CAJ | 학술논문

目的制定小儿手足口病疾病严重程度评分法,指导临床医护人员早期识别小儿手足口病危重病例,进行早期干预,提高抢救成功率,降低后遗症发生率和死亡率.方法以PCIS为基础,结合手足口病重症患儿常见的高热和神经系统损害症状,自行设计了“小儿手足口病疾病严重程度评分法”.通过回顾性分析2008年4月至2010年11月病例(A组,88例)的资料,评估了该评分法的效度、可信度.并将该评分法前瞻性地应用于201 1年5月至2013年10月所有收治的重症手足口病病例(B组,118例),根据评分结果给予相对应的治疗和监护措施.最后将前3年(A组)与后3年(B组)患儿的预后情况进行比较.结果评分法的分值与临床患儿实际病情严重程度一致性较好.AB 2组的基线资料比较差异无统计学意义,而2组病例在神经系统后遗症发生率和病死率等方面经x2检验,差异具有统计学意义.结论 “小儿手足口病疾病严重程度评分法”能较好地评估手足口病重症患儿的病情危重程度.临床早期应用该评分法能较客观地评估手足口病患儿,以便及时发现危重症病例,并给予相应的治疗与监护措施,对于提高手足口病危重症患儿的抢救成功率,减少神经系统后遗症发生率和降低死亡率具有一定的临床实用价值,值得在儿科临床推广应用.
목적 제정소인수족구병질병엄중정도평분법,지도림상의호인원조기식별소인수족구병위중병례,진행조기간예,제고창구성공솔,강저후유증발생솔화사망솔.방법 이PCIS위기출,결합수족구병중증환인상견적고열화신경계통손해증상,자행설계료“소인수족구병질병엄중정도평분법”.통과회고성분석2008년4월지2010년11월병례(A조,88례)적자료,평고료해평분법적효도、가신도.병장해평분법전첨성지응용우201 1년5월지2013년10월소유수치적중증수족구병병례(B조,118례),근거평분결과급여상대응적치료화감호조시.최후장전3년(A조)여후3년(B조)환인적예후정황진행비교.결과 평분법적분치여림상환인실제병정엄중정도일치성교호.AB 2조적기선자료비교차이무통계학의의,이2조병례재신경계통후유증발생솔화병사솔등방면경x2검험,차이구유통계학의의.결론 “소인수족구병질병엄중정도평분법”능교호지평고수족구병중증환인적병정위중정도.림상조기응용해평분법능교객관지평고수족구병환인,이편급시발현위중증병례,병급여상응적치료여감호조시,대우제고수족구병위중증환인적창구성공솔,감소신경계통후유증발생솔화강저사망솔구유일정적림상실용개치,치득재인과림상추엄응용.
Objective To develop the severity score of pediatric hand foot and mouth disease (HFMD),guide health care providers in the early detection and intervention of critical ill cases,in order to improve the survival rate and reduce the incidence of complications and mortality.Methods Based on PCIS,the severity score of HFMD in children was designed by adding fever and nervous system damage symptoms,which was the common symptoms of severe cases.The data of the cases who admitted in April 2008 to November 2010 (group A,88 cases) was retrospectively analyzed to evaluate the validity and credibility of the score.The score were prospectively applied to all of the HFMD cases who admitted from May 2011 to October 2013(group B,118 cases),delivering corresponding treatment and care measures based on scoring result as well.At last the outcome of the two groups was compared.Results It exhibited quite good consistency between the scores and the clinical condition of patients with HFMD.The general information of two groups was not significantly different,but the survival rate,the incidence of neurological sequel and the mortality between two groups were significantly different by x2 test.Conclusions The score can objectively and accurately assess the severity of HFMD in children.Clinical application of this scoring method to assess the children with HFMD can identify critical ill cases as early as possible.Corresponding intervention delivering in time may improve the outcome.It is proved to have positive clinical value to increase the survival rate,decrease the incidence of neurological sequel and the mortality of critical ill HFMD cases,and is worthy of clinical application in pediatric department.