医学临床研究
醫學臨床研究
의학림상연구
JOURNAL OF CLINICAL RESEARCH
2013年
12期
2336-2339
,共4页
付四毛%温小丽%何冰洁%马力忠%刘玉玲%熊涌%黄月霞%朱建萍%张胜%龙晓玲%罗序峰
付四毛%溫小麗%何冰潔%馬力忠%劉玉玲%熊湧%黃月霞%硃建萍%張勝%龍曉玲%囉序峰
부사모%온소려%하빙길%마력충%류옥령%웅용%황월하%주건평%장성%룡효령%라서봉
手足口病/诊断%手足口病/治疗
手足口病/診斷%手足口病/治療
수족구병/진단%수족구병/치료
Hand,Foot and Mouth Disease/DI%Hand,Foot and Mouth Disease/TH
[目的]探讨2011年手足口病（HFMD）诊疗指南危重症早期预警指标对危重症 HFMD的预警价值。[方法]采用2011年HFMD诊疗指南早期预警指标回顾性分析2009年6月至2011年5月本院收治的重症 HFMD患儿438例（第一组）。然后前瞻性分析2011年6月至2013年5月本院收治的重症 HFMD患儿509例（第二组）。按符合2011年 HFMD诊疗指南危重症早期预警指标项目的数目把重症 HFMD患儿分为4类。结合最终进展为危重症 HFMD的对应例数，探讨2011年 HFMD诊疗指南危重症早期预警指标的预警价值。[结果]第一组按符合危重症早期预警指标的数目进行分类：符合一项的患儿314例，转为危重症 HFMD为10例，发生率3．2％；符合两项的患儿为223例，转为危重症 HFMD 21例，发生率为9．4％；符合三项的患儿为101例，转为危重症 HFMD 48例，发生率为47．5％；符合四项的患儿为18例，转为危重症为15例，发生率为83．3％。第二组按预警指标对重症 HFMD患儿进行分类：符合一项的患儿416例，转为危重症HFMD为5例，转为危重症HFMD的发生率为1．2％；符合两项的患儿为105例，转为危重症 HFMD 8例，发生率为7．6％；符合三项的患儿为42例，转为危重症 HFMD 12例，发生率为28．6％；符合四项的患儿为8例，转为危重症为7例，发生率为87．5％。符合三项时两组危重症转化发生率比较差异具有统计学意义（ P＜0．05）。[结论]2011年H FM D诊疗指南危重症早期预警指标可以较好的预测重症转为危重症患儿的发生，特别是符合三项的重症 H FM D患儿需要高度重视，积极干预，避免伤残，提高救治率。
[目的]探討2011年手足口病（HFMD）診療指南危重癥早期預警指標對危重癥 HFMD的預警價值。[方法]採用2011年HFMD診療指南早期預警指標迴顧性分析2009年6月至2011年5月本院收治的重癥 HFMD患兒438例（第一組）。然後前瞻性分析2011年6月至2013年5月本院收治的重癥 HFMD患兒509例（第二組）。按符閤2011年 HFMD診療指南危重癥早期預警指標項目的數目把重癥 HFMD患兒分為4類。結閤最終進展為危重癥 HFMD的對應例數，探討2011年 HFMD診療指南危重癥早期預警指標的預警價值。[結果]第一組按符閤危重癥早期預警指標的數目進行分類：符閤一項的患兒314例，轉為危重癥 HFMD為10例，髮生率3．2％；符閤兩項的患兒為223例，轉為危重癥 HFMD 21例，髮生率為9．4％；符閤三項的患兒為101例，轉為危重癥 HFMD 48例，髮生率為47．5％；符閤四項的患兒為18例，轉為危重癥為15例，髮生率為83．3％。第二組按預警指標對重癥 HFMD患兒進行分類：符閤一項的患兒416例，轉為危重癥HFMD為5例，轉為危重癥HFMD的髮生率為1．2％；符閤兩項的患兒為105例，轉為危重癥 HFMD 8例，髮生率為7．6％；符閤三項的患兒為42例，轉為危重癥 HFMD 12例，髮生率為28．6％；符閤四項的患兒為8例，轉為危重癥為7例，髮生率為87．5％。符閤三項時兩組危重癥轉化髮生率比較差異具有統計學意義（ P＜0．05）。[結論]2011年H FM D診療指南危重癥早期預警指標可以較好的預測重癥轉為危重癥患兒的髮生，特彆是符閤三項的重癥 H FM D患兒需要高度重視，積極榦預，避免傷殘，提高救治率。
[목적]탐토2011년수족구병（HFMD）진료지남위중증조기예경지표대위중증 HFMD적예경개치。[방법]채용2011년HFMD진료지남조기예경지표회고성분석2009년6월지2011년5월본원수치적중증 HFMD환인438례（제일조）。연후전첨성분석2011년6월지2013년5월본원수치적중증 HFMD환인509례（제이조）。안부합2011년 HFMD진료지남위중증조기예경지표항목적수목파중증 HFMD환인분위4류。결합최종진전위위중증 HFMD적대응례수，탐토2011년 HFMD진료지남위중증조기예경지표적예경개치。[결과]제일조안부합위중증조기예경지표적수목진행분류：부합일항적환인314례，전위위중증 HFMD위10례，발생솔3．2％；부합량항적환인위223례，전위위중증 HFMD 21례，발생솔위9．4％；부합삼항적환인위101례，전위위중증 HFMD 48례，발생솔위47．5％；부합사항적환인위18례，전위위중증위15례，발생솔위83．3％。제이조안예경지표대중증 HFMD환인진행분류：부합일항적환인416례，전위위중증HFMD위5례，전위위중증HFMD적발생솔위1．2％；부합량항적환인위105례，전위위중증 HFMD 8례，발생솔위7．6％；부합삼항적환인위42례，전위위중증 HFMD 12례，발생솔위28．6％；부합사항적환인위8례，전위위중증위7례，발생솔위87．5％。부합삼항시량조위중증전화발생솔비교차이구유통계학의의（ P＜0．05）。[결론]2011년H FM D진료지남위중증조기예경지표가이교호적예측중증전위위중증환인적발생，특별시부합삼항적중증 H FM D환인수요고도중시，적겁간예，피면상잔，제고구치솔。
