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收集2009年1~10月在聊城市传染病医院住院的手足口病2234例完整资料,随机抽取轻症和重症各80例,回顾性分析手足口病流行中轻症与重症的差异,探讨早期鉴别重症患儿的包括临床症状、体征、血WBC、血糖、血清肌酸激酶同工酶(CK-MB)及X线胸片检测指标,采取积极干预和有效阻断措施及临床转归情况。结果重症组持续高热、呼吸心率增快、食欲不振显著、神经系统受累发生率较轻症组显著升高(P<0.05);重症组血WBC、CK-MB、血糖检测指标均显著高于轻症组(P<0.05);重症组X线胸片显示肺纹理明显增多模糊发生率显著高于轻症组(P<0.05)。重症组患儿采取有效阻断措施后治愈率97.5%,转ICU率2.5%,未出现死亡病例。提示早期发现高危因素,及时阻断病情向危重症转化是提高抢救成功率、降低死亡率的关键。
A total of 2234 cases of hand, foot and mouth disease hospitalized in Liaocheng Infectious Disease Hospital from January to October in 2009 were collected and 80 cases of mild and severe cases were randomly selected. The differences between mild and severe cases of hand, foot and mouth disease were retrospectively analyzed, Identify critically ill children, including clinical symptoms, signs, blood WBC, blood glucose, serum creatine kinase (CK-MB) and X-ray examination of indicators, to take active intervention and effective blocking measures and clinical outcome. Results Severe cases of persistent high fever, respiratory rate, loss of appetite significantly, the incidence of nervous system involvement was significantly higher than the mild group (P <0.05); severe group of blood WBC, CK-MB, blood glucose were significantly higher indicators of detection (P <0.05). The X-ray images of severe cases showed a significant increase in lung texture and the incidence of vagueness was significantly higher than that of mild cases (P <0.05). Severe group of children take effective blocking measures after the cure rate was 97.5%, ICU rate of 2.5%, did not appear to die. Prompted the early detection of risk factors, promptly blocked the transfer of the disease to critical illness is to improve the success rate of rescue and reduce the mortality of the key.