本文選題：手足口病 + 病例分析　； 參考：《吉林大學(xué)》2013年碩士論文

【摘要】：目的：本研究通過描述2012~2013年在沈陽(yáng)市鐵西區(qū)某醫(yī)院就診并住院的手足口病患者的年齡、性別、發(fā)病時(shí)間、臨床表現(xiàn)、治療效果等情況，了解該醫(yī)院手足口病的臨床特征，為該醫(yī)院手足口病的預(yù)防控制和治療提供科學(xué)依據(jù)，并提出合理化建議。 方法：收集在該院就診并住院的282例手足口病患兒的完整病歷，在病歷中提取所要研究的項(xiàng)目形成個(gè)案調(diào)查表，采用回顧法收集相關(guān)數(shù)據(jù)資料，從而描述患病人群性別、年齡、醫(yī)療付費(fèi)方式等分布以及臨床表現(xiàn)和治療等情況。采用t檢驗(yàn)、u檢驗(yàn)、方差分析、卡方檢驗(yàn)對(duì)資料進(jìn)行分析。 結(jié)果：本次調(diào)查的282例手足口病患者中，男性117人，占60.6%，女性111人，占39.4%。手足口病患者以1～5歲的兒童為主，占總數(shù)的89.72%，其中3～5歲者最多，占總數(shù)的71.28%；以幼托兒童為主，占總數(shù)的63.83%；以城市兒童為主，占總數(shù)的88.65%。手足口病全年發(fā)病，但以夏季和初秋季高發(fā)，其中6月～9月發(fā)病人數(shù)最多，占總數(shù)的89.36%。患兒入院后多數(shù)有發(fā)熱表現(xiàn)，發(fā)熱者占總數(shù)的62.4%；多數(shù)患兒的皮疹持續(xù)時(shí)間為6～8天，皮疹部位主要為手、足、口、臀部。治療藥物以抗病毒藥物為主，其中痰熱清的使用較為廣泛，占總數(shù)的84.04%。大多數(shù)手足口病患兒的病程為6～8天，占總數(shù)的80.50%。城市和農(nóng)村患兒的住院天數(shù)間的差別有統(tǒng)計(jì)學(xué)意義（p=0.002），城市家庭患兒的平均住院時(shí)間為6.67天，農(nóng)村的患兒的平均住院天數(shù)為5.30天，農(nóng)村患兒比城市患兒住院時(shí)間短。不同醫(yī)療付費(fèi)方式的住院天數(shù)間的差別有統(tǒng)計(jì)學(xué)意義（p0.001），市城鎮(zhèn)居民基本醫(yī)療保險(xiǎn)的患兒的平均住院時(shí)間為6.94天，新型農(nóng)村合作醫(yī)療保險(xiǎn)的患兒的平均住院時(shí)間為6.78天，自費(fèi)患兒的平均住院天數(shù)為5.54天，，兩兩比較可知，自費(fèi)患兒的住院時(shí)間比市城鎮(zhèn)醫(yī)療保險(xiǎn)的和新型農(nóng)村合作醫(yī)療保險(xiǎn)的患兒短。 結(jié)論： （1）5歲以下嬰幼兒及幼托兒童為手足口病的重點(diǎn)預(yù)防人群，幼托機(jī)構(gòu)等兒童聚集單位為重點(diǎn)預(yù)防場(chǎng)所。 （2）手足口病流行有季節(jié)性差異，以夏季和初秋季發(fā)病例數(shù)多。 （3）手足口病患者大多數(shù)有發(fā)熱表現(xiàn)，以支氣管肺炎為主要并發(fā)癥。 （4）治療手足口病的藥物以痰熱清為主。 （5）農(nóng)村患者比城市患者的住院時(shí)間短；自費(fèi)的醫(yī)療支付方式比市城鎮(zhèn)居民醫(yī)療保險(xiǎn)和新型農(nóng)村合作醫(yī)療保險(xiǎn)方式的住院時(shí)間短。
[Abstract]:Objective: to investigate the clinical characteristics of hand-foot-mouth disease (HFMD) in a hospital in Tiexi, Shenyang from 2012 to 2013 by describing the age, sex, onset time, clinical manifestation and therapeutic effect of HFMD. To provide the scientific basis for the prevention, control and treatment of hand, foot and mouth disease in this hospital, and to put forward some reasonable suggestions. Methods: the complete medical records of 282 children with hand, foot and mouth disease (HFMD) in our hospital were collected. The item forming case questionnaire was extracted from the medical records, and the relevant data were collected by retrospective method, so as to describe the sex and age of the patients. The distribution of medical payment and the clinical manifestation and treatment. T test, ANOVA and chi-square test were used to analyze the data. Results: of 282 patients with HFMD, 117 were males (60.6%) and 111 females (39.4%). The majority of HFMD patients were children aged 1 to 5 years old, accounting for 89.72% of the total number, among which the 3- and 5-year-olds were the most, accounting for 71.28% of the total, mainly for the young children, accounting for 63.83% of the total, and mainly for the urban children, accounting for 88.65% of the total. The incidence of HFMD in the whole year was higher than that in summer and early autumn, and the number of HFMD from June to September was the most, accounting for 89.36. 6% of the total. Most of the children had fever after admission, the fever accounted for 62.4% of the total, and the rash lasted for 68 days. The skin rash was mainly in the hands, feet, mouth and buttocks. Antiviral drugs are the main treatment drugs, among which Tanreqing is widely used, accounting for 84.04 of the total. The course of disease in most children with HFMD was 6 days, accounting for 80.50% of the total. The difference of hospitalization days between urban and rural children was statistically significant. The average hospitalization time of urban children was 6.67 days, and that of rural children was 5.30 days, which was shorter than that of urban children. The average hospitalization time of children with basic medical insurance for urban residents was 6.94 days, and the average hospitalization time of children with new rural cooperative medical insurance was 6.78 days. The average hospitalization days of self-funded children were 5.54 days. Compared with each other, the hospitalization time of self-funded children was shorter than that of urban medical insurance and new rural cooperative medical insurance. Conclusion: Children under 5 years of age and young children are the focus of prevention of hand, foot and mouth disease population, child care institutions and other units for key prevention of children. (2) there is seasonal difference in the prevalence of HFMD, with more cases occurring in summer and early autumn. Febrile symptoms were found in most patients with hand, foot and mouth disease, with bronchopneumonia as the main complication. 4) the main drug for hand, foot and mouth disease is Tanreqing. 5) the hospitalization time of rural patients is shorter than that of urban patients, and the self-paid medical treatment is shorter than that of the urban residents' medical insurance and the new rural cooperative medical insurance.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R512.5

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