Clinical treatment analysis of 142 critical cases of severe hand-foot-mouth disease

Abstract

Objective To investigate the clinical characterics of critical hand-foot-mouth disease (HFMD),and to provide basis for clinical diagnosis and treatment.Methods The clinical data of 142 cases of critical HFMD in 558 cases hospitalized children with severe HFMD were retrospectively analyzed admitted in our hospital from June to October in 2011 were retrospectively analyzed admitted.Results Through the active and effective treatment,141 patients(including 2 cases with acute flaccid paralysis)were cured and discharged from hospital except 1 patients with pulmonary hemorrhage after admission for less than 10 hours,by mechanical ventilation for 60 hours,pulmonary hemorrhage had stopped,but the children persisted with the status of high fever and coma,the parents abandoned treatment and automatically discharged from hospital.The stool specimens RT-PCR detection and nucleic acid sequencing of the 141 cases showed:129 cases were positive,in which EV71 were 125 cases,CoxA16 were 4 cases.Conclusions The cendition of patients with critical HFMD were critical,and it is a serious threat to the health of children.It was important to early diagnose and treatment of critical HFMD.In the study,patients all suffered from hypertension,and were actively given phentolamine and small part of sodium nitroprusside depressor therapy,then hypertension was controled,the neurogenic pulmonary edema was actively treated,and the success rate of rescue was improved.Only 13 cases obtained ventilator therapy.The curative effect was satisfactory.Early detection,diagnosis and treatment of critical HFMD can reduce the intravenous immunoglobulin treatment and application of mechanical ventilation and improve the cure rate and reduce the sequelae. Key words: Hand-foot and mouth disease; Critical case; Hypertension; Neurogenic pulmonary edema; Therapy