Xiong Xiao-yu, Liu Chun-feng, Wang Li-jie, Li Jiu-jun, Xu Wei, Wen Guang-fu, Song Wen-liang, Wang Yu-jing
Shengjing Hospital of China Medical University, Shenyang, China.
Zhonghua Er Ke Za Zhi. 2012 Jun;50(6):435-9.
To investigate the characteristics of circulatory disturbance and treatment of severe hand-foot-and-mouth disease (HFMD).
The clinical characteristics, laboratory findings, therapy and outcome of 22 severe HFMD patients were retrospectively analyzed.
All the 22 severe HFMD patients came from the countryside. All these patients had encephalitis. Fifteen cases had myocardial injury. All had symptoms of sympathetic excitation and 17 cases had hypertension [(128 ± 16)/(81 ± 14) mm Hg (1 mm Hg = 0.133 kPa)]. Fourteen cases had exacerbation with rapid decline of blood pressure [(61 ± 12)/(33 ± 12) mm Hg]. In cardiorespiratory failure stage, 13 patients had neurogenic pulmonary edema accompanied by circulatory failure and 12 cases had a lower glasgow scores (less than 7). Myocardial injury and ECG change were found in some cases. Inotropic and pressor drugs were given in patients with circulatory collapse. Five cases received fluid resuscitation due to refractoriness to inotropic drugs. Nine patients received blood purification. Seventeen survived and 5 cases died due to circulatory failure.
Circulation failure of severe HFMD is the main cause of death. Early and appropriate circulation support is very important to reduce mortality.
探讨重症手足口病（HFMD）循环障碍的特点及治疗方法。
回顾性分析22例重症手足口病患者的临床特征、实验室检查结果、治疗方法及预后。
22例重症手足口病患者均来自农村。所有患者均有脑炎。15例有心肌损伤。所有患者均有交感神经兴奋症状，17例有高血压[（128±16）/（81±14）mmHg（1mmHg = 0.133kPa）]。14例病情加重，血压迅速下降[（61±12）/（33±12）mmHg]。在心肺功能衰竭期，13例患者发生神经源性肺水肿并伴有循环衰竭，12例格拉斯哥评分较低（小于7分）。部分病例出现心肌损伤及心电图改变。对循环衰竭患者给予了强心和升压药物。5例因对强心药物反应不佳而接受了液体复苏。9例患者接受了血液净化治疗。17例存活，5例因循环衰竭死亡。
重症手足口病的循环衰竭是主要死亡原因。早期及适当的循环支持对降低死亡率非常重要。
