Reviewer: You Xiangmei (Director of Nutrition Department of No.903 (formerly 1 17) Hospital of Joint Logistics Support Force, and expert consultant of China Clinical Nutrition Network).
Recently, several classes in my daughter's kindergarten were closed because there were many children with "herpetic angina" in the class. At first glance, many parents looked puzzled, but everyone should know about "hand, foot and mouth disease".
First of all, these two diseases are very similar, both of which are common infectious diseases of children caused by enterovirus. April-July is a high incidence period every year, and they often occur in infants and children (especially under 5 years old). The difference is that herpetic angina is mainly herpes in the pharynx and soft palate, and sore throat is obvious. Most of the fever is high, and it comes and goes in a hurry, which is highly contagious, but it is also good. Besides the oral cavity, the hand, foot, buttocks and perianal region of hand, foot will grow transparent blisters, and rash can also be seen in joints. After the rash, fever is mostly moderate and low, and the symptoms of sore throat are not obvious. Moreover, children with hand, foot and mouth disease under 3 years old are more likely to have complications such as encephalitis and myocarditis than herpetic angina, and their condition is relatively serious.
Secondly, these two diseases are viral infections, so antibiotics are not needed; All belong to self-limited diseases, so clinical treatment mainly focuses on symptomatic treatment and nursing, such as fever reduction, enhanced disinfection, skin and oral mucosa care, psychological care and so on. Among them, diet care is also a very important link, especially for children with herpetic angina. Because of the obvious sore throat, oral herpes and repeated high fever can easily affect eating, and drooling and refusal to eat often occur.
Correct diet care includes the following aspects:
① Adequate nutrition
Balanced nutrition is the basis of improving children's immunity. Considering children's frequent fever, it is advisable to eat more liquid or semi-liquid foods with high protein, high vitamins, rich nutrition and easy digestion, and the foods should be light, soft and digestible, such as milk, egg soup, fish porridge, shrimp porridge, vegetable porridge, lean winter melon porridge, etc., to maintain a balanced nutrition, eat more meals, drink more water, and eat more fresh vegetables and fruits.
② The food should be warm and cool:
There are many herpes in children's mouth, so foods that are too hot, too sour, too spicy, too salty, too dry, too irritating, and over-processed are not suitable for children to eat, so as to avoid causing pain in oral ulcers and refuse to eat. It is suitable for eating warm and cold milk, porridge, fruit, soft noodles, wonton, steamed eggs, juice that is not too sour, and a small amount of ice cream.
③ Patient feeding:
Children's appetite is easily affected by oral herpes pain, so they should be fed patiently. Children can be given interesting toys or watch favorite cartoons for a short time to distract their attention. For lactating babies, milk can be slowly fed into their mouths with a spoon.
④ Pay attention to oral cleaning and nursing:
Rinse your mouth with warm water before and after eating, and gently clean your mouth with a cotton swab dipped in normal saline for children who can't rinse their mouth. Patients with oral ulcer can be gargled or scrubbed with normal saline, and then sprayed with Bingboron Powder, watermelon frost or Smecta to promote the healing of ulcer surface.
⑤ Nutritional supplement:
Children who eat less can take some special medical dietary supplements orally; For seriously ill children who can't eat, nasal feeding diet can be adopted; Intravenous nutrition supplement can be given to children with excessive body temperature, swallowing discomfort and refusing to eat, so as to meet the needs of growth and development and disease loss.
⑥ Observation of complications:
For children with persistent high fever and poor conventional fever reduction effect, such as convulsions, convulsions, listlessness, poor eating, headache and vomiting, increased breathing and cyanosis, it is advisable to seek medical attention in time.
Finally, herpetic angina and hand-foot-mouth disease are mostly caused by fecal transmission and respiratory infection, so prevention is very important: keep good personal hygiene, wash hands frequently, ventilate frequently and disinfect frequently, disinfect toys and tableware, pay attention to diet preparation, rest, strengthen exercise, enhance self-immunity, and add EV7 1 vaccine to school-age children aged 6 months to 5 years as soon as possible to reduce the chance of illness. During the epidemic period of this disease, take children to densely populated places less, wear masks when going out, and children who have been infected must pay attention to isolation, especially those who have a second child at home. Isolation is the best means to prevent transmission.
References:
[1] LV Shuhua. Nursing and prevention of hand, foot and mouth disease in children. World's latest medical information abstracts [J], 2014,14 (31): 541-542.
Chen Shunzhen, Li Xuemin. Nursing and health education for children with herpetic angina. Contemporary Nurses, 2020,27 (16): 68-69.
Editorial Department of China Clinical Nutrition Network
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