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目的探讨重症手足口病(HFMD)病例的死亡原因。方法采用回顾性分析方法对本院收治的18例HFMD死亡病例的临床资料进行分析。结果本组病例年龄多小于3岁。患儿均有发热、呼吸困难和精神差,11例出现皮肤黏膜疹。血WBC升高18例(100%),AST升高10例(55.5%),ALT升高8例(44%),CK-MB升高7例(32.9%),LDH升高13例(61.1%),血糖升高17例(94.4%)。16例行脑脊液检查,其中14例有无菌性炎症改变。18例X线胸片示进展迅速的肺部渗出性病变。尸检3例,显示肺组织淤血、水肿、出血,支气管黏膜可见中性粒细胞浸润;中枢神经系统则表现为脑干、脑膜脑炎及脑水肿。结论早期识别并及时治疗HFMD重症病例,可明显降低其病死率。
Objective To investigate the causes of death in severe hand-foot-mouth disease (HFMD). Methods The clinical data of 18 HFMD death cases admitted to our hospital were analyzed retrospectively. Results The age of this group was less than 3 years old. Children have fever, poor breathing and mental retardation, skin rash in 11 cases. Blood WBC increased in 18 cases (100%), AST increased in 10 cases (55.5%), ALT increased in 8 cases (44%), CK-MB increased in 7 cases (32.9%), LDH increased in 13 cases (61.1 %), Elevated blood sugar in 17 cases (94.4%). 16 cases of cerebrospinal fluid examination, of which 14 cases of aseptic inflammation change. 18 cases of X-ray showed rapid progression of pulmonary exudative lesions. Autopsy in 3 cases, showing congestion, edema, hemorrhage, bronchial mucosa visible neutrophil infiltration; central nervous system is manifested as brainstem, meningoencephalitis and cerebral edema. Conclusion Early identification and timely treatment of HFMD severe cases, can significantly reduce the mortality.