[Critical care and therapy based different illness state of 80 patients with severe hand-foot-and-mouth disease seen in Shenzhen].
OBJECTIVE
To discuss the treatment strategy of severe hand-foot-and-mouth disease (HFMD) cases, prevent the severe cases from progressing to fatal condition and enhance the survival rate of critically ill patients.


METHODS
Eighty HFMD cases were divided into four groups, A, B, C and D, according to the severity of patients' nervous system manifestation and other system involved. Different intensive care and treatments were used and the effect and outcome were analyzed for each group. All statistical analyses were performed by using SPSS software 13.0. One-way ANOVA and Chi-square test were used for data analysis.


RESULTS
The most common symptoms were continuous fever (69/70) and myoclonic jerk (67/70). The fewer the rashes were, the more severe the patient's condition was, heart rate >200/min, hypertension, increase of white blood cells in peripheral blood and hyperglycemia were common in patients with lesions in brain stem and pulmonary edema. There were no relations between patient's conditions and CSF white blood cells and CRP. CNS involvement was highly associated with EV71 infection. There were 69 cases in group A, B and C in total and all recovered. Of 11 patients in group D, 6 got complicated neurogenic pulmonary edema and circulatory failure, 2 cases died and 9 cases survived, 8 cases recovered without sequelae while one case had sequelae of mental retardation and dyscinesia.


CONCLUSIONS
Administration of mannitol, methylprednisolone, IVIG and other supportive treatments in time and reasonably might have advantages in avoiding aggravation of the condition and enhancing the rate of successful rescue in patients with nervous system involvement.
He
Yan-xia
YX
Pediatric Intensive Care Unit, Shenzhen Children's Hospital, Shenzhen 518026, China.
Fu
Dan
D
Cao
De-zhi
DZ
Liu
Hong-yan
HY
Huang
Que-lan
QL
Li
Cheng-rong
CR
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003422:Critical Care; D005260:Female; D006232:Hand, Foot and Mouth Disease / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric; D008297:Male; D009420:Nervous System / Q000821:virology; D015996:Survival Rate