CAJ | 학술논문

目的：分析手足口病患儿临床特征及转归,有助于基层医院提高对该病的认识,及早采取传染病隔离措施,以减少流行季节手足口病的发病率。方法回顾性分析2014年3—9月该院133例手足口病住院患儿的病例资料。分析该组患儿的一般资料、年龄构成比、临床症状、辅助检查及治疗效果。结果①发病年龄以幼儿及学龄前患儿为主,集中于7个月~6.5岁之间,其中83.46%为1~6岁幼儿。②80%患儿分布在城乡结合部,居民及远离城乡结合部发病率较低；③临床症状以发热伴随皮疹同时出现者为主,约占64.66%,皮疹先于发热者12.78%,发热先于皮疹者17.29%,仅有皮疹者5.26%。④辅助检查肠道病毒EV71-IgM阳性者35.48%,CRP阳性者13.64%,血常规：白细胞计数≥10.0×109/L者42.86%,中性粒细胞百分比≥50%者52.63%,心肌酶谱中CK-MB阳性者6.77%。⑤住院天数为7 d者占70.68%,≥8天者7例,≤5 d者32人,8人转院(属于手足口病重症,进入病程Ⅱ～Ⅲ期)。其中7人因病情较重(属于手足口病重症,进入病程Ⅱ～Ⅲ期)转西安市儿童医院感染科住院治疗,跟踪随访无死亡病例。结论手足口病易感人群以学龄前儿童为主；城乡结合部人口密集,发病率高；掌握手足口病的临床特点对于基层医院做好手足口病的防治起主要作用；普通型手足口病大部分非肠道病毒EV71感染,住院天数以5～7 d为主,实验室检查提示常常合并细菌感染。重症的发病率4.51%。
목적：분석수족구병환인림상특정급전귀,유조우기층의원제고대해병적인식,급조채취전염병격리조시,이감소류행계절수족구병적발병솔。방법회고성분석2014년3—9월해원133례수족구병주원환인적병례자료。분석해조환인적일반자료、년령구성비、림상증상、보조검사급치료효과。결과①발병년령이유인급학령전환인위주,집중우7개월~6.5세지간,기중83.46%위1~6세유인。②80%환인분포재성향결합부,거민급원리성향결합부발병솔교저；③림상증상이발열반수피진동시출현자위주,약점64.66%,피진선우발열자12.78%,발열선우피진자17.29%,부유피진자5.26%。④보조검사장도병독EV71-IgM양성자35.48%,CRP양성자13.64%,혈상규：백세포계수≥10.0×109/L자42.86%,중성립세포백분비≥50%자52.63%,심기매보중CK-MB양성자6.77%。⑤주원천수위7 d자점70.68%,≥8천자7례,≤5 d자32인,8인전원(속우수족구병중증,진입병정Ⅱ～Ⅲ기)。기중7인인병정교중(속우수족구병중증,진입병정Ⅱ～Ⅲ기)전서안시인동의원감염과주원치료,근종수방무사망병례。결론수족구병역감인군이학령전인동위주；성향결합부인구밀집,발병솔고；장악수족구병적림상특점대우기층의원주호수족구병적방치기주요작용；보통형수족구병대부분비장도병독EV71감염,주원천수이5～7 d위주,실험실검사제시상상합병세균감염。중증적발병솔4.51%。
Objective To analyze the clinical characteristics and outcomes of children with Hand-foot-and-mouth disease (HFMD), which can help primary-level hospitals to improve awareness of the disease in order to take early measures to reduce the incidence of HFMD in the epidemic season.Methods A retrospective analysis of our hospital 2014.03-2014.09 data of 133 cases of HFMD is adopted, analyzing of this group of children with general information, age composition ratio, clinical symptoms, auxiliary examinations and treatment effect.Results ① Age of onset in infants and preschool children mainly concentrates in the age of between 6.5~7 months, 83.46%of which are 1~6 years old children. ②The distribution of 80%of hospitalized patients is in the urban fringe. The incidence of this disease drops considerably in the far-away urban fringe areas; ③Clinical symptoms of fever are accompanied by the occurrence of rash simultaneously, accounting for about 64.66%. Rash prior to fever accounts for 12.78%and fever prior to rash accounts for 17.29%, while the hospitalized patient with only rash accounts for 5.26%.④Patients with EV71-IgM positive account for 35.48%, CRP positive 13.64%;blood test:patients with white blood cell count≥10.0 × 109/L are 42.86%, neutrophils≥50%are 52.63%, and myocardial enzymes in CK-MB positive are 6.77%.⑤Hospitalized patients with<7 bed days account for 70.68%. Cases with≥8 bed days and≤5 bed days are 7 and 32 respectively.8 patients were transferred, 7 of which (severe HFMD, belonging to courseⅡ~Ⅲ) were transferred to Xi an Children s Hospital infectious disease department due to severe HFMD.Conclusions HFMD susceptible population are mainly preschool children. The urban fringe is a populated area with high incidence of disease. Mastering the HFMD clinical characteristics plays a major role in helping primary-level hospitals to take measures to prevent it. The common type of HFMD is due to parenteral infection. The average hospitalization days are from 5 to 7. The results of the Laboratory examination often reveals complicated with bacterial infection. The incidence of severe HFMD is 4.51%.