foot and mouth disease ( HFMD ) with neurological involvement. Methods The clinical features, treatment, and prognosis of severe HFMD with neurological involvement were retrospectively analyzed in 50 children who had been hospitalized during the period of June to October 2010. Results 33 of 50 children ( 66% ) were younger than 3. All of the children ( 100% ) had fever and rash. Fatigue occurred in 46 (92%) children, irritation in 39 ( 78% ), limb tremble in 36 ( 72% ), and vomiting in 25 ( 50% ).Blood leukocyte count increased in 21 patients ( 42% ), cerebrospinal fluid leukocyte count increased in 33 ( 66% ), CRP increased in 12 ( 24% ), blood sugar increased in 10 ( 20% ), and EV71 was positive in 33 ( 66% ). 48 children were cured after treatment and 2 were dead. Conclusions The symptoms of fatigue, irritation, limb tremble, and vomiting are the early support for diagnosing neurological complications caused by HFMD. Early intervention with mannitol, high-dose gamma globulin, and methylpred-nisolone can markedly improve the prognosis of severe hand, foot and mouth disease
展开▼
