本文選題：手足口病 + 心肺衰竭　； 參考：《臨床兒科雜志》2017年04期

【摘要】：目的分析重癥手足口病(HFMD)并發(fā)心肺衰竭患兒的臨床及流行病學(xué)特點(diǎn),并尋找重癥相關(guān)危險(xiǎn)因素。方法回顧分析2014年1月至2014年12月因手足口病住院,且臨床分期為2期及以上患兒的臨床資料。結(jié)果共入選321例重癥手足口病住院患兒,普通組(臨床分期2期)306例,無死亡病例;心肺衰竭組(臨床分期3、4期)15例,7例死亡,兩組病死率差異有統(tǒng)計(jì)學(xué)意義(P0.001)。心肺衰竭組中位年齡9個月(6~20月齡),低于普通組的24月齡(3月齡~12歲),差異有統(tǒng)計(jì)學(xué)意義(P0.01)。心肺衰竭組患兒熱峰(39.44±0.23)℃、熱程(5.01±0.94)d,高于普通組的(39.12±0.20)℃、(3.93±0.47)d,差異有統(tǒng)計(jì)學(xué)意義(P均0.05)。心肺衰竭組嘔吐、意識障礙、外周循環(huán)障礙、呼吸節(jié)律不齊以及肺水腫的發(fā)生率均高于普通組,差異有統(tǒng)計(jì)學(xué)意義(P均0.001)。心肺衰竭組腸道病毒71型(EV71)陽性率85.7%,高于普通組的61.4%,差異有統(tǒng)計(jì)學(xué)意義(P0.01);心肺衰竭組N末端腦鈉肽前體(NT-pro BNP)水平均增高(100.0%),普通組35.3%增高,差異有統(tǒng)計(jì)學(xué)意義(P0.001)。結(jié)論兒童HFMD出現(xiàn)嘔吐、意識障礙、循環(huán)障礙、呼吸節(jié)律紊亂,以及EV71陽性和NT-pro BNP水平升高,存在發(fā)生心肺衰竭的風(fēng)險(xiǎn),需重點(diǎn)監(jiān)測病情變化。
[Abstract]:Objective to analyze the clinical and epidemiological characteristics of severe HFMD complicated with heart and lung failure and to find out the risk factors of severe HFMD. Methods from January 2014 to December 2014, the clinical data of children with hand-foot-mouth disease were retrospectively analyzed. Results A total of 321 hospitalized children with severe hand-foot-mouth disease were enrolled in this study. There were 306 cases in the general group and 7 cases in the group of cardiopulmonary failure (15 cases died in stage 3 or 4). The difference of mortality between the two groups was statistically significant (P 0.001). The median age of cardiopulmonary failure group was 9 months and 20 months, which was lower than that of 24 months old and 3 months old and 12 months old. The difference was statistically significant (P 0.01). In the heart and lung failure group, the heat peak temperature was 39.44 鹵0.23 鈩，

本文編號：1906359