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

【摘要】：目的探討EV71型重癥手足口病(HFMD)并神經(jīng)源性肺水腫(NPE)的臨床特點(diǎn)、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(jìn)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(duì)兩組病例的性別比例、發(fā)病年齡、發(fā)病至機(jī)械通氣的時(shí)間、入院至機(jī)械通氣的時(shí)間、所出現(xiàn)的臨床表現(xiàn)及實(shí)驗(yàn)室檢查結(jié)果分別進(jìn)行統(tǒng)計(jì)學(xué)整理分析。對(duì)兩組病情動(dòng)態(tài)變化、治療及轉(zhuǎn)歸情況進(jìn)行統(tǒng)計(jì)學(xué)比較分析。 結(jié)果與轉(zhuǎn)歸對(duì)兩組病例的性別比例及發(fā)病年齡進(jìn)行統(tǒng)計(jì)分析(P0.05),無(wú)明顯統(tǒng)計(jì)學(xué)差異。兩組患兒起病至機(jī)械通氣時(shí)間比較(P0.05),無(wú)明顯統(tǒng)計(jì)學(xué)差異；而入院至機(jī)械通氣時(shí)間比較(P0.05),差異具有統(tǒng)計(jì)學(xué)意義。對(duì)兩組患兒所出現(xiàn)的臨床表現(xiàn)分別進(jìn)行χ2檢驗(yàn),其中臨床表現(xiàn)為眼球異常運(yùn)動(dòng)、昏迷、呼吸節(jié)律改變、咳粉紅色泡沫痰、肺內(nèi)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(jì)學(xué)差異。對(duì)兩組病例的外周血白細(xì)胞計(jì)數(shù)、血生化、心肌酶及腦脊液檢查分別進(jìn)行χ2檢驗(yàn),P值均0.05,表明兩組病例的上述實(shí)驗(yàn)室檢查結(jié)果無(wú)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(jīng)機(jī)械通氣30min～6h內(nèi)肺部Up音明顯減少或消失,機(jī)械通氣時(shí)間21h～36d,成功脫機(jī)。死亡組患兒均于機(jī)械通氣0.5～72h后死亡 結(jié)論NPE是臨床急癥,對(duì)出現(xiàn)神經(jīng)系統(tǒng)損害的HFMD患者,應(yīng)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(zhēng)地進(jìn)而進(jìn)行有效的藥物治療,及時(shí)應(yīng)用機(jī)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(hào)：1880904