某医院282例手足口病病例分析

发布时间：2018-06-03 05:48

本文选题：手足口病 + 病例分析　；参考：《吉林大学》2013年硕士论文

【摘要】：目的：本研究通过描述2012~2013年在沈阳市铁西区某医院就诊并住院的手足口病患者的年龄、性别、发病时间、临床表现、治疗效果等情况，了解该医院手足口病的临床特征，为该医院手足口病的预防控制和治疗提供科学依据，并提出合理化建议。方法：收集在该院就诊并住院的282例手足口病患儿的完整病历，在病历中提取所要研究的项目形成个案调查表，采用回顾法收集相关数据资料，从而描述患病人群性别、年龄、医疗付费方式等分布以及临床表现和治疗等情况。采用t检验、u检验、方差分析、卡方检验对资料进行分析。结果：本次调查的282例手足口病患者中，男性117人，占60.6%，女性111人，占39.4%。手足口病患者以1～5岁的儿童为主，占总数的89.72%，其中3～5岁者最多，占总数的71.28%；以幼托儿童为主，占总数的63.83%；以城市儿童为主，占总数的88.65%。手足口病全年发病，但以夏季和初秋季高发，其中6月～9月发病人数最多，占总数的89.36%。患儿入院后多数有发热表现，发热者占总数的62.4%；多数患儿的皮疹持续时间为6～8天，皮疹部位主要为手、足、口、臀部。治疗药物以抗病毒药物为主，其中痰热清的使用较为广泛，占总数的84.04%。大多数手足口病患儿的病程为6～8天，占总数的80.50%。城市和农村患儿的住院天数间的差别有统计学意义（p=0.002），城市家庭患儿的平均住院时间为6.67天，农村的患儿的平均住院天数为5.30天，农村患儿比城市患儿住院时间短。不同医疗付费方式的住院天数间的差别有统计学意义（p0.001），市城镇居民基本医疗保险的患儿的平均住院时间为6.94天，新型农村合作医疗保险的患儿的平均住院时间为6.78天，自费患儿的平均住院天数为5.54天，，两两比较可知，自费患儿的住院时间比市城镇医疗保险的和新型农村合作医疗保险的患儿短。结论：（1）5岁以下婴幼儿及幼托儿童为手足口病的重点预防人群，幼托机构等儿童聚集单位为重点预防场所。（2）手足口病流行有季节性差异，以夏季和初秋季发病例数多。（3）手足口病患者大多数有发热表现，以支气管肺炎为主要并发症。（4）治疗手足口病的药物以痰热清为主。（5）农村患者比城市患者的住院时间短；自费的医疗支付方式比市城镇居民医疗保险和新型农村合作医疗保险方式的住院时间短。
[Abstract]:Objective: to investigate the clinical characteristics of hand-foot-mouth disease (HFMD) in a hospital in Tiexi, Shenyang from 2012 to 2013 by describing the age, sex, onset time, clinical manifestation and therapeutic effect of HFMD. To provide the scientific basis for the prevention, control and treatment of hand, foot and mouth disease in this hospital, and to put forward some reasonable suggestions. Methods: the complete medical records of 282 children with hand, foot and mouth disease (HFMD) in our hospital were collected. The item forming case questionnaire was extracted from the medical records, and the relevant data were collected by retrospective method, so as to describe the sex and age of the patients. The distribution of medical payment and the clinical manifestation and treatment. T test, ANOVA and chi-square test were used to analyze the data. Results: of 282 patients with HFMD, 117 were males (60.6%) and 111 females (39.4%). The majority of HFMD patients were children aged 1 to 5 years old, accounting for 89.72% of the total number, among which the 3- and 5-year-olds were the most, accounting for 71.28% of the total, mainly for the young children, accounting for 63.83% of the total, and mainly for the urban children, accounting for 88.65% of the total. The incidence of HFMD in the whole year was higher than that in summer and early autumn, and the number of HFMD from June to September was the most, accounting for 89.36. 6% of the total. Most of the children had fever after admission, the fever accounted for 62.4% of the total, and the rash lasted for 68 days. The skin rash was mainly in the hands, feet, mouth and buttocks. Antiviral drugs are the main treatment drugs, among which Tanreqing is widely used, accounting for 84.04 of the total. The course of disease in most children with HFMD was 6 days, accounting for 80.50% of the total. The difference of hospitalization days between urban and rural children was statistically significant. The average hospitalization time of urban children was 6.67 days, and that of rural children was 5.30 days, which was shorter than that of urban children. The average hospitalization time of children with basic medical insurance for urban residents was 6.94 days, and the average hospitalization time of children with new rural cooperative medical insurance was 6.78 days. The average hospitalization days of self-funded children were 5.54 days. Compared with each other, the hospitalization time of self-funded children was shorter than that of urban medical insurance and new rural cooperative medical insurance. Conclusion: Children under 5 years of age and young children are the focus of prevention of hand, foot and mouth disease population, child care institutions and other units for key prevention of children. (2) there is seasonal difference in the prevalence of HFMD, with more cases occurring in summer and early autumn. Febrile symptoms were found in most patients with hand, foot and mouth disease, with bronchopneumonia as the main complication. 4) the main drug for hand, foot and mouth disease is Tanreqing. 5) the hospitalization time of rural patients is shorter than that of urban patients, and the self-paid medical treatment is shorter than that of the urban residents' medical insurance and the new rural cooperative medical insurance.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R512.5

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