Zhonghua er ke za zhi = Chinese journal of pediatrics · 2012
[Characteristics of circulatory disturbance and the treatment of severe hand-foot-and-mouth disease].
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Xiong Xiao-yu, Liu Chun-feng, Wang Li-jie, Li Jiu-jun, Xu Wei, Wen Guang-fu, Song Wen-liang, Wang Yu-jing
Аннотация
OBJECTIVE: To investigate the characteristics of circulatory disturbance and treatment of severe hand-foot-and-mouth disease (HFMD).
METHOD: The clinical characteristics, laboratory findings, therapy and outcome of 22 severe HFMD patients were retrospectively analyzed.
RESULT: All the 22 severe HFMD patients came from the countryside. All these patients had encephalitis. Fifteen cases had myocardial injury. All had symptoms of sympathetic excitation and 17 cases had hypertension [(128 ± 16)/(81 ± 14) mm Hg (1 mm Hg = 0.133 kPa)]. Fourteen cases had exacerbation with rapid decline of blood pressure [(61 ± 12)/(33 ± 12) mm Hg]. In cardiorespiratory failure stage, 13 patients had neurogenic pulmonary edema accompanied by circulatory failure and 12 cases had a lower glasgow scores (less than 7). Myocardial injury and ECG change were found in some cases. Inotropic and pressor drugs were given in patients with circulatory collapse. Five cases received fluid resuscitation due to refractoriness to inotropic drugs. Nine patients received blood purification. Seventeen survived and 5 cases died due to circulatory failure.
CONCLUSION: Circulation failure of severe HFMD is the main cause of death. Early and appropriate circulation support is very important to reduce mortality.
METHOD: The clinical characteristics, laboratory findings, therapy and outcome of 22 severe HFMD patients were retrospectively analyzed.
RESULT: All the 22 severe HFMD patients came from the countryside. All these patients had encephalitis. Fifteen cases had myocardial injury. All had symptoms of sympathetic excitation and 17 cases had hypertension [(128 ± 16)/(81 ± 14) mm Hg (1 mm Hg = 0.133 kPa)]. Fourteen cases had exacerbation with rapid decline of blood pressure [(61 ± 12)/(33 ± 12) mm Hg]. In cardiorespiratory failure stage, 13 patients had neurogenic pulmonary edema accompanied by circulatory failure and 12 cases had a lower glasgow scores (less than 7). Myocardial injury and ECG change were found in some cases. Inotropic and pressor drugs were given in patients with circulatory collapse. Five cases received fluid resuscitation due to refractoriness to inotropic drugs. Nine patients received blood purification. Seventeen survived and 5 cases died due to circulatory failure.
CONCLUSION: Circulation failure of severe HFMD is the main cause of death. Early and appropriate circulation support is very important to reduce mortality.