ISSN 1674-3865  CN 21-1569/R
主管:国家卫生和计划生育委员会
主办:中国医师协会
   辽宁省基础医学研究所
   辽宁中医药大学附属医院

Chinese Pediatrics of Integrated Traditional and Western Medicine ›› 2017, Vol. 9 ›› Issue (4): 304-307.doi: 10.3969/j.issn.1674-3865.2017.04.010

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Risk factors of severe hand-foot-mouth diseased complicated with heart and lung function failure in children and the observation on the therapeutic effect

MA Yongtao, ZHAO Hong, XU Huimin, LI Yuping   

  1. Emergency Department of Kaifeng Children's Hospital, Kaifeng 475000,China
  • Published:2017-08-25 Online:2017-12-08

Abstract:
Objective
To study the risk factors of severe hand-foot-mouth diseased(HFMD) complicated with heart and lung function failure in children and the therapeutic effect.
Methods
A total of 108 HFMD children were treated in Kaifeng Children's Hospital from May 2015 to May 2016,and they were randomly divided into two groups: two-drug group and three-drug group, with 54 children in each. There were 45 cases with heart and lung failure and 9 cases without heart and lung failure in each group. The treatment of two-drug or three-drug was performed according to the disease condition. Xiyanping injection and gamma globulin were used in the two-drug treatment group; Xiyanping injection, gamma globulin and mannitol or milrinone or dobutamine were used in the three-drug group. Analyze the risk factors of the HFMD children complicated with heart and lung failure; observe the clinical effect, complications, mortality, average hospital stay, recovery time of myocardial enzyme, and the time to withdraw respirator.
Results
The total effective rate in three-drug group was 100.0%(54/54),significantly higher than the 83.3%(45/54) of the two-drug group, the difference being statistical(P<0.05).The incidence rate of complications and mortality in three-drug group was significantly lower than that in two-drug group(P<0.05).The average hospital stay, recovery time of myocardial enzyme and the time to withdraw respirator in three-drug group were all shorter than those in two-drug group(P<0.05). The hemodynamic change, EV71 infection, polypnea, disorders of consciousness and increase of troponin were of a higher proportion in children complicated with heart-lung failure than in those without, and the difference was of statistical significance(P<0.05).Multi-factor Logistic regression analysis showed that hemodynamic change, EV71 infection and polypnea were the independent risk factors.
Conclusion
The heart-lung function failure in Children with severe HFMD is mainly related to hemodynamic change, EV71 infection and polypnea. The three-drug treatment can achieve great effect, which lengthens the survival time of patients, improves the prognosis and meets the treatment demand. Therefore it should be popularized.

Key words: Hand-foot-mouth disease, Severe, Heart and lung function failure, Risk factors, Treatment effect, Child