硝普钠治疗2183例危重型手足口病临床分析

Clinical Analysis of 2183 Cases of Severe Hand Foot Mouth Disease Treated with Sodium Nitroprusside

摘要: 目的：总结我科近4年危重型手足口病(HFMD)临床诊治经验及病原学分析。方法：对我院2014年1月~2017年12月收治住院的2183例危重型手足HFMD，在治疗脑炎的同时，积极给予硝普钠治疗、控制高血压。本组病例1372例(65.85%)加用了静脉丙种球蛋白治疗。结果：本组病例在入院时及时用硝普钠治疗高血压，明显减少了呼吸机机械通气的应用及降低死亡病例，减少静脉丙种球蛋白使用病例数及剂量，缩短了住院时间，降低医疗成本，取得了满意疗效。结论：目前HFMD己成为全球性疾病，危重型病原以EV71为主。本组病例均出现高血压，高血压严重程度与病情成正比。本组病例在入院时及时用硝普钠治疗高血压，明显减少了呼吸机机械通气的应用及降低死亡病例，减少静脉丙种球蛋白使用病例数及剂量，缩短了住院时间，降低医疗成本，取得了满意疗效。早期诊断危重型HFMD患儿，及时用硝普钠治疗高血压，是抢救危重型HFMD最重要的措施之一，是最大限度提高危重型HFMD治愈率的关键。

Abstract: Objective: To summarize the clinical experience in diagnosis and treatment of severe hand foot mouth disease (HFMD) in recent 4 years. Methods: 2183 cases of severe hand and foot HFMD ad-mitted to our hospital from January 2014 to December 2017 were treated with sodium nitroprusside and high blood pressure while treating encephalitis. 1372 cases (65.85%) of this group were treated with intravenous immunoglobulin. Results: This group of patients in the hos-pital timely use of sodium nitroprusside in the treatment of hypertension, significantly reduced the application of mechanical ventilation and reduced mortality, reduced the number of cases using intravenous immunoglobulin and dose, shortened hospitalization time, reduced medical costs, and achieved satisfactory results. Conclusion: At present, HFMD has become a global disease, and EV71 is the main pathogen. Hypertension is present in this group, and the severity of hypertension is directly proportional to the disease. Early diagnosis of severe HFMD patients and timely treatment of hypertension with sodium nitroprusside is one of the most important measures to rescue critical HFMD and is the key to maximizing the cure rate of critical HFMD.