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手足口病可以使用“病毒唑”吗?

2016-12-21 石浩强 上海交通大学医学院附属瑞金医院

手足口病 VS 病毒唑利巴韦林,相信妈妈们都不会陌生,当孩子病毒感冒了或是患上手足口病时,都会接触到这种药物。作为一种抗病毒老药,利巴韦林又被大家称为“病毒唑”,很多人一看到这名字就自认为能治疗各种病毒性疾病了,当然也包括感冒和手足口病。不过妈妈们可要留神了,因为这样的认识存在很大误区。利巴韦林究竟是治疗手足口病、儿童感冒发热的良药,还是副作用风险巨大、危害儿童生命健康的“毒药”呢?我们来听听瑞金

手足口病 VS 病毒唑


利巴韦林,相信妈妈们都不会陌生,当孩子病毒感冒了或是患上手足口病时,都会接触到这种药物。作为一种抗病毒老药,利巴韦林又被大家称为“病毒唑”,很多人一看到这名字就自认为能治疗各种病毒性疾病了,当然也包括感冒和手足口病。不过妈妈们可要留神了,因为这样的认识存在很大误区。


利巴韦林究竟是治疗手足口病、儿童感冒发热的良药,还是副作用风险巨大、危害儿童生命健康的“毒药”呢?我们来听听瑞金医院药剂科石浩强副主任药师怎么说。


利巴韦林可否用于手足口病?


可用,但应只限于重症。


手足口病是由肠道病毒引起的传染病,引发手足口病的肠道病毒有20多种,其中以肠道病毒71型(EV71)最为常见。多发生于5岁以下儿童,表现口痛、厌食、低热、手、足、口腔等部位出现小疱疹或小溃疡。潜伏期多为2~10天,平均3~5天。


手足口病属于自限性疾病,一般不需要特殊治疗。症状较轻的手足口病只需要注意隔离,避免交叉感染。适当休息,清淡饮食,做好口腔、皮肤护理及对症治疗(如出现发热等症状采用中西医结合治疗)即可,预后良好。95%以上的小儿患着均属于普通病例表现,此类患者并不需要使用利巴韦林进行治疗,只需进行常规治疗后即可自愈,且多在1周内痊愈,预后良好。



还有大概5%的病例报道为重症表现,尤其是小于3岁的儿童。其病情进展迅速,症状为持续高热、精神萎靡、呕吐、全身无力、呼吸异常、循环功能障碍,发病1~5天左右出现脑膜炎、脑炎(以脑干脑炎最为凶险)、脑脊髓炎、肺水肿等,还有极少数病例病情危重,甚至可致死亡,存活病例亦可留有后遗症。对于此等患者需及时就诊,对症进行神经系统受累治疗、呼吸循环衰竭治疗、恢复期治疗,不可耽误病情。


医者·说


《EV71型感染重症病例临床救治专家共识(2011年版)》中提到,“目前尚无确切有效的抗EV71病毒的药物。利巴韦林体外试验证实有抑制EV71复制和部分灭活病毒作用,可考虑使用,用法为每天10~15 mg/kg体重,分2次静脉滴注,疗程3-5天”。


谨记四句话:


1、利巴韦林对于上呼吸道感染(感冒)没有作用。

2、备孕女性、孕妇、哺乳期妇女禁用利巴韦林。

3、不建议首选静脉给药剂型,可考虑雾化吸入。

4、用药期间注意复查血常规、生化等指标。


综上所述,利巴韦林并不适用于常规的感冒发热、流行性感冒及普通病例表现的手足口病。


对于重症的手足口病,利巴韦林仍不失为一个可选的良药,针对现在尚无特异性抗EV71病毒药物,利巴韦林作为广谱抗病毒药物完全可以发挥其优势,帮助患儿改善危重病证,尽早脱离危险。


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    2017-06-10 lingqf
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    2016-12-21 丁小鑫

    可以用中药抗病毒治疗吧?抗病毒口服液!板蓝根?可以吗?

    0

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    2016-12-21 知难而进

    谢谢分享!!!!!!

    0

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    2016-12-21 ann y

    手足口病可以使用“病毒唑”吗?

    0

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    2016-12-21 ann y

    手足口病可以使用“病毒唑”吗?

    0

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