CAJ | 학술논문

目的探讨参与手足口病(HFMD)住院患儿治疗和护理的医务人员及患儿家属的HFMD病毒隐性感染情况,进行分析,旨在为HFMD的防治工作提供依据.方法 2013年3-6月HFMD流行期间,分别选取HFMD病区医务人员42人、患儿家属101人,采集咽拭子或粪便样本,并根据家属接触的密切程度,将家属分为密切接触组和非密切接触组.样本全部进行肠道病毒通用型、肠道病毒71型(EV71)和柯萨奇病毒A组16型(CA16)定量分型,判断是否为HFMD隐性感染.结果医务人员送检标本42例,均为阴性.HFMD家属送检的101例标本中,检测出肠道病毒核酸通用型阳性25例(24.75％),其中EV71阳性22例(21.78％),其他肠道病毒阳性3例(2.97％),CA16未检出.HFMD患儿家属的咽拭子标本EV病毒阳性检出率为3.45％,粪便标本EV病毒阳性检出率为33.33％,差异有统计学意义(x2 =9.913,P＜0.01);咽拭子标本EV71病毒阳性检出率为3.45％,粪便标本为29.17％,差异有统计学意义(x2=8.028,P＜0.01).非密切接触组家属的EV阳性率为23.40％ (11/47),EV71阳性率为23.40％(11/47),密切接触组家属分别为25.93％(14/54)和20.37％(11/54),两组之间比较差异均无统计学意义(P＞0.05).结论了解HFMD的传播机制,对患儿家属等传播环节进行有效的护理干预,有利于HFMD的防控.建立医院感染监控系统、重视消毒隔离、强化卫生宣教、强化医务人员医院感染意识等,能防止院内交叉感染,值得推广.
목적 탐토삼여수족구병(HFMD)주원환인치료화호리적의무인원급환인가속적HFMD병독은성감염정황,진행분석,지재위HFMD적방치공작제공의거.방법 2013년3-6월HFMD류행기간,분별선취HFMD병구의무인원42인、환인가속101인,채집인식자혹분편양본,병근거가속접촉적밀절정도,장가속분위밀절접촉조화비밀절접촉조.양본전부진행장도병독통용형、장도병독71형(EV71)화가살기병독A조16형(CA16)정량분형,판단시부위HFMD은성감염.결과 의무인원송검표본42례,균위음성.HFMD가속송검적101례표본중,검측출장도병독핵산통용형양성25례(24.75％),기중EV71양성22례(21.78％),기타장도병독양성3례(2.97％),CA16미검출.HFMD환인가속적인식자표본EV병독양성검출솔위3.45％,분편표본EV병독양성검출솔위33.33％,차이유통계학의의(x2 =9.913,P＜0.01);인식자표본EV71병독양성검출솔위3.45％,분편표본위29.17％,차이유통계학의의(x2=8.028,P＜0.01).비밀절접촉조가속적EV양성솔위23.40％ (11/47),EV71양성솔위23.40％(11/47),밀절접촉조가속분별위25.93％(14/54)화20.37％(11/54),량조지간비교차이균무통계학의의(P＞0.05).결론 료해HFMD적전파궤제,대환인가속등전파배절진행유효적호리간예,유리우HFMD적방공.건립의원감염감공계통、중시소독격리、강화위생선교、강화의무인원의원감염의식등,능방지원내교차감염,치득추엄.
Objective To explore and analyze the on-site investigation of hand,foot and mouth disease (HFMD) silent infection among medical staffs and children families,so as to provide evidence for the prevention of HFMD.Methods Totals of 42 medical staffs,who worked at HFMD ward,and 101 family members,who had children with HFMD,had been selected to take throat swab and stool samples during the period of HFMD outbreak from March to June 2013.According to the close degree of contact,the family members were divided into intimate contact group and non close contact group.All samples qualitatively classified through universal enterovirus type (UE),enterovirus 71 type (EV71),Coxsackie virus A group 16 type (CA16) to judge weather HFMD was silent infection or not.Results All 42 medical staffs presented negative for samples,but 25 cases of family members (24.75％) showed positive UE,22 cases positive EV71 (21.78％),3 cases other positive enterovirus type (2.97％),no positive CA16.The throat swap positive EV rate of HFMD children family members reached 3.45％,EV positive rate of stool samples 33.33％ (x2 =9.913,P ＜ 0.01);the positive EV71 rate for throat swap was 3.45％,stool samples 29.17％ (x2 =8.028,P ＜0.01).The EV and EV71 positive rate and for family members in the non close contact group were 23.40％ (11/47) and 23.40％ (11/47) compared 25.93％ (14/54) and 20.37％ (11/54) for family members in the close contact group.Conclusions When we understand the mechanism of transmission,we can improve the prevention of HFMD.It is worthy to popularize the measures such as the establishment of hospital infection prevention system,the increasing attention of disinfection and isolation,strengthening health education and awareness of medical staffs.