目标性救治措施在危重型手足口病并心肺(1)
摘要：目的 分析目标性救治措施在危重型手足口病并心肺功能衰竭前期抢救中的运用价值。方法 对32例于2014年3月～2015年7月入住百色市两家三甲医院、三家二甲医院重症医学科的重型手足口病伴心肺功能衰竭前期患儿，采用目标性救治为研究组；将2012年1～12月份未设定目标性救治的重型手足口病伴有心肺功能前衰竭的患儿22例为对照组，进行回顾性对比分析。结果 研究组存活21例(65.63%)与对照组比较6例(27.27%)，差异有统计学意义(P<0.05)；治疗后第7d，研究组体温(37.14±0.58)、心率(120.46±12.42)、收缩压(94.74±42.62)、血糖(6.85±1.45)、白细胞计数(10.23±3.30)均低于对照组(37.63±0.79，132.54±15.91，79.83±27.74，9.66±3.82，12.84±3.90)，经比较差异有统计学意义(P<0.05)，C反应蛋白经比较差异无统计学意义(P>0.05)。结论 目标性救治措施能提高危重型手足口病患儿的抢救成功率，挽救患儿的生命。
关键词：目标性救治措施；手足口病；心肺功能衰竭前期；效果
Abstract：Objective To explore the practical value of targeted treatment measures toward the severe hand-foot-and-mouth disease combined with early cardio-pulmonary failure. Methods 32 cases of severe hand-foot-and-mouth disease combined with early cardio-pulmonary failure patients who were admitted into the two tertiary hospitals and the ICU of three secondary hospitals in Baise city during March 2014 and July 2015 was the experimental group， they were treated with targeted treatment measures； 22 cases of severe hand-foot-and-mouth disease combined with early cardio-pulmonary failure patients during January 2012 and December 2012 was the controlled group， they were not treated with targeted treatment measures； the curing results of the two group were analyzed with retrospectively contrastive analysis. Results The survival rate of experimental group (21 cases， 65.63%) was higher than the controlled group (6 cases， 27.27%)， the difference had statistical meaning (P<0.05)； after 7 days of treatment， the temperature (37.14±0.58)，heart rate (120.46±12.42)， systolic pressure (94.74±42.62)， blood sugar (6.85±1.45) and white blood cell count (10.23±3.30) of the experimental group were all lower than the controlled group (37.63±0.79，132.54±15.91，79.83±27.74，9.66±3.82，12.84±3.90)， the differences had statistical meanings (P<0.05)， the difference of C-reactive protein did not have statistical meaning (P>0.05). Conclusion Targeted treatment measure can increase the rescue success rate of severe hand-foot-and-mouth disease patients， rescuing children's life.
Key words：Targeted treatment measures；Hand-foot-and-mouth disease；Early cardio-pulmonary failure； Effect
手足口病( hand-foot-mouth disease，HFMD)是儿童常见的急性传染病，以3岁以下婴幼儿发病率高；多由肠道病毒7l型(EV71) 感染引起；EV71 具有高度嗜神经性，脑干是最易感染的部位[1]。临床上分为 4 期：手足口出疹期、神经系统受累期、心肺功能衰竭前期和心肺功能衰竭期，大多患儿预后良好，但少部分可发展为重症、危重症，甚至死亡[2]；心肺功能衰竭前期是HFMD重症病例中的危重型。2014年百色市HFMD发病率在广西甚至全国处于高位，重症病例、死亡病例数多，成为广西乃至全国重点防控地区[3]；卫生行政部门多次召开诊治小组会议，统一部署临床各期、特别是重症病例的诊治方案；运用目标性救治措施，分阶段、分项目，设立抢救目标，兼顾救治每个环节，为临床提供系统有效的救治方法。现总结如下。, http://www.100md.com(罗秀状 黄芳艳 黄积德)
关键词：目标性救治措施；手足口病；心肺功能衰竭前期；效果
Abstract：Objective To explore the practical value of targeted treatment measures toward the severe hand-foot-and-mouth disease combined with early cardio-pulmonary failure. Methods 32 cases of severe hand-foot-and-mouth disease combined with early cardio-pulmonary failure patients who were admitted into the two tertiary hospitals and the ICU of three secondary hospitals in Baise city during March 2014 and July 2015 was the experimental group， they were treated with targeted treatment measures； 22 cases of severe hand-foot-and-mouth disease combined with early cardio-pulmonary failure patients during January 2012 and December 2012 was the controlled group， they were not treated with targeted treatment measures； the curing results of the two group were analyzed with retrospectively contrastive analysis. Results The survival rate of experimental group (21 cases， 65.63%) was higher than the controlled group (6 cases， 27.27%)， the difference had statistical meaning (P<0.05)； after 7 days of treatment， the temperature (37.14±0.58)，heart rate (120.46±12.42)， systolic pressure (94.74±42.62)， blood sugar (6.85±1.45) and white blood cell count (10.23±3.30) of the experimental group were all lower than the controlled group (37.63±0.79，132.54±15.91，79.83±27.74，9.66±3.82，12.84±3.90)， the differences had statistical meanings (P<0.05)， the difference of C-reactive protein did not have statistical meaning (P>0.05). Conclusion Targeted treatment measure can increase the rescue success rate of severe hand-foot-and-mouth disease patients， rescuing children's life.
Key words：Targeted treatment measures；Hand-foot-and-mouth disease；Early cardio-pulmonary failure； Effect
手足口病( hand-foot-mouth disease，HFMD)是儿童常见的急性传染病，以3岁以下婴幼儿发病率高；多由肠道病毒7l型(EV71) 感染引起；EV71 具有高度嗜神经性，脑干是最易感染的部位[1]。临床上分为 4 期：手足口出疹期、神经系统受累期、心肺功能衰竭前期和心肺功能衰竭期，大多患儿预后良好，但少部分可发展为重症、危重症，甚至死亡[2]；心肺功能衰竭前期是HFMD重症病例中的危重型。2014年百色市HFMD发病率在广西甚至全国处于高位，重症病例、死亡病例数多，成为广西乃至全国重点防控地区[3]；卫生行政部门多次召开诊治小组会议，统一部署临床各期、特别是重症病例的诊治方案；运用目标性救治措施，分阶段、分项目，设立抢救目标，兼顾救治每个环节，为临床提供系统有效的救治方法。现总结如下。, http://www.100md.com(罗秀状 黄芳艳 黄积德)