Analysis Of The Clinical Characteristics And Risk Factors On The Critical HFMD

Research purposes:this experiment were to study the risk factors for early identification of children with critical HFMD,and analysis those cases' characteristics and risk factors,which may helped the doctor prejudged the progress of the disease and communicated with parents smoothly.Research methods:Select children in our hospital from January,2015 to May 2017,According to the illness status and the progress of condition,those children can be divided into three groups:A:children with severe hand,foot and mouth disease without progression when living in the hospital?severe group?;B:children with severe hand,foot and mouth disease but get progress when living in the hospital?progress group?;C:children with critical hand,foot and mouth disease?critical group?.We needed to summarize and analysis theirs general conditions,clinical manifestations and laboratory results,and then find the differences between theirs general conditions,clinical manifestations and laboratory results.Logistic regression was used to analyze the clinical risk factors of the progress cases and the critical cases Results:a total of 227 cases of children into the study,including 145 cases of severe group,31 cases of progression group,51 cases of critical cases.First,analysis of single factor:severe group compared with progress group:The differences of age,Sex,clinic time,hot,heart rate,breathing,body shaking,convulsions,depression,lethargy,respiratory rhythm change,myoclonus,Babinski sign,skin pattern,CRT>3 s,HCO3,CK,CK-MB,creatinine,count of white blood cell,neutrophils ratio,ratio of lymphocytes,platelet,hemoglobin,blood sugar,PH value,BE value,LAC,CRP and PCT level had no statistically significance?p>0.05?.The differences of blood pressure level,startle reaction,vomiting,abdominal distension,BNP value,troponin value,and thermal peak had statistically significance?p<0.05?.severe group compared with critical group:The differences of age,sex,clinic time,thermal process,breathing,startle reaction,limb jitter,myoclonus,HCO₃,CK,CK-MB,creatinine,neutrophils ratio,ratio of lymphocytes,hemoglobin,platelet,BE value,LAC,CRP and PCT level difference had no statistically significance?P>0.05?.The differences of blood pressure,heart rate,CRT>3s,skin pattern,thermal spike,convulsions,vomiting,lethargy,Babinski sign,changes in respiratory rhythm,breathing,abdominal distension,BNP values,the rapid of troponin values,blood sugar levels,white blood cell count,PH value had statistically significance?p<0.05?.Second,the multi-factor Logistic regression analysisthe regression equation of progress group is logit P=-5.158+2.838?2+3.298?6+1.667?6,among the aquation the?2??5??6 are st-artle frequently?OR=17.08?,abdominal distension?OR=127.07?an-d elevated of BNP?OR=1.95?;The regression equation of critical group is logitP=-6.221+2.638?4+1.470?5+2.725?8+3.672?11+2.852?12+1.907?13,among the aquation the?4??5??8??11??12??13 respectively are convulsions,?OR=13.911?,vomit?OR=4.351?,meningeal s-timulation?OR=15.263?,respiration increased?OR=39.333?,tro-ponin increased?OR=17.323?,blood sugar increased?OR=7.174?.Conclusion:startle frequently,abdominal distension,elevated of BNP were the risk factors for those patient with severe hand,foot and mouth disease who got therapy but still get worse.Increased blood pressure,heart rate increase fast,CRT>3 s,skin pattern,thermal spike,frequent twitch,vomiting,drowsiness,Meningeal stimulation,respiratory rhythm change,breathing faster,abdominal distension,Increased BNP,increased CTnT,elevated blood sugar,increased white blood cell count,and PH change were the risk factors for critical hand,foot and mouth disease.The sensitivity and specificity of the above factors were not identical,whitch should be comprehensively judgment.