摘要目的 探讨无创正压通气在救治重症手足口病中的应用.方法 选择需呼吸支持的重症手足口病患儿进行无创正压通气治疗；对病情恶化、无创正压通气治疗效果不明显时,改气管插管机械通气治疗.结果 对74例需呼吸支持的重症手足口病患儿进行无创正压通气,治愈63例；11例无创正压通气失败后,改为机械通气治疗,10例治愈,1例放弃治疗.同期,直接采用气管插管机械通气治疗82例,71例治愈出院；8例合并呼吸机相关性肺炎患儿改无创通气,治愈出院；3例放弃治疗.结论 无创正压通气可以有效治疗重症手足口病,显著降低重症手足口病患儿的气管插管率、呼吸机相关性肺炎的发生和医疗成本,缩短平均住院日.

abstractsObjective To investigate the clinical effect of noninvasive positive pressure ventilation (NIPPV) on severe hand-foot-mouth disease (HFMD).Methods Noninvasive positive pressure ventilation was used to treat the cases of severe hand-foot-mouth that needed breath support; when the disease grew worse and noninvasive positive pressure ventilation was not effective,mechanical ventilation with tracheal intubation was used.Results Seventy-four cases of severe HFMD were treated with NPPV,of which 63 cases were cured ; 11 cases were treated with mechanical ventilation after the failure of NIPPV,of which 10 cases were cured,1 case gave up the treatment.Eighty-two cases were treated with mechanical ventilation combined with tracheal intubation directly,of which 71 cases were cured,8cases used NIPPV after complicated with ventilatior-associated pneumonia and were cured,3 cases gave up the treatment.Conclusions NIPPV can treat severe HFMD effectively,reduce the rate of intubation,ventilatior-associated pneumonia,medical care cost and shorten the mean hospitalization.