732例手足口病的流行病学和临床特征分析

发布时间：2018-01-26 03:59

  本文关键词： 手足口病 流行病学 临床特征　出处：《大连医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:手足口病是小儿常见急性传染病。本研究通过调查分析2015年至2016年期间临床确诊手足口病的患儿的流行病学及临床特征,分析比较2015年与2016年手足口病流行病学区别,重症手足口病组与普通型手足口病之间的区别与联系,为临床早期干预手足口病,特别是重症手足口病的及时诊治提供临床依据,同时为手足口病的预防提供相关依据。方法:收集2015年与2016年期间住院患者732例为研究对象,均为临床确诊手足口病患者,其中重症组手足口病患儿103人,普通型手足口病儿童629人,男童459人,女童273人,肠道病原学检测阳性625人,未检测出肠道病毒107人。应用回顾性调查分析方法,查阅病例原始记录,收集患儿的年龄、性别、居住情况、发病季节、病原体、临床特点、C-反应蛋白、白细胞计数、血糖等资料。归纳整理上述资料,采用卡方检验分析比较2015年与2016年手足口病发病年龄、季节分布差异,比较重症组与普通组的性别、年龄、发病季节、病原体、临床特点、C-反应蛋白、白细胞计数、血糖的差异。结果:(1)手足口病多发生于5岁以下的儿童,其占手足口病患病总数的94.3%,尤以1-2岁儿童的患病率最高,占手足口病总病例的37.8%。男童明显多于女童,男女比例为1.68:1。散居儿童较托幼儿童及其他居住类型更容易发生手足口病,分别占65.6%、30.3%、4.1%。(2)2016年手足口病病例共470例,较2015年明显增多,两年中手足口病患儿在年龄的分布上差异存在统计学意义(P0.05)。主要表现在普通型手足口病患儿中2016年发病年龄较2015年增加。(3)手足口病好发于夏日,夏季与其他季节中重症型与普通型手足口病患者病例比较,差异存在统计学意义(P0.05),2016年与2015年手足口病在季节分布上不同,差异有统计学意义(P0.05)。(4)不一样的肠道病毒感染的普通组与重症组对比,差异具有统计学意义(P0.05)。相对于柯萨奇A组16型病毒,肠道病毒71型更容易导致重症型手足口病。近两年引起手足口病的主要病原体在发生变化,非EV71、非CA16的其他肠道病毒占总阳性病例的57.8%。(5)普通组和重症组的多个因素差异比较分析中,抽搐、体温超过39℃、呼吸心率增快、烦躁、肢体抖动、呕吐、颈强、白细胞计数升高、C-反应蛋白升高与血糖升高是重症型手足口病发生的危险因素(P0.05)。结论:HFMD好发于5岁及以下儿童,男童多于女童,散居多见,整年均可发病,夏日多见。抽搐、体温超过39℃、呼吸心率增快、烦躁、肢体抖动、呕吐、颈强、白细胞计数增高、C-反应蛋白上升与血糖升高是重症手足口病的危险因素。
[Abstract]:Objective: hand, foot and mouth disease (HFMD) is a common acute infectious disease in children. This study analyzed the epidemiology and clinical characteristics of HFMD from 2015 to 2016. To analyze and compare the epidemiology of HFMD in 2015 and 2016, and the relationship between severe HFMD and common HFMD, which is the early intervention of HFMD. In particular, the timely diagnosis and treatment of severe hand-foot-mouth disease provide clinical basis for the prevention of hand-foot-mouth disease. Methods: from 2015 to 2016, 732 inpatients were collected as the study objects. All patients were clinically diagnosed with HFMD, including 103 children with HFMD in severe group, 629 children with HFMD of common type, 459 boys and 273 girls. Enterovirus was detected in 625 cases, and no enterovirus was detected in 107 cases. Retrospective investigation and analysis were used to check the original records of the cases and collect the age, sex, living condition and incidence season of the children. Pathogen, clinical features, C-reactive protein, white blood cell count, blood sugar and other data. Summarized the above data, chi-square test was used to compare the onset age of HFMD in 2015 and 2016. The sex, age, onset season, pathogen, clinical characteristics of C- reactive protein and white blood cell count were compared between the severe group and the normal group. Results Hand-foot-mouth disease (HFMD) occurred mostly in children under 5 years old, accounting for 94.3% of total HFMD, especially in children aged 1-2 years. Boys accounted for 37.8% of total HFMD cases, and the ratio of boys to girls was 1.68: 1.The children in the diaspora were more prone to HFMD than toddlers and other types of residence. In 2016, there were 470 cases of hand, foot and mouth disease, which was significantly higher than that in 2015. There was significant difference in age distribution between children with HFMD in the past two years (P 0.05). The age of onset of HFMD in 2016 was increased by 3% than that in 2015 (P < 0.05). Hand, foot and mouth disease occurs in summer. The difference between severe and common HFMD cases in summer and other seasons was statistically significant (P 0.05). The seasonal distribution of HFMD in 2016 and 2015 was different. The difference was statistically significant (P 0.05. 0. 05. 4) the difference of enterovirus infection between the common group and the severe group was compared. The difference was statistically significant compared with Coxsackie A group 16 virus. Enterovirus 71 is more likely to cause severe hand-foot-mouth disease. The main pathogens causing HFMD in the last two years are changing, not EV71. Other enteroviruses other than CA16 accounted for 57.8% of the total positive cases.) in comparison and analysis of multiple factors between the common group and the severe group, convulsions, body temperature over 39 鈩，

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