腸道病毒71型感染重癥手足口病33例隨訪分析

[摘要] 目的 對腸道病毒EV71感染重癥手足口病患兒進行隨訪分析，了解預后情況。 方法 對2011年3～12月新鄉市中心醫院收治的33例確診為腸道病毒EV71感染的重癥手足口病患兒出院后3個月進行跟蹤隨訪，觀察預后情況。 結果 腸道病毒EV71感染重癥手足口病33例患兒入院時均有不同程度的嗜睡、精神狀態的改變（萎靡和煩躁）以及四肢抖動、驚跳等中樞神經系統表現，經治療后有2例遺留有不同程度的后遺癥，余均預后良好。 結論 腸道病毒EV71更易致中樞神經系統損害及AFP且具有發病年齡小，病情兇險，病死率高的特點，及早發現、及時干預治療可減輕其預后。

[關鍵詞]腸道病毒71型；手足口病；預后

[中圖分類號] R725.1 [文獻標識碼] B [文章編號] 2095-0616（2013）13-211-02

Follow-up analysis of 33 patients with enterovirus 71 infected severe hand-foot-mouth disease

LOU Ying JING Huijuan LIANG Peng

Department of Pediatrics，Xinxiang Central Hospital，Xinxiang 453011，China

[Abstract] Objective To follow up the children with Enterovirus 71 （EV71） infected severe hand-foot-mouth disease in order to understand the prognosis. Methods Thirty-three children diagnosed with EV71 infected severe hand-foot-mouth disease treated in the Xinxiang Central Hospital from March to December 2011 were followed up 3 months after discharge and the prognosis was observed. Results On admission to the hospital， all the 33 children with EV71 infected severe hand-foot-mouth disease had varying degrees of lethargy， mental status changes （malaise and irritability） and central nervous system manifestations such as limb shake and startle. After the treatment， 2 children were left with different degrees of sequelae and the rest had a good prognosis. Conclusion EV 71 is more prone to causing central nervous system damage and AFP and has the characteristics such as low age of disease onset， dangerous conditions and high mortality. Early detection and timely intervention can improve the prognosis.

[Key words] EV71；HFMD；Prognosis

手足口病（hand- foot-mouth disease，HFMD）是一種由多種腸道病毒感染引起的急性傳染性疾病，以柯薩奇病毒A16型和腸道病毒71型最常見，EV71多導致重癥及危重癥病例的發生[1]，病情進展迅速，短期內危及生命，部分可遺留神經系統后遺癥。3歲以下的嬰幼兒是嚴重并發癥的高危人群，目前尚無安全有效的疫苗用于預防。因EV71感染所致的無菌性腦炎病情發展迅速，導致周圍神經損傷發生率已越來越高并且這種損傷致殘率極高。2011年3～12月期間對我院收治33例確診為腸道病毒EV71感染的重癥手足口病患兒出院后3個月進行跟蹤隨訪，對其臨床預后特點分析如下。

1 資料與方法

1.1 一般資料

2011年3～12月我院收治重癥手足口病經糞便病毒分離確診為EV71感染患兒33例，男21例，女12例，二者比例為1.75∶1；年齡為5個月～6歲，發病平均年齡為19個月。……