探讨重症手足口病(HFMD)临床特点及其诊疗方法。

选择2010年5月至2012年4月于本院住院治疗的146例重症HFMD患儿为研究对象(本研究遵循的程序符合本院人体试验委员会所制定的伦理学标准，得到该委员会批准，并征得受试对象监护人的知情同意，并与之签署临床研究知情同意书)。对其临床病历资料及相关辅助检查结果、住院时间及治疗、预后结果进行统计学分析。

本组患儿均出现发热、皮疹症状(100.0%)，出现精神欠佳、肢体抖动及嗜睡症状患儿为140例(95.9%)。病原学检测结果示肠道病者(EV)71呈阳性患儿为80例(54.8%)，柯萨奇病毒(Cox) A16呈阳性为35例(24.0%)，EV 71及Cox A16均呈阳性为25例(17.1%)。本组治愈患儿为135例(92.5%)，好转为5例(3.4%)，死亡为6例(4.1%)。

重症HFMD主要临床症状为发热、皮疹、精神欠佳、嗜睡等，病原学检查有一定辅助诊断价值，早发现及早期干预是治疗重症HFMD的关键。

To investigate the clinical features of hand foot and mouth disease(HFMD), and provide the basis of diagnosis and treatment.

From May 2010 to April 2012, 146 children with severe HFMD were included in the study. The clinical features, laboratory examinations, hospitalization time and the results of clinical treatment were analyzed. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Xiangyang Centre Hospital.Informed consent was obtained from each parents.

All severe HFMD patients had fever and skin rash in the study(100.0%), and 95.9% of them had weakness, limb shaking and sleepiness as well. The pathogenic examination results showed that 80 patients (54.8%)were positive in EV 71, 35 patients(24.0%) were positive in Cox A16, and 25 patients(17.1%) were positive in both of them.The treatment outcomes showed that 135 patients(92.5%) were cured, 5 patients(3.4%) were improved, 6 patients(4.1%) were dead.

The main symptoms of severe HFMD are fever, skin rash, weakness, limb shaking and sleepiness. The pathogenic examination is helpful to the diagnosis of HFMD. Early detection and intervention are the key point of treatment of severe HFMD.