本文關(guān)鍵詞： 手足口病 流行病學(xué) 臨床特征　出處：《大連醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:手足口病是小兒常見急性傳染病。本研究通過(guò)調(diào)查分析2015年至2016年期間臨床確診手足口病的患兒的流行病學(xué)及臨床特征,分析比較2015年與2016年手足口病流行病學(xué)區(qū)別,重癥手足口病組與普通型手足口病之間的區(qū)別與聯(lián)系,為臨床早期干預(yù)手足口病,特別是重癥手足口病的及時(shí)診治提供臨床依據(jù),同時(shí)為手足口病的預(yù)防提供相關(guān)依據(jù)。方法:收集2015年與2016年期間住院患者732例為研究對(duì)象,均為臨床確診手足口病患者,其中重癥組手足口病患兒103人,普通型手足口病兒童629人,男童459人,女童273人,腸道病原學(xué)檢測(cè)陽(yáng)性625人,未檢測(cè)出腸道病毒107人。應(yīng)用回顧性調(diào)查分析方法,查閱病例原始記錄,收集患兒的年齡、性別、居住情況、發(fā)病季節(jié)、病原體、臨床特點(diǎn)、C-反應(yīng)蛋白、白細(xì)胞計(jì)數(shù)、血糖等資料。歸納整理上述資料,采用卡方檢驗(yàn)分析比較2015年與2016年手足口病發(fā)病年齡、季節(jié)分布差異,比較重癥組與普通組的性別、年齡、發(fā)病季節(jié)、病原體、臨床特點(diǎn)、C-反應(yīng)蛋白、白細(xì)胞計(jì)數(shù)、血糖的差異。結(jié)果:(1)手足口病多發(fā)生于5歲以下的兒童,其占手足口病患病總數(shù)的94.3%,尤以1-2歲兒童的患病率最高,占手足口病總病例的37.8%。男童明顯多于女童,男女比例為1.68:1。散居兒童較托幼兒童及其他居住類型更容易發(fā)生手足口病,分別占65.6%、30.3%、4.1%。(2)2016年手足口病病例共470例,較2015年明顯增多,兩年中手足口病患兒在年齡的分布上差異存在統(tǒng)計(jì)學(xué)意義(P0.05)。主要表現(xiàn)在普通型手足口病患兒中2016年發(fā)病年齡較2015年增加。(3)手足口病好發(fā)于夏日,夏季與其他季節(jié)中重癥型與普通型手足口病患者病例比較,差異存在統(tǒng)計(jì)學(xué)意義(P0.05),2016年與2015年手足口病在季節(jié)分布上不同,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(4)不一樣的腸道病毒感染的普通組與重癥組對(duì)比,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。相對(duì)于柯薩奇A組16型病毒,腸道病毒71型更容易導(dǎo)致重癥型手足口病。近兩年引起手足口病的主要病原體在發(fā)生變化,非EV71、非CA16的其他腸道病毒占總陽(yáng)性病例的57.8%。(5)普通組和重癥組的多個(gè)因素差異比較分析中,抽搐、體溫超過(guò)39℃、呼吸心率增快、煩躁、肢體抖動(dòng)、嘔吐、頸強(qiáng)、白細(xì)胞計(jì)數(shù)升高、C-反應(yīng)蛋白升高與血糖升高是重癥型手足口病發(fā)生的危險(xiǎn)因素(P0.05)。結(jié)論:HFMD好發(fā)于5歲及以下兒童,男童多于女童,散居多見,整年均可發(fā)病,夏日多見。抽搐、體溫超過(guò)39℃、呼吸心率增快、煩躁、肢體抖動(dòng)、嘔吐、頸強(qiáng)、白細(xì)胞計(jì)數(shù)增高、C-反應(yīng)蛋白上升與血糖升高是重癥手足口病的危險(xiǎn)因素。
[Abstract]:Objective: hand, foot and mouth disease (HFMD) is a common acute infectious disease in children. This study analyzed the epidemiology and clinical characteristics of HFMD from 2015 to 2016. To analyze and compare the epidemiology of HFMD in 2015 and 2016, and the relationship between severe HFMD and common HFMD, which is the early intervention of HFMD. In particular, the timely diagnosis and treatment of severe hand-foot-mouth disease provide clinical basis for the prevention of hand-foot-mouth disease. Methods: from 2015 to 2016, 732 inpatients were collected as the study objects. All patients were clinically diagnosed with HFMD, including 103 children with HFMD in severe group, 629 children with HFMD of common type, 459 boys and 273 girls. Enterovirus was detected in 625 cases, and no enterovirus was detected in 107 cases. Retrospective investigation and analysis were used to check the original records of the cases and collect the age, sex, living condition and incidence season of the children. Pathogen, clinical features, C-reactive protein, white blood cell count, blood sugar and other data. Summarized the above data, chi-square test was used to compare the onset age of HFMD in 2015 and 2016. The sex, age, onset season, pathogen, clinical characteristics of C- reactive protein and white blood cell count were compared between the severe group and the normal group. Results Hand-foot-mouth disease (HFMD) occurred mostly in children under 5 years old, accounting for 94.3% of total HFMD, especially in children aged 1-2 years. Boys accounted for 37.8% of total HFMD cases, and the ratio of boys to girls was 1.68: 1.The children in the diaspora were more prone to HFMD than toddlers and other types of residence. In 2016, there were 470 cases of hand, foot and mouth disease, which was significantly higher than that in 2015. There was significant difference in age distribution between children with HFMD in the past two years (P 0.05). The age of onset of HFMD in 2016 was increased by 3% than that in 2015 (P < 0.05). Hand, foot and mouth disease occurs in summer. The difference between severe and common HFMD cases in summer and other seasons was statistically significant (P 0.05). The seasonal distribution of HFMD in 2016 and 2015 was different. The difference was statistically significant (P 0.05. 0. 05. 4) the difference of enterovirus infection between the common group and the severe group was compared. The difference was statistically significant compared with Coxsackie A group 16 virus. Enterovirus 71 is more likely to cause severe hand-foot-mouth disease. The main pathogens causing HFMD in the last two years are changing, not EV71. Other enteroviruses other than CA16 accounted for 57.8% of the total positive cases.) in comparison and analysis of multiple factors between the common group and the severe group, convulsions, body temperature over 39 鈩，

本文編號(hào)：1464613