摘要回顾性分析120例手足13病重症病例的早期临床特征,并与普通病例进行比较.结果 显示,120例重症病例发病主要集中在1～3岁,持续高热(55%)、血压升高(40%)、皮疹稀少(73.3%)是早期重要临床特征;精神萎靡及嗜睡或哭闹(70.8%)是重症病例早期即有的神经精神症状;肢体抖动或肌阵挛(80.0%)、呕吐(30.8%)是其早期中枢神经系统受累表现;血白细胞升高(75.8%)和血糖升高(32.5%)是早期诊断手足13病重症病例的重要检测指标.以上特征与手足口病普通病例相比较均有统计学意义(P<0.01或<0.05).通过20%甘露醇、静脉丙种球蛋白、糖皮质激素为主的早期治疗,患儿无一例死亡,未见不良反应.

abstractsThe clinical features of 120 severe cases with hand-foot-mouth disease (HFMD) were retrospectively analyzed compared with those of the regular cases. Clinical data showed that the age of mostsevere cases ranged from 1-3 years. Sustained high fever ( 55% ) , hypertension ( 40% ) , fewer rash (73.3%) were important clinical features. Lethargy, somnolence or restlessness (70. 8% ), vomiting (30. 8% ) were early signs of central nervous system ( CNS) ; and the CNS involvement in severe cases was characterized by body trembling or muscle spasm (80% ). High white cell count(75. 8% ) and high blood glucose levels(32. 5% ) were important makers to diagnose the severe HFMD at early stage. There were significant differences in presentation of above features between severe cases and regular cases of HFMD ( P < 0. 01 or P < 0. 05 ) . Early treatment with mannitol, gamma globulin and glucocorticoids were effective, no death was reported and no side effects were found in this case series.