Liu Rui-Hai, Li Jing, Qu Xian-Feng, Xu Ying-Jun, Qu Ni-Yan, Feng Xiang-Chun
Intensive Care Units, Qingdao Hospital for Women and Children, Qingdao, Shandong 266034, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2015 Mar;17(3):249-53.
To investigate the clinical characteristics of children with critical hand-foot-mouth disease (HFMD) who were treated with mechanical ventilation and to explore the risk factors for poor prognosis.
The clinical data of 63 children with critical HFMD who were admitted to the pediatric intensive care unit between April 2012 and September 2013 and needed mechanical ventilation were retrospectively analyzed.
Among the 63 children, 43 were boys and 20 were girls, and their mean age was 25 ± 18 months, with 81% under 3 years old. The four death cases were all under three years old. Compared with the cured cases, the death cases had a significantly lower mean age (8 ± 3 months vs 25 ± 18 months; P<0.05). Poor peripheral circulation above the elbow or knee joint, pulmonary edema involving at least two thirds of the lung field, and pulmonary hemorrhage were all closely related to death (P<0.01). The death cases and cured cases had significantly different peripheral white blood cell counts, blood lactic acid, and blood glucose (24 ± 11× 10⁹/L vs 12 ± 5×10⁹/L; 6.6 ± 1.8 mmol/L vs 3.6 ± 1.7 mmol/L; 16.4 ± 2.5 mmol/L vs 10.0 ± 3.0 mmol/L). The cases with critical illness score <90 had a significantly higher death risk (P<0.01).
Children with critical HFMD are mainly under 3 years old. The children face extremely high risk of death when they suffer from poor peripheral circulation above the elbow or knee joint, pulmonary edema involving at least two thirds of the lung field, and pulmonary hemorrhage. Significant increases in peripheral white blood cell counts, blood lactic acid, and blood glucose are risk factors for poor prognosis. Critical illness score is also related to poor prognosis.
探讨接受机械通气治疗的重症手足口病（HFMD）患儿的临床特征，并探索预后不良的危险因素。
回顾性分析2012年4月至2013年9月间收治于儿科重症监护病房且需要机械通气的63例重症手足口病患儿的临床资料。
63例患儿中，男43例，女20例，平均年龄为25±18个月，81%的患儿年龄在3岁以下。4例死亡病例均在3岁以下。与治愈病例相比，死亡病例的平均年龄显著更低（8±3个月 vs 25±18个月；P<0.05）。肘或膝关节以上外周循环不良、累及至少三分之二肺野的肺水肿以及肺出血均与死亡密切相关（P<0.01）。死亡病例与治愈病例在外周白细胞计数、血乳酸和血糖方面存在显著差异（24±11×10⁹/L vs 12±5×10⁹/L；6.6±1.8 mmol/L vs 3.6±1.7 mmol/L；16.4±2.5 mmol/L vs 10.0±3.0 mmol/L）。危重症评分<90分的病例死亡风险显著更高（P<0.01）。
重症手足口病患儿主要为3岁以下儿童。当患儿出现肘或膝关节以上外周循环不良、累及至少三分之二肺野的肺水肿以及肺出血时，面临极高的死亡风险。外周白细胞计数、血乳酸和血糖显著升高是预后不良的危险因素。危重症评分也与预后不良相关。
