CAJ | 학술논문

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.
목적 분석399례수족구병환인적림상특정、실험실검사급류행특점,가강대수족구병적인식급제고구치수평.방법 수집2009제저의학원부속제저시제일인민의원감염과수치적399례수족구병주원환인림상자료.분석기류행특정、림상표현、실험실검사、치료、전귀정황.결과 재해양본중,남성환인인수위274례,점총수적68.67％.녀성환인병례수위125,점총수적31.33％.수족구병발병이농촌다견,농촌인동병례358례,점양본용량적89.72％,차이유통계학의의(P＜0.01).본연구자료중소유환인균유피진.수부출현피진적환인위339례,점84.96％,족부피진자322례,점80.70％,반둔부피진자229례,점57.39％,반슬부피진자32례(8.02％),구강포진급궤양자293례,점73.43％.반인통、류연239례,반해수63례,반두통、구토77례,반심동과속108례.반지체두동191례,급성이완성탄탄1례,기수61례,추휵4례.출현병발증자공287례,점병례총수적71.93％.합병뇌막염、심기염등병발증자병정명현연장,기중2례사망,사망주요원인시신경원성폐수종、폐출혈、심폐순배쇠갈.결론 종합이상통계수거가이발현,수족구병환인중,절대부분위농촌인동,남해거다,1～3세인동점절대다수,대다출현발열,차열정집중재3-5d,피진다출현우수족구강부위,가인기심기、간공손해.중증병례대부분유EV71감염인기,신경계통증상칙이지체두동화구토위다견,일단출현신경원성폐수종칙사망솔겁고.인차수족구병환인일단출현지체두동화구토칙표명환인이위중증수족구병,급시처리유가능조지병정적진일보발전、강저사망솔.
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.