[Objective]To explore the value of early warning indicators in 2011 hand-foot-month disease(HFMD) diagnosis and treatment guideline in prewarning of critical illness patients with HFMD .[Methods]Totally 438 pediatric patients with HFMD (first group) in our hospital from June 2009 to May 2011 were analyzed retrospectively by using early warning indicators in 2011 HFMD di-agnosis and treatment guideline .Totally 509 pediatric patients with severe HFMD (second group) in our hospital from June 2011 to May 2013 were analyzed prospectively .According to the number to early warning indicators in 2011 HFMD diagnosis and treatment guideline ,all severe HFMD patients were divided into 4 groups .The corresponding case number of critical illness patients with HFMD in the end was considered comprehensively .The value of early warning indicators of critical illness in 2011 HFMD diagnosis and treat-ment guideline was discussed .[Results]According to the number to early warning indicators of critically ill HFMD ,there were 314 pa-tients with one indicator in which 10 patients converted to critically ill HFMD and the conversion rate was 3 .2% ,and 223 patient with 2 indicators in which 21 patients converted to critically ill HFMD and the conversion rate was 9 .4 ,and 101 patients with 3 indicators in which 48 patients converted to critically ill HFMD and the conversion rate was 47 .5% ,and 18 patients with 4 indicators in which 15 patients converted to critically ill HFMD and the conversion rate was 83 .3% in first group .According to the number to early warning indicators of severe HFMD ,there were 416 patients with one indicator in which 5 patients converted to critically ill HFMD and the con-version rate was 1 .2% ,and 105 patients with 2 indicators in which 8 patients converted to critically ill HFMD and the conversion rate was 7 .6% ,and 42 patients with 3 indicators in which 12 patients converted to critically ill HFMD and the conversion rate was 28 .6% , and 8 patients with 4 indicators in which 7 patients converted to critically ill HFMD and the conversion rate was 87 .5% in second group .There was significant difference in conversion rate of critical illness with 3 indicators between two groups ( P < 0 .05 ) .[Conclusion]Early warning indicators of critically ill HFMD in 2011 HFMD diagnosis and treatment guideline can better predict the in-cidence of severe HFMD converting to critically ill HFMD in pediatric patients .In particular ,severe HFMD patients with 3 indicators should be paid more attention and intervened actively in order to avoid disability and improve the treatment rate .
