中国当代儿科杂志Issue(3)：249-253,5.DOI:10.7499/j.issn.1008-8830.2015.03.010
需机械通气的危重症手足口病患儿临床特点及预后因素分析
Clinical characteristics and prognostic factors of children with critical hand-foot-mouth disease treated with mechanical ventilation
刘瑞海 1李晶 1曲先锋 1徐迎军 1曲妮燕 1冯向春1
作者信息
- 1. 青岛市妇女儿童医院重症监护病房，山东 青岛 266034
- 折叠
摘要
Abstract
ObjectiveTo investigate the clinical characteristics of children with critical hand-foot-mouth disease (HFMD) who were treated with mechanical ventilation and to explore the risk factors for poor prognosis.Methods The clinical data of 63 children with critical HFMD who were admitted to the pediatric intensive care unit between April 2012 and September 2013 and needed mechanical ventilation were retrospectively analyzed.ResultsAmong the 63 children, 43 were boys and 20 were girls, and their mean age was 25±18 months, with 81% under 3 years old. The four death cases were all under three years old. Compared with the cured cases, the death cases had a signiifcantly lower mean age (8±3 months vs 25±18 months;P<0.05). Poor peripheral circulation above the elbow or knee joint, pulmonary edema involving at least two thirds of the lung ifeld, and pulmonary hemorrhage were all closely related to death (P<0.01). The death cases and cured cases had signiifcantly different peripheral white blood cell counts, blood lactic acid, and blood glucose (24±11×109/L vs 12±5×109/L; 6.6±1.8 mmol/L vs 3.6±1.7 mmol/L; 16.4±2.5 mmol/L vs 10.0±3.0 mmol/L). The cases with critical illness score <90 had a signiifcantly higher death risk (P<0.01).ConclusionsChildren with critical HFMD are mainly under 3 years old. The children face extremely high risk of death when they suffer from poor peripheral circulation above the elbow or knee joint, pulmonary edema involving at least two thirds of the lung ifeld, and pulmonary hemorrhage. Signiifcant increases in peripheral white blood cell counts, blood lactic acid, and blood glucose are risk factors for poor prognosis. Critical illness score is also related to poor prognosis.关键词
手足口病/肠道病毒71型/机械通气/临床特点/预后/儿童Key words
Hand-foot-mouth disease/Enterovirus 71/Mechanical ventilation/Clinical characteristics/Prognosis/Child引用本文复制引用
刘瑞海,李晶,曲先锋,徐迎军,曲妮燕,冯向春..需机械通气的危重症手足口病患儿临床特点及预后因素分析[J].中国当代儿科杂志,2015,(3):249-253,5.
