文章摘要
孙绪丁,王建龙,卓琳,岳屹囡,朱洪峰.399例手足口病临床分析[J].济宁医学院学报,2011,(5):323-326
399例手足口病临床分析
Epidemiological study and prevention efforts of hand-foot-and-mouth disease
投稿时间:2011-09-15  
DOI:10.3969/j.issn.1000-9760.2010.05.007
中文关键词: 手足口病;EV71;发热;皮疹
英文关键词: Hand-foot-and-mouth disease;EV71;Fever;Rash
基金项目:
作者单位
孙绪丁 华中科技大学同济医学院附属同济医院, 湖北武汉 430022 
王建龙 济宁医学院附属济宁市第一人民医院, 山东济宁 272011 
卓琳 济宁医学院附属济宁市第一人民医院, 山东济宁 272011 
岳屹囡 济宁医学院附属济宁市第一人民医院, 山东济宁 272011 
朱洪峰 济宁医学院附属济宁市第一人民医院, 山东济宁 272011 
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中文摘要:
      目的 分析399例手足口病患儿的临床特征、实验室检查及流行特点,加强对手足口病的认识及提高救治水平。方法 收集2009济宁医学院附属济宁市第一人民医院感染科收治的399例手足口病住院患儿临床资料。分析其流行特征、临床表现、实验室检查、治疗、转归情况。结果 在该样本中,男性患儿人数为274例,占总数的68.67%。女性患儿病例数为125,占总数的31.33%。手足口病发病以农村多见,农村儿童病例358例,占样本容量的89.72%,差异有统计学意义(P<0.01)。本研究资料中所有患儿均有皮疹。手部出现皮疹的患儿为339例,占84.96%,足部皮疹者322例,占80.70%,伴臀部皮疹者229例,占57.39%,伴膝部皮疹者32例(8.02%),口腔疱疹及溃疡者293例,占73.43%。伴咽痛、流涎239例,伴咳嗽63例,伴头痛、呕吐77例,伴心动过速108例。伴肢体抖动191例,急性弛缓性瘫痪1例,嗜睡61例,抽搐4例。出现并发症者共287例,占病例总数的71.93%。合并脑膜炎、心肌炎等并发症者病程明显延长,其中2例死亡,死亡主要原因是神经源性肺水肿、肺出血、心肺循环衰竭。结论 综合以上统计数据可以发现,手足口病患儿中,绝大部分为农村儿童,男孩居多,1~3岁儿童占绝大多数,大多出现发热,且热程集中在3-5d,皮疹多出现于手足口腔部位,可引起心肌、肝功损害。重症病例大部分由EV71感染引起,神经系统症状则以肢体抖动和呕吐为多见,一旦出现神经源性肺水肿则死亡率极高。因此手足口病患儿一旦出现肢体抖动和呕吐则表明患儿已为重症手足口病,及时处理有可能阻止病情的进一步发展、降低死亡率。
英文摘要:
      Objective 399 hand-foot-and-mouth disease(HFMD)children were from Shandong Jining First People's Hospital whose clinical character, laboratory examination and epidemic characteristics were analyzed in order to enhance the understanding of HFMD and improve treatment level.Methods We collected 399 HFMD patiens from Shandong Jining First People's Hospital Infection Division and studied their epidemiologic feature, clinical manifestation, laboratory examination, treatment and clinical outcome.Data were processed by SPSS 12.0 statistical softwaruse and analyzed using epidemiological methods.Results In this sample, male children were 274 example, 68.67% of the total and female children 125, 31.33% of the total.The majority of HFMD patients came from rural area, rural children 358 cases accounting for 89.72% of the sample size, P<0.01, with statistical meaning.The children in this sample were all have rash, hand skin rash 339, 84.96% of the total, rashes on the foot 322, accounting for 80.70%, 229 cases in hip, accounting for 57.39%, 32 patients with the knee rash(8.02%), oral herpes and ulcer 293 cases, accounting for the 73.43%.With sore throat, salivate were 239 cases, cough 63 cases, headache, vomiting 77 cases, tachycardia 108 cases, body shaking 191 cases, acute atony paralysis 1 case, sleepiness 61 cases, twitch 4 cases.287 cases have complications accounting for 71.93% of the total cases.The complications such as meningitis and myocarditis significantly prolongs the course including 2 death and the main reason was neurogenic pulmonary edema, pulmonary hemorrhage and cardiopulmonary circulation failure.Conclusion The majority of HFMD children are from rural areas and most of them are boys.The age of these children is mainly from 1 to 3 years and most of them appear fever and the duration of fervescence for 3-5 days meanwhile the rashes are mainly in hand, foot and oral, which can lead to myocardial injury and the serious damage to the liver.In severe cases, most of them caused by the infection of EV71 and it is more common for body shaking and vomitting in neurological symptoms.Once the patient appears neurogenic pulmonary edema who will have a high mortality rate.Therefore, once these HFMD children have limb shaking and vomiting it indicates that they are severe HFMD children.As for these children, timely treatment would prevent further development of the disease and reduce mortality.
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