本文旨在探讨手足口病伴发脑损伤的发病趋势以及患儿的早期临床特点、救治经验和转归。对2008年8月1日~2009年7月31日本院门诊临床诊断为手足口病的患儿与入住本院的重症手足口病患儿进行综合分析，并着重对伴有脑损伤的43例患儿的临床表现、实验室检查、治疗及转归资料进行回顾性分析。结果显示，手足口病全年都有发生，4~7月和11、12月为发病高峰期。手足口病伴发脑损伤的患病率为1.57%，主要集中在5~10月。43例伴发脑损伤的患儿平均年龄2.89岁，最小5个月，最大13岁。临床分型以脑干脑炎最多，占48.8%（21/43），脑炎占32.6%（14/43），脑膜脑炎占18.6%（8/43）。主要治疗为使用甘露醇、甲基泼尼松龙、静脉丙种球蛋白；肺水肿前兆者尽早给予机械通气。98%患儿预后良好，平均住院11.1 d。本次调查证实，手足口病伴发脑损伤的患病率为1.57%，主要发生于5~10月，临床分型以脑干脑炎为多；早期诊断、积极降颅压、大剂量静脉丙种球蛋白和短期大剂量激素冲击治疗是阻止重症向危重症转变的有效手段。

The present paper aims to investigate the prevalence trends, early clinical characteristics and treatment experience of hand, foot and mouth disease complicated with brain injury. The outpatients clinically diagnosed as hand, foot and mouth disease and inpatients with severe hand foot and mouth disease diagnosed by comprehensive analysis in our chilidren’s hospital from August 1, 2008 to July 31, 2009 were chosen. The clinical manifestations, laboratory examination, treatment and outcome data from 43 cases of patients with hand, foot and mouth disease complicated with brain injury were retrospective analyzed. The results showed that hand, foot and mouth disease occurred throughout the year. The incidence of hand, foot and mouth disease complicated with brain injury was 1.57%, which mainly occurred from May to October. The average age of patients was 2.89 years old, with the youngest of 5 months old and the oldest of 13 years old. In clinical classification, brain stem encephalitis accounted for 48.8%, encephalitis accounted for 32.6%, meningoencephalitis accounted for 18.6%. Administration of mannitol, methyl-prednisolone, intravenous gamma globulin, and mechanical ventilation for those precursors of pulmonary edema as early as possible was the main treatment measure. Among the patients, 98% had a good prognosis. The hospital average length of stay was 11.1 d. The survey confirmed that the incidence of hand, foot and mouth disease complicated with brain injury was 1.57%, occurring mainly from May to October, and brain stem encephalitis is common. Early diagnosis, effectively reducing intracranial pressure, rational use of high-dose intravenous gamma globulin and short-term high-dose hormone are effective measures in preventing disease progression.