重症手足口病的早期识别

摘要

Objective To summarise the clinical characteristics of sever HFMD, and provide scientific evidences for later diagnosis and treatment of this disease. Methods The clinical data of hospitalized patients with HFMD from March to June of 2009 were analyzed retrospectively. Results Compared with mild cases of HFMD, the sever cases had longer total duration of fever(≥72h)(P<0.05) and smaller diameter of maculopapular(<3mm)(P<0.05). 24.71%of the patients with mild HFMD which had longer total duration of fever (≥72h) changed into severe cases, while it was 9.38%in children of being febrile<72h (P<0.01). The ratio from mild HFMD converted to the sever case between the patients of maculopapular diameter<3mm and≥3mm was respectively 25.33%and 10.71%(P<0.05). The severe HFMD was found in 20(36.36%) of 55 children of being febrile≥72h and maculopapular diameter<3mm compared with in 5(7.14%) of 70 children of being febrile<72h and maculopapular diameter ≥3mm(P<0.001) . Conclusion Longer total duration of fever (≥72h) and smaller diameter of maculopapular (<3mm) were the early clinical characteristics of the severe HFMD and should be pay more attention by paediatrician.%　　目的分析重症手足口病的临床特征，识别其早期症状，为重症手足口病的防治提供依据.方法对2010年3月至8月收治的重症手足口病和普通手足口病患儿的临床资料作回顾性分析.结果重症手足口病与普通手足口病患儿相比发热持续时间长(≥72h)(P<0.05)；皮疹小，直径<3mm(P<0.05).在发热持续≥72h和发热<72h的病例中，发展为重症手足口病的比例分别为24.71%和9.38%(P<0.01)；在皮疹直径<3mm和≥3mm的病例中，发展为重症的比例分别为25.33%和10.71%(P<0.05)；在发热≥72h同时皮疹直径<3mm和发热<72h同时皮疹≥3mm的病例中，重症的比例分别为36.36%和7.14%(P<0.001).结论发热持续时间≥72h、皮疹直径<3mm是重症手足口病的早期特征，临床医师应高度重视这些临床特征，及早干预治疗.