Clinical features and treatment of 147 cases with severe hand, foot and mouth disease receiving mechanical ventilation
10.3760/cma.j.issn.1673-4912.2011.01.011
- VernacularTitle:重症手足口病机械通气147例临床特点及救治体会
- Author:
Qiaozhi YANG
;
Hui TIAN
;
Jun LIANG
;
Shengying DONG
;
Zhijun LIU
- Publication Type:Journal Article
- Keywords:
Severe hand-foot-mouth disease;
Mechanical ventilation;
EV71
- From:
Chinese Pediatric Emergency Medicine
2011;18(1):30-32
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize the clinical features,diagnostic and treatment experience of severe hand,foot and mouth disease(HFMD) cases receiving mechanical ventilation from Jan 1 to Sep 6,2009 in our hospital and provide reference for reducing the occurrence of neurogenic pulmonary edema(NPE) and mortality. Methods 147 severe HFMD who received mechanical ventilation were analyzed by a retrospective investigation. Results 85.0% children were less than 3 years old and 100% patients had a fever. The mechanical ventilation occurred within 1 to 4 days after fever (3.06 ± 1. 02) d. Neurological complications presented as bad spirit,easy surprised, involuntary movement of the extremities and lethargy. Respiratory system complication presented as polypnea, hypepnea and irregular rhythm. Circulatory system complication presented as heart rate increase or decrease, hypertension or hypotension, piebald skin and low limb temperature.Some of the children had high white blood cell counting,glucose and lactic acid of the blood. The EV71-PCR positive rate was 34. 7% for throat swabs,and 42. 2% for anal swabs. Chest X-ray presented as increased broncho vascular shadows, exudation or nonapparent abnormality. Only three children were dead, fatality rate was 2. 0%. Conclusion The HFMD cases in this outbreak are relatively more serious,and change rapidly. It's difficult to treat as soon as NPE appeared,and it has high fatality rate. Early recognition of critical patients,timely giving mechanical ventilation,and the comprehensive treatment can reduce NPE incidence and the mortality.
