本文選題：手足口病 + 腸道病毒71�。� 參考：《山東大學》2012年碩士論文

【摘要】：目的探討EV71型重癥手足口病(HFMD)并神經源性肺水腫(NPE)的臨床特點、頭顱MRI特征及死亡主要原因,提高重型HFMD患者治愈率和生存率。 方法收集我院2008-2011年確診EV71型重癥HFMD的56例患兒的臨床資料,將其分為存活組及死亡組,兩組患兒均行胸部X線檢查,并進行血常規(guī)、生化、心肌酶及腦脊液檢查,存活組在病情平穩(wěn)的情況下均行顱腦MRI檢查。對兩組病例的性別比例、發(fā)病年齡、發(fā)病至機械通氣的時間、入院至機械通氣的時間、所出現(xiàn)的臨床表現(xiàn)及實驗室檢查結果分別進行統(tǒng)計學整理分析。對兩組病情動態(tài)變化、治療及轉歸情況進行統(tǒng)計學比較分析。 結果與轉歸對兩組病例的性別比例及發(fā)病年齡進行統(tǒng)計分析(P0.05),無明顯統(tǒng)計學差異。兩組患兒起病至機械通氣時間比較(P0.05),無明顯統(tǒng)計學差異；而入院至機械通氣時間比較(P0.05),差異具有統(tǒng)計學意義。對兩組患兒所出現(xiàn)的臨床表現(xiàn)分別進行χ2檢驗,其中臨床表現(xiàn)為眼球異常運動、昏迷、呼吸節(jié)律改變、咳粉紅色泡沫痰、肺內濕Up音、心率≥200次/分、口周發(fā)紺、皮膚花紋的病例比較(P均0.05),表明兩組病例的上述臨床表現(xiàn)有統(tǒng)計學差異。對兩組病例的外周血白細胞計數、血生化、心肌酶及腦脊液檢查分別進行χ2檢驗,P值均0.05,表明兩組病例的上述實驗室檢查結果無明顯差異。兩組患兒X線胸片檢查均呈明顯肺水腫表現(xiàn),存活組患兒顱腦MRI檢查均提示有腦干腦炎、腦軟化灶改變。存活組患兒經機械通氣30min～6h內肺部Up音明顯減少或消失,機械通氣時間21h～36d,成功脫機。死亡組患兒均于機械通氣0.5～72h后死亡 結論NPE是臨床急癥,對出現(xiàn)神經系統(tǒng)損害的HFMD患者,應密切注意病情變化,及早發(fā)現(xiàn)NPE的早期癥狀和體征,分秒必爭地進而進行有效的藥物治療,及時應用機械通氣,才能減少死亡率
[Abstract]:Objective to investigate the clinical features, cranial MRI features and main causes of death of EV71 type severe HFMD with neurogenic pulmonary edema, and to improve the cure rate and survival rate of severe HFMD patients. Methods the clinical data of 56 children with EV71 type HFMD diagnosed in our hospital from 2008 to 2011 were collected and divided into survival group and death group. The patients in both groups underwent chest X-ray examination, blood routine examination, biochemical examination, myocardial enzyme examination and cerebrospinal fluid examination. In the survival group, craniocerebral MRI was performed under the condition of stable condition. The sex ratio, the age of onset, the time from onset to mechanical ventilation, the time from admission to mechanical ventilation, the clinical manifestations and the results of laboratory examination were analyzed statistically. The dynamic changes, treatment and outcome of the two groups were compared and analyzed statistically. Results the sex ratio and onset age of the two groups were statistically analyzed (P 0.05), and there was no significant difference between the two groups. There was no significant difference between the two groups in the time from onset to mechanical ventilation (P 0.05), but the time from admission to mechanical ventilation was significantly higher than that from admission to mechanical ventilation (P 0.05). The clinical manifestations of the two groups were tested by 蠂 2. The clinical manifestations were abnormal movement of eyeball, coma, change of respiratory rhythm, cough of pink foam phlegm, voice of up in lung dampness, heart rate 鈮，

本文編號：1880904