J4 ›› 2012, Vol. 11 ›› Issue (6): 61-63.

• 临床医学 • 上一篇    下一篇

重症手足口病合并脑干脑炎例临床分析

目的:总结重症手足口病合并脑干脑炎患儿的早期临床特点、救治经验和转归。方法:对52例重症HFMD合并脑干脑炎患
儿的临床资料进行回顾性分析。结果:本组52例重症手足口病合并脑干脑炎患儿发热38例(73.08%),精神萎靡40例(76.76%),
易惊46例(88.46%),肢体抖动36例(69.23%),步态不稳21例(40.38%),嗜睡31例(59.61%),膝反射亢进或消失25例(48.07%)。早
期积极予甘露醇、甲泼尼龙、丙种球蛋白等治疗,52例患儿全部达到临床治愈,未遗留神经系统后遗症。发现肺水肿前兆者尽早
给予机械通气。结论:EV71引起的HFMD发生重症脑干脑炎的机会高,持续高热、精神萎靡、易惊、肢体抖动、嗜睡、肢端凉是重症
HFMD合并脑干脑炎的早期判断神经系统受损的主要指标,早发现,早干预可降低本病病死率及减少后遗症的发生。   

  1. 大理学院玉溪教学医院,云南玉溪 653100
  • 收稿日期:2012-03-29 修回日期:2012-05-08 出版日期:2012-06-15 发布日期:2012-06-15
  • 作者简介:冯荣学,主治医师,主要从事儿科研究.

Clinical Analysis of 52 Cases of Severe Hand-Foot-Mouth Disease Complicated with Brainstem Encephalitis

  1. People's Hospital of Yuxi City, Yuxi, Yunnan 653100, China
  • Received:2012-03-29 Revised:2012-05-08 Online:2012-06-15 Published:2012-06-15

摘要:

目的:总结重症手足口病合并脑干脑炎患儿的早期临床特点、救治经验和转归。方法:对52例重症HFMD合并脑干脑炎患
儿的临床资料进行回顾性分析。结果:本组52例重症手足口病合并脑干脑炎患儿发热38例(73.08%),精神萎靡40例(76.76%),
易惊46例(88.46%),肢体抖动36例(69.23%),步态不稳21例(40.38%),嗜睡31例(59.61%),膝反射亢进或消失25例(48.07%)。早
期积极予甘露醇、甲泼尼龙、丙种球蛋白等治疗,52例患儿全部达到临床治愈,未遗留神经系统后遗症。发现肺水肿前兆者尽早
给予机械通气。结论:EV71引起的HFMD发生重症脑干脑炎的机会高,持续高热、精神萎靡、易惊、肢体抖动、嗜睡、肢端凉是重症
HFMD合并脑干脑炎的早期判断神经系统受损的主要指标,早发现,早干预可降低本病病死率及减少后遗症的发生。

关键词: 手足口病, 脑干脑炎, 早期临床表现

Abstract:

Objective: To summarize the early clinical characteristics, medical experience and prognosis of severe hand-foot-mouth
disease (HFMD)merger with brainstem encephalitis. Methods: Clinical data from 52 cases of severe HFMD merger with brainstem
encephalitis children were retrospectively analyzed. Results: There were 38 cases of fever (73.08 %), 40 cases of sluggishness
(76.76 %), 46 cases of bockigkeit(88.46 %), 36 cases of body shaking(69.23 %), 21 cases of instability gait(40.38 %), 31 cases
of sleepiness (59.61 %), and knee hyper-reflexia or disappear in 25 patients (48.07 %). With early and active use of mannitol,
methylprednisolone and intravenous immunoglobulin (IVIG), and early mechanical ventilation when found the pulmonary edema, all
52 cases of patients were clinically cured with no legacy of neurological sequelae. Conclusion: Severe HFMD caused by EV71 are
more likely complicated with brainstem encephalitis. High fever, sluggishness, bockigkeit, body shaking, sleepiness, cool extremities
are the major indicaters of the early damaged nerve system of severe HFMD merger with brainstem encephalitis. Early detection and
intervention can reduce disease mortality and occurrence of sequelae.

Key words: hand-foot-mouth disease, brainstem encephalitis, early clinical performance

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