目的 了解重症手足口病的危险因素及临床特点,为完善临床治疗提供科学依据.方法 回顾性分析2009年4月～2010年5月在笔者医院住院的244例手足口病患儿的临床资料.分为普通型手足口病组(普通组)和重症手足口病组(重症组),比较两组患者的临床特点,通过多因素分析筛选出重症手足口病的危险因素.结果 244例患儿中,重症手足口病58例,发生率23.7%;多因素分析显示:年龄<3岁、意识障碍、抽搐、精神差、颈抵抗、神经反射异常、体温39℃及以上>3天、外周血白细胞>12×109/L以及血糖>9mmol/L是重症手足口病的危险因素(P<0.05).年龄、精神差、神经反射异常、体温39℃>3天以及血糖>9mmol/L等5项指标是手足口病重症化的独立性相关因素,具有早期预警作用.结论 对于年龄<3岁且有精神、神经系统症状的高热手足口病患儿需重视其病情,及早发现及正确治疗干预对提高治愈率尤为重要.%Objective The study was conducted to analyze the risk factors and clinical features of severe hand - faot - mouth disease ,thus to provide scientific bases for clinical treatments. Methods Retrospective analysis was performed to analyze the clinical data of 244 children with hand - foot - mouth disease in our hospital from April 2009 to May 2010. Clinical characteristics were compared between two groups, and risk factors of severe hand - foot - mouth disease were analyzed by logistic regression test. Results Among total 244 cases, 58 cases were severe hand - foot - mouth disease, accounted for 23.7％ . Logistic regression test showed that younger than 3 years,disturbance of consciousness, twitch, poor spirit, neck resistance, abnormal neural reflex, temperature 39℃ lasted than three days, WBC ＞ 12 × 109/L and blood glucose ＞ 9mmol/L were the high risk factors of hand - foot - mouth disease. Age, poor spirit, abnormal neural reflex, temperature 39℃ lasting more than three days and blood glucose ＞9mmoVL were independented relevant factors trending to seriousness, and played an important role in early waming. Conclusion Attention should be paid to observe hand - foot - mouth disease severe trendy of children paitents younger than 3 years with nervous system symptoms and high fever. Early detection and intervention with proper treatment were particularly important for improving cure rate.
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