發(fā)布時(shí)間：2018-05-23 12:13

  本文選題：普通手足口病 + 重癥手足口病��； 參考：《重慶醫(yī)科大學(xué)》2012年碩士論文

【摘要】：目的：探討不同類型手足口病臨床特征差異，以早期識(shí)別重癥及危重癥手足口病，及時(shí)治療，防止并發(fā)癥，，改善預(yù)后。 方法：以2011年3-9月重慶醫(yī)科大學(xué)附屬兒童醫(yī)院收治的626例手足口病為研究對(duì)象，其中普通手足口病102例、重癥手足口病499例、危重癥手足口病25例，采用卡方檢驗(yàn)（或秩和檢驗(yàn)）比較普通組、重癥組、危重癥組在臨床特征方面的差異。 結(jié)果：各型手足口病在年齡和性別構(gòu)成比上無(wú)顯著差異，均好發(fā)于三歲以下男性兒童，危重癥組中年齡小于3歲（80%）所占比例比重癥組（67。9%）及普通組（67。7%）高。危重癥死亡率（40%）顯著高于重癥及普通組。重癥組持續(xù)高熱（體溫≥39℃或發(fā)熱時(shí)間≥3天）、嘔吐、神萎、嗜睡或昏睡、驚跳、肢體抖動(dòng)、無(wú)力、抽搐、頸阻陽(yáng)性發(fā)生率顯著高于普通組；危重癥組持續(xù)高熱、不典型皮疹、神萎、昏迷、煩躁、反復(fù)抽搐、瞳孔改變、頸阻陽(yáng)性、肌張力改變（增高或降低）、巴氏征陽(yáng)性、氣促、呼吸困難、呼吸節(jié)律改變、肺部羅音、心率增快(心率≥160次/分)、心音改變、末梢循環(huán)改變率顯著高于重癥組。輔助檢查方面，重癥組及危重癥組糞便腸道病毒EV71檢出率均顯著高于普通組；危重癥組血糖（血糖≥10mmol/L）及白細(xì)胞（WBC≥16×109/L）顯著增高、肝功能異常發(fā)生率、腦電圖陽(yáng)性率、腦MRI陽(yáng)性率、腦CT陽(yáng)性率、胸片滲出性改變顯著高于重癥組。 結(jié)論：對(duì)臨床診斷的手足口病患兒，應(yīng)盡快完善手足口病病原學(xué)檢查，高度重視小于3歲、持續(xù)高熱、皮疹不典型、EV71感染的患兒，密切觀察有無(wú)驚跳、肢體抖動(dòng)、無(wú)力等神經(jīng)系統(tǒng)受累表現(xiàn)，同時(shí)監(jiān)測(cè)呼吸、心率、末梢循環(huán)等生命體征，早期完善外周血白細(xì)胞計(jì)數(shù)、血糖、胸片檢查，必要時(shí)做腦電圖及頭顱影像學(xué)檢查，有助于早期發(fā)現(xiàn)重癥、危重癥患兒，積極治療，改善預(yù)后。
[Abstract]:Objective: to explore the difference of clinical characteristics of different types of hand, foot and mouth disease in order to identify severe hand, foot and mouth disease in early stage, treat it in time, prevent complications and improve prognosis. Methods: from March to September 2011, 626 cases of hand, foot and mouth disease, including 102 cases of hand, foot and mouth disease, 499 cases of severe hand, foot and mouth disease and 25 cases of critical hand, foot and mouth disease, were studied. Chi-square test (or rank sum test) was used to compare the clinical characteristics of common group, severe group and critical group. Results: there was no significant difference in age and sex composition of all types of hand, foot and mouth diseases, which occurred in male children under three years of age, and the proportion of patients with severe diseases younger than 3 years old was higher than that of patients with severe hand, foot and mouth diseases (67.9%) and 67.7% (normal group). The critical death rate was significantly higher than that in the severe group and the general group. The incidence of persistent high fever (body temperature 鈮

本文編號(hào)：1924676